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Rehabilitation Articles

Postural Syndrome

What is postural syndrome?
Postural syndrome is an umbrella term for condition where pain can be felt in several common locations all the way from the lower back to the neck and shoulders. Even hands and upper limbs and the feet and lower limbs can have pain that is directly or indirectly related to postural syndrome. For example direct pain would be trigger points and ischaemic pain in the buttocks or posterior thigh from prolonged sitting, whereas indirect Lower limb pain may include adaptive shortening/tightness in the hip flexors giving anterior hip pain or even referring pain down the ITB region and lateral knee.

In a typical (and early) Postural Syndrome there is no significant damage or trauma to tissue. Patients with postural syndrome only experience an ache or pain during activities placing sustained stress on normal tissue.

The mechanism of pain onset in postural syndrome can be demonstrated by gently bending your index finger backwards until you feel a stretch. At this point there is no tissue damage or pain, however, if you maintain this position for long enough, your finger will gradually become painful or ache. Postural syndrome in the spine occurs in a similar fashion and typically occurs due to sitting or standing in poor positions for prolonged periods of time.  

Physical Therapist's Guide to Total Shoulder Replacement (Arthroplasty)

Total shoulder arthroplasty (TSA), often called a total shoulder replacement, is a surgical procedure in which part or all of the shoulder joint is replaced. It is estimated that 53,000 people in the United States have shoulder replacement surgery each year, according to the Agency for Healthcare Research and Quality. That number compares to the more than 900,000 Americans a year who have knee and hip replacement surgery. Physical therapists can help patients who undergo a TSA return to their previous levels of physical activity, including fitness training, or participation in sports like swimming or golf.

What is Total Shoulder Arthoplasty?
Total shoulder arthroplasty is a surgical procedure in which part or all of the shoulder joint is replaced. It is performed on the shoulder when medical interventions, such as other conservative surgeries, medication, and physical therapy no longer provide pain relief. The decision to have a TSA is made following consultation with your orthopedic surgeon and your physical therapist.


Hyperkyphosis is a spinal deformity causing a forward-curved posture of the upper back (thoracic spine). Posture is the characteristic way you position your body; posture changes many times throughout the day due to a variety of factors, including what you are doing and how long you have been doing it. Sometimes, however, a person's posture can cause the thoracic curvature to become excessive and stiff, making it difficult to change. Such is the case with hyperkyphosis (sometimes called “humpback,” “round back,” or “dowager’s hump”). This condition can affect people of all ages, but the thoracic curvature most often begins to increase in people over 40 and continues with advancing age. It is believed that 20% to 40% of older adults—both men and women—will develop hyperkyphosis.

What is Hyperkyphosis?
Hyperkyphosis is a spinal deformity that occurs when the natural forward-curving shape of the upper back becomes excessive. It results in the appearance of rounded shoulders with the head and neck positioned forward of the trunk. People with this condition often have difficulty standing up straight. The worsening of the curvature is associated with a higher risk of health problems, including back and neck pain, breathing difficulties, and falls.

Meniere’s Disease

What is Meniere’s disease?
Meniere’s disease is a disorder that affects the inner ear. The inner ear is responsible for hearing and balance. The condition causes vertigo, the sensation of spinning. It also leads to hearing problems and a ringing sound in the ear. Meniere’s disease usually affects only one ear.

The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that 615,000 people in the United States have Meniere’s disease. Around 45,500 people are diagnosed each year. It’s most likely to occur in people in their 40s and 50s.

Meniere’s disease is chronic, but treatments and lifestyle changes can help ease symptoms. Many people diagnosed with Meniere’s disease will go into remission within a few years after their diagnosis.

What Is Osteopenia?

Think of it as a midpoint between having healthy bones and having osteoporosis.

Osteopenia is when your bones are weaker than normal but not so far gone that they break easily, which is the hallmark of osteoporosis.

Your bones are usually at their densest when you’re about 30. Osteopenia, if it happens at all, usually occurs after age 50. The exact age depends how strong your bones are when you're young. If they're hardy, you may never get osteopenia. If your bones aren't naturally dense, you may get it earlier.

Osteopenia -- or seeing it turn into osteoporosis for that matter -- is not inevitable. Diet, exercise, and sometimes medication can help keep your bones dense and strong for decades.

Who Is Most Likely to Get It?

This condition happens when your body gets rid of more bone than it is creating.

Physical Therapist's Guide to Temporomandibular Joint Disorder

Temporomandibular joint disorder, or dysfunction, (TMD) is a common condition that limits the natural functions of the jaw, such as opening the mouth and chewing. It currently affects more than 10 million people in the United States. It is sometimes incorrectly referred to as simply “TMJ,” which represents the name of the joint itself. TMD affects more women than men and is most often diagnosed in individuals aged 20 to 40 years. Its causes range from poor posture, chronic jaw clenching, and poor teeth alignment, to fracture or conditions such as lockjaw, where the muscles around the jaw spasm and reduce the opening of the mouth. Physical therapists help people with TMD ease pain, regain normal jaw movement, and lessen daily stress on the jaw.

What Is Temporomandibular Joint Disorder?

Temporomandibular joint disorder (TMD) is a common condition that limits the natural function of the jaw, such as opening the mouth and chewing, and can cause pain. The temporomandibular joint (TMJ) is a hinge joint that connects your jaw to your skull in front of your ear. The TMJ guides jaw movement and allows you to open and close your mouth and move it from side to side to talk, yawn, or chew. TMD can be caused by:

Physical Therapist on Building Better Posture

Bad posture can lead to health problems.

