Tag Archives: Physical Therapy

Common Neck and Back pain problems:

Neck and back pain can be caused by a variety of problems. Some people may have certain genetic conditions, such as scoliosis or arthritis, that contribute to the pain. Other patients may develop conditions such as Facet syndrome, myofascial pain, disc degeneration, degenerative disc disease, headache, SI joint disease, or muscle or joint strains. Additionally, some back and neck pain can also be caused by surgery or pregnancy.

Treatment: Physical therapy is often used to reduce pain and swelling, restore flexibility and range of motion, and strengthen the muscles of the back and neck. In many cases, it can ease the symptoms and also help in a quick recovery of the back or neck.

One way to accomplish this is through manual therapy. This is a technique in which the physical therapist manually adjusts and massages your back and neck, applying pressure to the soft tissues and bones. Cervical and lumbar exercise therapy is also another way doctors recommend certain exercises to strengthen and stabilize your back. Certain modalities, such as heart, ice, and electrical stimulation, may also be used to reduce symptoms and help your muscles relax during your exercise.

Prevention: One of the best ways to prevent back and neck pain is to educate yourself on proper posture, ergonomic principles, stretching and strengthening. For example, it is very important to always keep your chest out, chin in, and stomach tight in order to use your postural muscles to support your spine. Use neutral positions when sleeping, drive with your head against the headrest, avoid reading in bed, and use a screen at eye level when using a computer. Whenever you have to bend over, always use a half kneeling position to avoid putting too much pressure on your back.

If you notice the onset of back or neck pain, always see a physical therapist right away so they can treat the problem before it gets worse.

Neck and back pain can limit your life and prevent you from doing what you love. By choosing Active Physical Therapy to rehabilitate your neck and back, our experts, certified therapists and team can relieve patients’ suffering and help them return to full mobility. Active Physical Therapy provides over 26 physical therapy locations throughout the Maryland, Baltimore, Washington DC, Anne Arundel County, Carroll County.

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Injuries Around Shoulder Joint

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Physical Therapy for Shoulder injury

The mechanism of injury can be interpreted by asking about the mode of injury such as fall by asking about the mode of injury ,such as fall from height, road traffic accident, position of the limb or body at the time of injury, any rotational force acting on the body and the type of activity done by the time of injury.

The mechanism of injury, site of injury, pain and disabilities should be interpreted from the history.

Examination

Inspection: The patient should be examined in sitting position with his upper torso and upper limbs exposed upto the waist.

Attitude: The position of the limb on inspection should be noted. In fractures of clavicle and anterior dislocation of shoulder, the patient often supports the injured limbs with the other hand. The arm segment may appear short or long depending on in fracture neck of scapula, there will be lengthing of the arm.

Swelling or deformity: In anterior dislocation of shoulder, the anterior axillary fold may be abnormally prominent due to the presence of head of humerus. A swelling along the line of clavicle, diffuse swelling surrounding the proximal humerus may be seen in fractures of the underlying bones. The lateral end of clavicle may appear to be prominent in acromioclavicular joint injuries. The medial end of clavicle may be seen prominently in sternoclavicular injuries.

Shoulder contour: Normally, the shoulder has a round contour due to prominence of the greater tuberosity beneath the deltoid muscle. The greater tuberosity projects beyond the edge of acromion process giving the normal contour. In dislocation of the shoulder joint, due to loss of projection of greater tuberosity, the normal contour will be lost. This is a valuable sign of dislocation. In deltoid paralysis due to axillary nerve injuries, there may be wasting of the muscle causing apparent loss of contour of the shoulder. The shoulder contour may be masked by diffuse swelling associated with fractures of the proximal humerus.

Bony arch: The bony arch is formed by the clavicle, acromion process and spine of scapula. Any deformity in the bony arch should be noted for.

Palpation

The bony points to be palpated are: clavicle, proximal humerus, acromion process, spine and borders of scapula for signs of fracture.

Clavicle: By standing behind the sitting patient, the examiner places both his hands on the medial end of clavicle and runs his fingers along the shaft of both the clavicles. Any irregularity, gap or crepitus should be looked for. In acromioclavicular joint dislocation, the lateral end of clavicle may be displaced upward. On pressing the lateral end of clavicle, it depresses and bounces back like a piano key.

