Physical Therapy Information, Educational Information, Glossary

Knee Pain and Surgery

ACL tears


Barefoot running

Frequent Muscle Cramps

Motion Sickness and Dizziness

Golf and Lower Back Pain

Tennis Elbow

Rotator Cuff Injuries

Chronic Shoulder Injures

Ankle Sprains

Martials Arts Injuries

Reflex Sympathetic Dystrophy

Coordination in Athletic activities


Golf and Low Back Pain

Due to the bent forward posture and the repetitive swinging, the lower back may become irritated. Combined with faulty postural habits, muscle weakness, limited flexibility and poor fitting equipment, the spine may become extremely irritated and lead to difficulty with regular movements of daily life.

Rest, physical therapy and a gradual return to exercise (often with assistance) is usually indicated. Proper fitting equipment and mechanics are crucial.

We often help analyze movements and suggest training with a Medicus swing trainer to achieve a more efficient swing.

Tennis Elbow

Surprisingly, it affects more players than “golfer’s elbow”. Characterized by pain with gripping or moving the wrist and hand, it is brought on by absorbing too much shock or vibration through the hand, most commonly with swinging a club and initiating impact on the ball. The area of the elbow affected is very fibrous and does not have a good blood supply, leading injuries to stay inflamed for prolonged periods of time. Stiffness accompanies the pain and a gradual return to activity is necessary to avoid further injury. Physical Therapy can dramatically speed the recovery time and get you back playing at the top of your game!

Rotator Cuff Injuries and Tears
When people injure their shoulder and suddenly notice they cannot move, they often experience fear, panic and a fair amount of pain. Usually, once the inflammation eases, pain decreases and movement can be restored.

Upon visiting a specialist and having imaging studies, many people express concern when hearing they have a rotator cuff tear. This is not always cause for alarm; a partial tear of the rotator cuff is more akin to fraying of a rope, weakening the integrity and thickness of the tendon. As long as painful movements and inflammation is controlled, the tendon will heal and can be strengthened with physical therapy.

A complete or full thickness rotator cuff tear presents with an inability to raise the arm initially, especially slowly, without the use of momentum or substituting muscle groups.

One of the most damaging injuries is one in which the dominant arm is affected and the person does work which involves overhead movements. This can lead to further damage at the shoulder joint and force the shoulder to move in a compromising manner, leading to pain at the neck and upper back.

Tips for avoiding chronic injury at the shoulder- A Physical Therapist's perspective

Locate any tender spots at the shoulder. You can contact us to help you distinguish all the tendons and where they can be palpated to accurately check for inflammation or tenderness.

Prevent injury before it happens. Be careful when exercising and avoid combined movements in which your elbow rises above the level of your shoulder. Exercises which do this may lead to impingement and rotator cuff damage.

Maintain adequate flexibility. By keeping an almost circular freedom of movement at the shoulder, you maintain the ability to reach overhead, to the side and rotate freely which what the shoulder is designed to do. If you are limited, you should seek help in order to avoid pain and further damage to the joint and the delicate balance of the rotator cuff function.

Three important things to do after an ankle sprain

1. Apply ice and rest- typically ice for 10-15 minutes will help to relieve inflammation and prevent further damage to the anterior talofibular ligaments or other supporting structures.

2. Try to remember the offending cause- was it a twist while walking on the sidewalk? Were you wearing high heels? Any information is useful in aiding in prevention.

3. See a specialist- Typically, you do not need to see an orthopedist for this problem, a physical therapist should be able to decrease the inflammation, increase range of motion and strength.

Ankle sprains are not self-limiting by nature, they will not recover fully on their own and will recur if you do not undergo adequate physical therapy or care to regain the muscular control necessary to maintain stability of the ankle.

Martial Arts/ MMA Injuries

With the advent of physical & contact sports such as mixed martial arts, kickboxing and Brazilian jiu-jitsu, many more recreational injuries are being reported to health care professionals. Below are 3 common injuries to watch out for when participating in these sports.