What Is Good Posture, And Why Is It Important?
"To me, good posture is carrying your body in a way that is mechanically safe," Patel says. "So, that means that your spine is in its natural curves, which allows the muscles to activate from the inside out, and gives us a solid foundation for when we need to move.

"If we sit in poor posture for long periods of time, essentially our brain begins to create a strong connection between the way that we're sitting and how we want our muscles to be activated all the time. So we begin to create these pathways, which are essentially shortcuts. And so instead of our brain being wired to access movement in a mechanically sound way, it then starts to access movement more from the outside in, which essentially sets us up for injury down the line."

Achilles Tendon Rupture

What Is the Achilles Tendon?  
A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the heel cord, the Achilles tendon facilitates walking by helping to raise the heel off the ground.

What Is an Achilles Tendon Rupture?
An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

Achilles tendon ruptures are most often seen in "weekend warriors" typically, middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.


Adductor Muscle Strain

What is an Adductor Muscle (Groin) Strain?
An adductor muscle strain is an acute injury to the groin muscles on the medial aspect (inside) of the thigh. Although several different muscles can be injured, the most common are the Adductor Longus, Medius, and Magnus, and the Gracilis.

Strains reflect tears of the muscle-tendon unit, due to forceful contraction of the muscles against resistance, often during an eccentric load. Eccentric refers to a muscle contraction while the muscle is lengthening, versus concentric, in which the muscle shortens during the contraction. Most weight-lifting involves concentric contraction; “Negatives” during bench press is an example of an eccentric contraction.

Tears can occur at muscle origin or insertion, at the muscle-tendon junction, or within the belly of the muscle(s). Most commonly, tears occur at the muscle-tendon junction. Uncommonly, the tendon injury occurs at the site of its’ bony attachment.

Strains can be graded I-III based upon their severity. Grade I involves a mild strain with some injury, bleeding, tenderness, but no significant fiber disruption. A Grade II injury involves injury to the muscle-tendon fibers but the overall integrity of the muscle-tendon unit is preserved. A Grade III injury involves disruption leading to a loss of overall tendon integrity. Most adductor muscle strains are Grades I or II.

Soccer injury: Six of the Most Common Injuries Soccer Players Suffer

Soccer is one of the most common sports in the world. It is estimated that over one-quarter of a billion people play across the world. Participation in soccer is rising, so it should be no surprise that the rate of soccer injury is high. In this article, I discuss soccer injury, including six of the most common soccer injuries and their typical treatments.

Ankle sprain
An ankle sprain is an extremely common soccer injury. Inversion injuries (or what many people think of as rolling the ankle) can injure the ligaments on the lateral side of the ankle, causing an ankle sprain. The injury can be a mild sprain that causes the athlete to miss a few days or a week or two. Or it can keep an athlete out of soccer for 4 to 6 weeks. Surgery is rarely needed for an acute ankle sprain. Ice, rest, a brace or taping, and physical therapy are some of the measures used to help an athlete return to play.
Jones fracture
The metatarsals are the long bones of the foot. A Jones fracture refers to a fracture in a specific location along the fifth metatarsal. The fifth metatarsal is the long bone on the lateral (outside) side of the foot beneath the little toe. This particular fracture typically occurs at the junction between the base of the bone and the midshaft (long, cylindrical middle portion of the bone).

Athletes who suffer a Jones fracture face a difficult challenge. This fracture is tough to get to heal without surgery. Due to the risk of nonunion in athletes, orthopedic surgeons often choose to fix the fracture surgically. Surgery usually involves placement of a screw inside the bone across the fracture. If nonoperative treatment, such as a cast or a boot, is attempted, close observation with regular x-rays is critical to ensure that the fracture is healing appropriately.

How Physical Therapy Can Help Your Recovery

A physical therapist is a specialist trained to work with you to restore your activity, strength, and motion following an injury or surgery. Physical therapists can teach specific exercises, stretches, and techniques and use specialized equipment to address problems that cannot be managed without this specialized physical therapy training.

Physical Therapy and Rehabilitation
Physical therapists are trained to identify deficiencies in the biomechanics of the body. Working with a physical therapist can target specific areas of weakness in the way our bodies work. They can relieve stress and help the body function without pain.

Physical therapists are knowledgeable about surgical procedures and treatment goals and can tailor their efforts to improve your well-being. After surgical procedures, it is important that therapy is guided by the surgical procedure. Physical therapists are knowledgeable about your body's limitations after surgery and can help ensure a successful outcome.

Stretching Tight Muscles and Joints
Stretching is vital in maintaining a good range of motion with joints and the flexibility of muscles. If you have stiff joints or tight muscles, normal activities, such as climbing stairs or reaching overhead, can be severely affected. With proper stretching, these functions can be preserved.

Common Football Injuries

Football is a rough sport, and despite the helmets, pads, braces, and supports, injuries are a common part of the game. The combination of the size of the players, speed of play, and physical nature of the game makes football injuries quite common.

Sprains and Strains
Sprains and strains are the most common type of football injury. Treatment of sprains and strains usually is best accomplished by the "R.I.C.E." method (Rest, Ice, Compression, Elevate).

Fractures account for one-quarter of all serious football injuries (i.e. injuries that require hospital care). Commonly fractured bones include the finger, wrist, and leg.

Tips from the Experts

Tips from the Experts


Millions of people suffer from low back pain each day. Most are between the ages of 30 and 50, and many endure not only back pain, but also severe pain or numbness running into one or both legs. The result: loss of activity, inability to work and inability to participate in the activities we enjoy most. It is estimated that some 80 to 90% of Americans will suffer from back pain during their lifetime, about 50% of which will have more than one episode. Often times, you will hear the name “Sciatica” associated with this pain, and rightly so.

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