Proximal humerus: By standing on the side of the patient, the elbow is flexed and the proximal humerus is palpated bimanually by keeping one hand and the medial surface of arm and other on the outer surface of the arm. By standing behind the patient, the examiner slides his fingers down from the acromion process to the arm to palpate the greater tuberosity and proximal humerus. If the head of humerus is in normal position, then there will be a bony resistance to palpation. In dislocations, there will be an empty feeling in the shoulder region. The head may be palpable in either of axillary folds. Diffuse tenderness may be present in fractures of proximal humerus. In an intact humerus, the medial epicondyle will be in the same direction as that of the head of humerus.

Scapula: The acromion process and spine of scapula are palpated for irregularity, bony tenderness and crepitus. The axillary and vertebral borders are palpated for signs of fracture. The coracoids process is situated half an inch below the clavicle at its junction with medial two third and lateral one third. Fracture neck of scapula is diagnosed by axial pressure applied through the arm with the elbow flexed.

Movements

Both active and passive movements of the shoulder should be tested. In anterior dislocation of the shoulder, the patient will not be able to touch the opposite shoulder with his hand of affected extremity. This is called Dugas test.

Tests for detecting anterior dislocation of shoulder:

Hamilton ruler’s test: In normal persons, a straight ruler cannot be placed between the acromion process and lateral epicondyle because of the presence of greater tuberosity in its normal position. In dislocation of the shoulder, a ruler can be placed.

Callaway’s test: The vertical circumference of the axillary is increased in dislocation of shoulder due to the presence of head in the anterior axillary fold.

Measurements

The length of the arm is measured from the angle of acromion process to the lateral epicondyle.

Neurological examination: In fracture of the clavicle, brachial plexus may be injured. In fractures and dislocations of humorous, axillary nerve may get damaged. Axillary nerve damage may manifest as paralysis of deltoid muscle and anesthesia in skin over the lower part of deltoid muscle.

Active physical Therapy providing state-of-the-art physical therapy throughout the state of Maryland having multiple locations located in (Aspen Hill/ Layhill Road, Clinton, Clinton WHC, College Park/ Berwyn Heights, Columbia/ Elkridge, Columbia Aquatic, Gaithersburg/ Germantown, Hyattsville/ Langley Park, Landover, Laurel, Oxon Hill/ Temple Hills, Rockville), Washington, D.C (Washington D.C. N.W./ Near GWU , Washington D.C. N.E./ Brookland CUA, Washington D.C. S.E./ Capitol Hill), Western Maryland (Frederick, Hagerstown), Southern Maryland (California/ Lexington Park, Fort Washington La Plata, Prince Frederick, Waldorf), and Baltimore Metro area (Baltimore/ Mt. Vernon, Dundalk, Glen Burnie, Rosedale/ Near Franklin Sq. Med. Ctr.). We specialize in evaluation and treatment of acute and chronic conditions of the Upper Extremity. Experienced, Qualified and Skilled Certified therapists and our dynamic clinical staff focus on providing personalized attention, individual care, and a positive friendly environment during your treatment session. You can also make your appointment online to start your treatment within 24 to 48 hours at Active Physical Therapy, For more information just visit our Website:-http://active-physicaltherapy.com/

Treatment of Hand Joint Pain:

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Volar Barton (Palmar rim dislocation) is a palmar rim fracture of distal radius. The most common cause of this type of fracture is a drop on an outstretched hand.

Mechanism

It is due to palmar tensile stress and dorsal shear stress and is usually combined with Radial styloid fracture.

Clinical Features

Pain
Swelling
Tenderness
Loss of wrist movements
Palmar flexion is grossly restricted and painful

Radiograph

Palmar rim of distal radial articular surface is displaced dorsally. Proximally and posteriorly and may be associated with dorsal subluxation of the wrist.

Treatment

Conservative

Reduction is simple, but retention is difficult. Long arm cast is used.

Surgery

If reduction does not remain satisfactorily with the wrist in neutral or slight palmar flexion, fixation with K-wire, external fixators and buttress plate, etc. may be done. Ellis T-’shaped buttress plate fixation is the preferred method of treatment.