Hip bursitis/ inflammation
This is often reported in those who kick forcibly to the front, especially in Tae Kwon Do and the athletic kicking martial arts such as kickboxing. If you experience pain at the front of the hip, you should try to rest it and apply ice for ~10 minutes until the area is a bit numb. Repeated kicking should be avoided until pain is relieved.

Shin injuries
Most common in Muay Thai and when training, people often injure their shins (front of tibia) by training and kicking hard objects in order to toughen the point of impact on their lower legs. To relieve these painful areas, you should try to avoid kicking hard objects or wait until it is not extremely tender to the touch before you begin training anew. Ice applied to the shin

ACL tears
Mostly due to planting the foot and pivoting over it or by being kicked while only standing on one leg, this can be debilitating and traumatic. Unfortunately, I have seen many individuals continue training or fighting once this occurs, causing more damage and eventually requiring surgery. Proper protection of the standing or supporting leg is crucial to avoiding injury along with enough kinesthetic awareness to avoid a locked knee posture.

Reflex Sympathetic Dystrophy & Complex Regional Pain Syndrome

May be due to an altered firing pattern, or function, of the nerves in the affected extremity. Many people report tingling or numbness that varies throughout the day, often making activity excruciating to bear.

The most important stage to arrest and prevent RSD from setting in is in the early phase. Skin inspection and movement (if allowed) are crucial to prevent it

RSD & its role with pain

Reflex Sympthatetic Dystrophy (RSD) can be a debilitating condition, affecting many individuals post-operatively or those not undergoing surgery. Often characterized by swelling of the affected extremity, extreme tenderness to touch, impaired sensation and changes in skin texture.

While RSD is still poorly understood, the advent of spinal cord stimulators has proved beneficial to some individuals while others benefit from physical therapy addressing limitations in strength and flexibility.

Often, the pain can be unbearable to the point that clothing cannot be on the affected body part, due to an increase in pain. Medication may help to temporarily alleviate this pain and contrast baths, consisting of alternate heat and cold applications may stimulate the body part to decrease pain.

This is a very difficult condition to deal with, as it affects all aspects of life. We help those experiencing difficulty with this condition using an integrated approach of different specialties to minimize the pain and increase function.

Extreme Coordination & what it means for You
We are always astonished at the feats skilled athletes perform and marvel at their seemingly superhuman abilities. However, we often remember these feats are learned skills, practiced almost endlessly so they become routine in nature. For any skilled athlete, mistakes such as falling, twisting ankles, tripping, dropping a football or missing a shot lead to a change in the nervous system and its function.

Our bodies neuromuscular feedback mechanism is constantly adapting to the input provided when engaging in a high level athletic activity. The same level of neuromuscular activity is exhibited when someone has a difficult time with walking, going up stairs or controlling speed when walking down a ramp. The problem arises when there isn’t enough muscular strength to perform the activity or not enough ability to summon the strength efficiently (what I like to think of as coordination).

Train Like A Pro

We can train ourselves the same way athletes do, even if it is at a lower level of activity. If you are having a difficult time with walking, the best thing to do is attempt to analyze why the walking is difficult. Breaking down the difficult task into component motions can make it easier to assess performance and deficiencies within them.









Heat vs. Ice? Which one do I use?

While both can be helpful and have their place during recovery, there are some guidelines to keep in mind.

Heat is typically more effectve with chronic injuries and relieves stiffness quickly. Ice can relieve inflammation and swelling quickly, often more than oral anti-inflammatories, without affectin your stomach.

Some people have a sensitivity to cold which can make it more difficult to use ice and other treatments are available if this occurs.

As a general rule, if the injury is recent and there is swelling or inflammation, ice should be applied. It should be applied for a period no longer than 10-15 minutes in order to prevent frostbite and tissue damage.

Did you know?

When walking, you don't use your knee muscles to a high degree- in our pampered urban world, many don't realize how weak their knees are until they have to walk in a hilly neighborhood or go up a flight of stairs.