Active Physical Therapy provides state of the art physical therapy throughout the state of Maryland. Active’s friendly staff looks forward to assisting you in making your appointment in any of our clinics. Contact Us

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Elbow Pain and Problems

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The elbow is a hinge joint between the lower end of the humerus bone in the upper arm and the upper end of the radius and ulnar bones in the lower arm. The arm is bent and rotated at the elbow by the biceps muscles in the upper arm. Ligaments located at the front, back, and sides of the elbow help stabilize the joint.

Elbow pain can be caused by many problems. A common cause in adults is tendinitis. This is inflammation and injury to the tendons, which are soft tissues that attach muscle to bone.

Lateral Elbow Pain: Causes, Symptoms And Treatment

Use of the upper limb in sport demands a well functioning elbow. In addition, injuries in this region may interfere with the patient’s everyday activities. The clinical approach to elbow pain is considered under the following headings:

Lateral Elbow Pain, with a particular focus on
Extensor Tendinopathy
Medial Elbow Pain
Posterior Elbow Pain
Acute Elbow Injuries
Forearm Pain
Upper Arm Pain.

Lateral Elbow Pain

Lateral elbow pain is an extremely common presentation among sportspeople and manual workers. The most common cause is an overuse syndrome related to excessive wrist extension. This condition has traditionally been known as ‘tennis elbow’. This is an unsatisfactory term as it gives little indication of the pathological processes involved. In fact, the condition is more common in non-tennis players than in tennis players. It has also been referred to as ‘lateral epicondylitis’. This is also inappropriate as the site of the abnormality is usually just below the lateral epicondyle and the primary pathology is due to collagen disarray rather than inflammation.

The primary pathological process involved in this condition is tendinosis of the extensor carpiradials brevis (ECRB) tendon, usually within 1-2 cm of its attachment to the common extensor origin at the lateral epicondyle. This condition will be referred to as extensor tendinopathy.

Other conditions that may cause lateral elbow pain include synovitis of the radio humeral joint, radiohumeral bursitis and entrapment of the posterior interosseous branch of the radial nerve (radial tunnel syndrome). These conditions may exist by themselves or in conjunction with extensor tendinopathy.

There is often a contribution to lateral elbow pain from the cervical and upper thoracic spines and neural structures. This may be a relatively minor contribution or, in some cases, the main cause of the patients elbow pain. A full assessment of the cervical spine and neural structures is essential in examination of the patient with lateral elbow pain.

History

The characteristics of the patients lateral elbow pain should be elicited. The diffuse pain of extensor tendinopathy typically radiates from the lateral epicondyle into the proximal forearm extensor muscle mass. Occasionally the pain may be more localized. The onset of pain may be either acute or insidious. There may have been recent changes in training or technique, note-taking or equipment used in sport or work.

The severity of pain ranges from relatively trivial pain to an almost incapacitating pain that may keep the patient awake at night. It is important to note whether the pain is aggravated by relatively minor everyday activities, such as picking up a cup, or whether it requires repeated activity, such as playing tennis or bricklaying, to become painful.

Pain may radiate into the lateral aspect of the forearm. This may be consistent with posterior interosseous nerve entrapment or irritation of other neural structures. If pain is closely related to the activity level, it is more likely to be of a mechanical origin. If pain is persistent, unpredictable or related to posture, referred pain should be considered.

Certain movements, usually those involving wrist extension or gripping, will aggravate mechanical pain. Referred pain is affected by prolonged posture, such as lengthy periods seated at a desk or in a car. Associated sensory symptoms, such as pins and needles, may indicate a neural component. Presence of neck, upper thoracic or shoulder pain should also be noted.

Often by the time the patient presents to the sports medicine clinician, he or she will already have undergone a variety of treatments. It is important to note the response to each of these treatments.

An activity history should also be taken, noting any recent change in the level of activity. In tennis players, note any change in racquet size, grip size or string tension and whether or not any comment has been made regarding his or her technique.

Extensor tendinopathy

For this major sports medicine condition, we review the pathology, outline the clinical presentation, and then discuss evidence based and clinically founded treatment.

Clinical Features

Extensor tendinopathy occurs in association with any activity involving repeated wrist extension against resistance. This includes sporting activities, such as tennis ,squash and badminton, as well as occupational and leisure activities, such as carpentry, bricklaying, sewing and knitting. Computer use has been shown to be associated with the development of this condition. The peak incidence is between the ages of 40 and 50 years but this condition may affect any age group.

There are two distinct clinical presentations of this condition. The most common is an insidious onset of pain, which occurs 24-72 hours after unaccustomed activity involving repeated wrist extension. This occurs typically after a person spends the weekend laying bricks or using a screwdriver. It is also seen after prolonged sewing or knitting .In the tennis player, it may occur after the use of a new racquet, playing with wet, heavy balls or over hitting, especially hitting into the wind. It also occurs when the player is hitting ‘late’(getting the position slowly), so that body weight is not transferred correctly and the player relies on the forearm muscles exclusively for power.

Treatment

No single treatment has proven to be totally effective in the treatment of this condition. A combination of the different treatments mentioned below will result in resolution of the symptoms in nearly all cases.

The basic principles of treatment of soft tissues injuries apply. There must be control of pain, encouragement of the healing process, restoration of flexibility and strength, treatment of associated factors (e.g. increased neural tension, referred pain),gradual return to activity with added support and correction of the predisposing factors.

Control of Pain

It remains unclear as to how much pain is ideal in the treatment of tendinopathies. Clinical experience suggests that a low level of pain, which does not worsen with training, is likely to not be harmful for tendon healing. However, some patients require relative rest, application of ice and analgesia for comfort.

HOW TO GET BACK TO RUNNING AFTER BACK PAIN?

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Running is arguably the most basic form of exercise. Runners face many challenges in their life, they get hurt,stay busy and tired. Back pain is very common nowadays not only for runners or athletes, 70% of the population has been facing the same issue. They go to the doctor’s clinic and miss their official and routine work. Sports injuries are also another concept to consider the back pain from muscle aching to a shooting, burning or stabbing sensation. Most back pains gradually improve with home treatment and self care. Repeated heavy lifting or sudden awkward movement cause muscle or ligament strain and spasms. Osteoarthritis can affect lower back pain. Pain can be acute, sub acute or chronic under the categories of muscles, bones, lower back, buttocks and specific sensation is sharp, electric, burning type pain that can originate from any part of the body. When an injury at some point extended break at your movements due to pain but there is good news your muscles have a memory of those past activities. A few things are common if you want to run after acute or chronic back pain. Start with your own unique challenges and requirements to help your body. To get back to running after a long interval follow some important steps:-

Understand The Cause

Whenever a long interval enters in any kind of activity it is difficult to start from the point you left and there must be a cause that why a person left that from schedule. In the case of a runner Runner spine’s vertebrae and discs experience extra pressure, lower back pain due to bending or lifting in high frequency. At the same time, to get back to your recovery track, you should go to the doctor to diagnose why you have back pain. You don’t need any scans if you are going through a short term of pain but if you have a sudden injury you should take your extra care for diagnosing the reason. After this process the doctor will arrange a PT for you, to skip the doctor you can go to the Physical Therapy, A skilled Physical Therapist will be able to access you and provide you with diagnosis and treatment plan. Developing muscle strength and aerobic capacity at rehab will help to reschedule your elapsed exertion.

Don’t let your Injury keep you Down

When you are suffering from an acute back injury, take a rest for a couple of days after bending, twisting or straining. Don’t rest too much time after injury because the more time you take to get comfortable, the more it will feel hard to come back. At the prior times of injury more chances are there to function properly within a week or 2 weeks. In fact unused muscles switch themselves off. For that reason, start walking by the wall as your pain decreases, begin normal and slow movements such as walking around the house, and start slow and regular exercise. Listen to your body if you are feeling any tenderness, communicate with your Physical Therapist who can alleviate pain and regain function. They must focus on the exercises and stretches designed for you in PT sessions.

Celebrate Each Step

Start counting your progress day by day, try warming up under your Healthcare’s treatment plan. A Physical Therapist will also identify your weak points so that he/she can analyse where to give stress and rest so you can handle the pain with comfort. If you have any impact on joints, PT will schedule not only running but runs with biking, swimming which will make cardiovascular endurance without stressing your joints. Sometimes the runners get frustrated as one who was running 40- 50 miles per week is not able to walk around. Be positive, your positive emotions reinforce you to get back in action. Commit yourself to join body strength training sessions in the Rehab Center. Measure day by day progress and praise yourself. Self care works more than healthcare. Your encouragement to yourself will help to design your new road map of success.

Have Patience

Casual Runners or Professional Athletes always want to run as soon as possible. No one is happy by sitting during an injury. Don’t be scared and do not increase your weekly mileage by more than 10% in order to help your body. Keep in mind and be aware to stress the muscles. Your Pt would design a plan for you to improve your blood flow to your muscles. Don’t increase your running speed before your PT’s recommendations. You can continue if pain does not return. PT always designs a healing and training process from walk to run progression, for each new activity take your time as your body is in healing process and if you are going to exert pressure as you were before strain or injury it will cause more stress and take a long time to heal. Let your body adapt. For a couple of months run on the alternative days to allow for recovery and time for the body. Everyone’s recovery time can be different, as the injury caused can take more or less time to recover as compared to other patients with the same injury. PT will help you from walk to run with some additional elliptical, cycling, swimming to mix it up during the week. Chances of reinjury are the biggest risk during or after a painful injury. Start under the guidance of your PT to lessen the risk, that will enhance the progression of running in which PT will include to give strength to previous injured tissue.

Use your Physical Therapy Knowledge

After Rehabilitation when you come back at your home, higher chances of skipping your PT schedule and it hinders the linear progress. Always stay in contact with your Physical Therapy Center and use the plan given by your trainer. Post Rehab, keep in mind your PT is there for you even after you are discharged. Physical Therapy is important to help you get to running as soon as you can. Physical therapists by their equipment analyse the deficiencies in your running style. Therapy team will overdo for your quick recovery with specific therapy techniques. They will educate you on some key concepts for do’s and don’ts. Once or twice a weekly rehab day allows you to keep working at the cause of injury.

Live Smart

Add good habits, avoid lying on one side, get into a neutral position. Don’t look down for a long time without a break. Physical exercises are the dental floss of the running world. Stick to your prescribed physical plan. Runners already know the importance of strong glutes to control your hip rotation and prevent injury pain. Show more attention to your calves, soleus strength.

To Get Back to Running Consider Rules-

All running to be completed at liberal rate.
No speed work until you completely return to the Running phase.

Don’t run in a row of days, choose alternative days to give your body time to recover.
Focus on the duration you are adding day by day.
Stop the discomfort and judge your each run.
Consider 6-8 Rehabilitation Center meetings to your PT in a month.
Practice Patience, Get Strong.

Contact Active Physical Therapy

Biceps Tendinitis

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Biceps Tendinitis is a common shoulder pathology which usually develops in younger athletic population due to repetitive overhead injuries. The patients suffering from this condition usually have to suffer pain, lesser range of motion & strength and impaired functional mobility. This pathology develops over the time with pain located at the front of the shoulder.

What do we mean by Biceps Tendinitis?

There are two parts of biceps muscles: the long head and the short head. The long head is usually affected with tendinitis. Biceps tendinitis is known as the inflammation of the tendon around the long head of biceps muscles. The most commonly irritated tendon is the one that attaches the top of the biceps muscles to the shoulder. Biceps tendinitis results due to the repetitive stress which in turn results into irritated, swollen and painful tendon.

What causes Biceps Tendinitis?

Excessive and abnormal forces applied across the tendon results into biceps tendinitis. Apart from this, several other conditions also contribute towards developing the condition including:

Tension and pulling of a tendon or muscle
Compression i.e. pushing, pinching or shearing
Weak rotator cuff and upper back muscles
Tight shoulder joints or muscles
Poor body mechanics
Overuse from certain types of work or sports
Gradual wear and tear
Continuous or repetitive shoulder actions
Abrupt increase in exercise routine
Age- relate bodily changes
Degeneration in a tendon
A direct injury to the shoulder.

What are the potential signs and symptoms of Biceps Tendinitis?

Biceps tendinitis is common amongst the athletes involved in swimming, throwing, gymnastics and other contact sports. Workers who are involved in overhead shoulder work or heavy lifting are at greater risk. The sufferers commonly report symptoms including:

Sharp pain in the front of shoulder
Tenderness in the front of the shoulder
Pain radiating towards neck down the arm
Feeling pain after every activity
Weakness around the shoulder joint
Catching or clicking sensation near top of the biceps
Pain aggravating with flexion, forearm supination or elbow flexion.

What are the Physical Treatments to treat Biceps Tendinitis?

Once you are diagnosed with Biceps Tendinitis your physical therapy will develop a customized treatment program while keeping your specific goals and condition in mind. Your physical therapy may suggest:

Initially RICE; rest, ice, compression and evaluation may be suggested. He may also advice to avoid the activity aggravating the condition
Soft-tissue therapy, electrical stimulation or ultrasound therapy may be suggested
Series of stretching or strengthening exercises may be suggested to regain lost range of motion
Postural corrections may be suggested to correct the sitting and standing posture.
Physical therapists may also employ hands-on therapy to gently move or mobilize your shoulder
Functional training would be provided to prevent future injuries. He would point out and correct your faulty movement.

Contact Active Physical Therapy for the state-of-art treatment of any of your musculoskeletal disease. Our treatment modules are planned and coordinated according to the needs, requirements and urgencies of our patients. The treatment modules co-ordinated by us will not only cure your current ailment but also pose a check on the further ones.

Juvenile Disc Disorder

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Most of the times, chronic back pain or long term back problems are associated with elderly or middle-aged people. But Juvenile Disc Disorder can also affect the people as young as 20 years of age. It means that if you are an adolescent, even then you cannot save yourself from this deformity. The fact is; some patients may inherit a prematurely aging spine.

What do we understand by Juvenile Disc Disorder?

Juvenile Disc Disorder is a condition, where end-plates of disc spaces are not that much strong to bear the pressures generated within the disc spaces. Such a condition leads to disc herniations into the vertebral bodies and triggers back pain at quite an early age.

The condition is very much similar to that of degenerative disc disease but with a difference that in this condition, degeneration starts at a much earlier age and generally, most of the discs of lumbar spine are involved as opposed to that of degenerative disc disorder, where only one or two discs are typically involved.

What are the causes of Juvenile Disc Disorder?

Following factors can lead to Juvenile Disc Disorder:

Injury to back
Weakening of discs due to wear and tear
Strain and stress you put on your backs
Changes in your discs and other spine structures
Decreasing of water in the discs
Discs become less spongy and much thinner
Space between the vertebrae above and below the disc gets smaller
Hypermobility of facet joints
Your genes; you may be pre-disposed to excessive wear and tear of joints.

What are the potential signs and symptoms of Juvenile Disc Disorder?

Any part of your spine can get affected due to Juvenile Disc Disorder but low back or neck is most commonly affected parts. Other signs and symptoms of the disease include:

Chronic back and neck pain
Pain at the site of damaged disc
Pain radiating to another body part
More pain while sitting for a long time
Feeling of pain while bending, lifting or twisting
Feeling less pain while walking, running or if you change positions frequently
Pain subsides with rest.

What are the treatment options suggested by the Physical Therapists to treat Juvenile Disc Disorder?

Physical Therapy treatment to treat Juvenile Disc Disorder is much similar to that of Degenerative Disc Disorder. Most of the patients respond well to the physical therapy techniques and recovery is possible in about five-six weeks. Physicals therapists may suggest the following techniques to treat Juvenile Disc Disorder:

Physical Therapist may suggest rest or restricted activity but for few days only. Extended rest is not recommended and mild activity is suggested for better healing.
A daily hamstring stretching and aerobic conditioning may be suggested for the better healing
Deep tissue massage is recommended to release the tension in soft tissues like; ligaments, tendons or muscles
Heat therapy is suggested to remove the waste by-products caused due to spasms.
Cold therapy is used to lessen the pain and inflammation.
Spinal traction is administered to eliminate the pain caused due to the muscle tightness or compressed nerves.
Various exercises to improvise the flexibility, strength, core stability and range of motion are practised.
An individualized treatment program, taking into account your health and history is formulated
Your physical therapists will make you learn about various body mechanics to limit pain. Positions causing pain will also be made familiar to you.
Proper work ergonomics and posture corrections are taught to help you to take better care of your back.
Strengthening exercises to strengthen abdominal and back muscles are also recommended.

Juvenile Disc Disorder can wreak havoc on the back of an adolescent, so the parents should watch out for the early signs of the disease and if you find out any warning signs, should go for immediate diagnosis and treatment. Contact Active Physical Therapy for the state-of-art treatment of any of your musculoskeletal disease. Our treatment modules are planned and coordinated according to the needs, requirements and urgencies of our patients. The treatment modules co-ordinated by us will not only cure your current ailment but also pose a check on the further ones.

Cubital Tunnel Syndrome: Causes, Symptoms and Treatment

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Cubital Tunnel Syndrome is the second most common nerve compression, caused by increased pressure on the ulnar nerve at the elbow. The people, who repeatedly lean on their elbows or bend their elbows for sustained periods, are more likely to get affected by this condition. This condition is more common in men than women.

What do you mean by Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome affects ulnar nerve where it crosses the inside edge of the elbow. This inside edge is relatively unprotected area and ulnar nerve here is entrapped between bone and skin in the tunnel called ‘Cubital Tunnel’. When the ulnar nerve in the cubital tunnel gets compressed or irritated due to an injury or pressure, it called cubital tunnel syndrome. This condition affects the Baseball Pitchers more, as the twisting motion used to throw a slider can easily damage ligaments in their elbow.

What are the common causes of Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome can occur due to following possible reasons:

Sustained bending of elbow during sleep
Leaning over your elbow for longer time
Fluid build-up in the elbow
A direct blow to inside edge of the elbow
Previous fracture, injury or dislocation of the elbow
Arthritis of elbow or bone spurs
Any cyst near the elbow
Repetitive bending, twisting or flexion of elbow during painting, playing an instrument or using power tools
Obesity or other health conditions like hypothyroidism or diabetes

What are the potential signs and symptoms of Cubital Tunnel Syndrome?

Typical symptoms of Cubital Tunnel Syndrome may include:

Numbness and tingling sensation or intermittent pain in the elbow
Pain in the elbow extending to your forearm and hand
Weakness in hand and fingers
Being unable to straighten your ring and little finger
Tenderness in the inside edge of the elbow
Difficulty in gripping and holding the objects
Reduced ability to pinch the thumb and little finger
Claw-like deformity of the hand

How can physical therapy help to treat Cubital Tunnel Syndrome?

Physical therapy treatment for Cubital Tunnel Syndrome includes patient education along with identification, modification and limiting the causes resulting into nerve inflammation. Apart from this, physical therapists may suggest:

Ergonomic considerations and changes in patterns of activities causing the condition
Specific elbow padding may be provided for work and leisure activities as well
Splinting at night may be suggested to limit range of motion enhancing the compression
Ulnar gliding exercises and modalities are practiced to relieve the painful symptoms
Modification of job activities, if needed, may be suggested
Therapists will suggest you different ways to rest your elbow and also educate you about the ways to use your elbow without putting any extra strain in it.
Heat or cold treatments may be applied to ease the pain
Strengthen and stretching exercises are used to strengthen the muscles of the forearm
Range-of-motion exercises are used to help you to return full length of muscles that are shortened due to protective posturing

Contact Active Physical Therapy for the state-of-art treatment of any of your musculoskeletal problems. Our certified ad dedicated physical therapists design individualized treatment plans depending upon your condition and problem.

Radial Tunnel Syndrome

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What do we mean by Radial Tunnel Syndrome? What are its potential causes, symptoms and treatment options?

Most of the athletes visit physical therapists for their lateral elbow pain. Physical therapists are of the view that Radial Tunnel Syndrome (RTS) occurs due to swelling or irritation of radial nerve because of the friction caused due to compression by muscles.

What do you mean by Radial Tunnel Syndrome?

Radial Tunnel Syndrome occurs when the radial nerve gets compressed where it passes through a tunnel near the elbow. This compression happens in proximal forearm where the radial nerve splits into PIN (main trunk) and sensory branch (minor trunk).

What are the causes of Radial Tunnel Syndrome (RTS)?

Pain of Radial Tunnel Syndrome occurs due to the pressure on radial nerve. Other causes of Radial Tunnel Syndrome include:

Injury
Bone Tumors
Inflammation/Swelling of surrounding tissues
Non-cancerous fatty-tumors
Too Small tunnel
Repetitive bending, gripping and pinching of wrist
Direct blow to the outside of elbow
Continuous twisting of arm

What are the potential symptoms of Radial Tunnel Syndrome (RTS)?

The symptoms of Radial Tunnel Syndrome start getting worse when you bend your wrist backward or hold an object with a stiff wrist. Following are the symptoms of Radial Tunnel Syndrome:

Tenderness and pain on the outside of elbow
Pain in the forearm and hand during activity
Minimized grip and forearm strength
Pain that worsens while rotating wrist
Cutting and stabbing pain at top of the forearm or at the back of hand, when you straighten your fingers
Numbness and tingling down the forearm

How can Physical Therapy be helpful to treat Radial Tunnel Syndrome (RTS)?

Fore mostly, the physical therapist will advise you to avoid the repetitive activities which involve your wrists. If Radial Tunnel Syndrome is caused due to your work site conditions, your work site conditions would be modified. Apart from these, following therapeutic techniques would be administered to treat the condition:

Stretching and strengthening exercises would be administered to reduce pain
Cold and heat therapies would be practiced
Range of motion exercises would be administered to restore tissue flexibility and normal functioning of the joints
You would be advised to wear night-splint to limit your elbow movements at night
Soft –tissue massage would be used to promote blood circulation
Modalities like ultrasound, moist heat and electrical stimulation may also be used
Spinal manual therapy may be used to improve neural mobility
Ergonomic interventions like; load management, postural awareness and workstation modification are used
Functional strengthening exercises are used to treat Radial Tunnel Syndrome

Contact Active Physical Therapy for the state-of-art treatment of your overuse injuries. Our certified and skilled physical therapists are always ready to help you with customized treatment plans as per your needs and requirements.

What is Little League Shoulder and How is Physical Therapy Beneficial to Treat the Problem?

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Little League Shoulder also referred to as Pitcher’s Shoulder or Throwing Shoulder is a type of overuse injury; commonly affecting gymnasts, pitchers and young athletes lying in the age group of 10 to 15 years. Under this condition, the shoulder pain intensifies with the stressful use of arm.

What do we mean by Little League Shoulder?

Little League Shoulder is an injury to the proximal growth plate at the upper end of the humerus at the shoulder. The growth plate is a part of the bone that grows actively as a person matures. If not treated properly, it can cause disruption in the normal bone growth. The injury to the growth plate occurs due to repetitive throwing and overhead movements of the shoulder. Children who participate actively in baseball the whole year around are more likely to be affected by this injury.

How can Physical Therapy help your child to relieve the symptoms of Little League Shoulder?

As throwing and reaching are completely bodily activities and moreover the Little-League injury is a musculoskeletal injury; advanced Physical Therapy modalities can best treat this dysfunctional problem. Physical Therapy targets at restoring the strength, function, mobility and stability to the injured player’s shoulder before he returns to his usual sports’ activities. Following treatment options may be adopted by the Physical Therapists to help the young athletes to relieve Little League Shoulder:

Initially, physical therapists will prescribe rest, ice and compression to reduce pain and inflammation.
Any of the sports’ activities of the child will be restricted for 2 to 3 months or as required.
Corrective Therapies will be administered to correct those mechanical faults that are causing stress to the shoulder.
Strengthening exercises will be suggested to restore strength and function to the muscles in elbow, shoulder, upper back and shoulder blades.
Soft tissue massage and Joint mobilization techniques will be employed by the physical therapists to lessen the pain and as well as tendon irritation. These modalities also help to restore normal joint mechanics.
Modalities such as Ultrasound, Electrical Stimulation, Laser and Cold techniques will be used to enhance motion and to lessen the inflammation of shoulder joint and surrounding tendons’ muscles.
Posterior Shoulder Capsule stretches will be prescribed to enhance the flexibility of shoulder muscles.
Neuromuscular Re-education program; including the progressive throwing program is introduced to improve movement techniques and mechanics of the players.
Once the player is ready to return to the normal sports’ activities; physical therapists will educate him about correct warm-up techniques, throwing mechanic, pitch count and cool-down techniques.

Active Physical Therapy provides prompt Sports Rehabilitation Physical Therapy in one-on-one setting for the active athletes and players. Our diligent and compassionate physical therapists help the athletes to get back to their sports’ activities as more vigorous and better than before.