ORTHOPEDIC CONDITIONS

Whether you have had hip/knee replacement, a broken arm, back surgery, shoulder problems, any type of surgery, even joint or muscle pain; you can be assured that we have proven rehab techniques that can help you recover. We are known as “Back Experts”, but that’s just the beginning.

1. Joint Replacements can be done on several areas of the body including the knee, hip, ankle and shoulder. Post-operative physical therapy immediately after surgery is essential to a successful recovery. Many patients begin physical therapy the day after their procedure while still in the hospital and continue to home physical therapy or outpatient physical therapy. In therapy you will work on regaining your strength and range of motion while decreasing pain and swelling and ensuring proper wound healing so that you can return to full function. Based on your condition and goals, your physical therapist will work together with you to build a treatment plan to safely and effectively return you to your best self.

2. Rotator Cuff or Labrum Repairs are common shoulder surgeries performed due to sport or other traumatic injuries as well as tissue breakdown due to over use or wear and tear. The rotator cuff is a set of four muscles that stabilize the ball and socket-type shoulder joint and act to rotate and raise your arm. Symptoms of a tear in a rotator cuff tendon include pain when reaching, raising the arm or lifting objects. The labrum is a ring of cartilage in the ‘socket’ portion of the shoulder joint that provides stability to the joint by acting as a suction cup and deepens the space for the ‘ball’ portion of the humerus to sit. Symptoms of a labral tear include painful popping or catching in the shoulder with certain movements as well as feeling that the shoulder is loose or unstable. Surgery to repair a torn rotator cuff tendon or labrum often involves:

  • Removing loose fragments of tendon, cartilage and other debris from the space where the rotator cuff tendons move- this is called ‘debridement’.
  • Sewing torn edges of the rotator cuff tendon back together or anchoring the tear in the labrum back to the ‘socket’ of the shoulder.
  • In cases of a rotator cuff repair: making more room for the tendon to reduce pinching or irritation. This may include shaving bone or bone spurs from the shoulder space where your tendons move.

Beginning physical therapy as soon as possible is paramount in regaining your strength and range of motion, decreasing pain and swelling and ensuring proper wound healing so that you can return to full function. Based on your condition and goals, your physical therapist will work together with you to build a treatment plan to safely and effectively return you to your best self. Click here to receive more about rotator cuff and labrum repairs.

3. Knee Surgical Repairs (ACL, PCL, MCL, LCL, Meniscus) are performed to address torn ligaments or cartilage in the knee. Most commonly, this occurs after sports injuries when the knee is twisted on a planted foot, after trauma or due to wear and tear. The ACL and PCL ligaments are inside of your knee between the femur and tibia bones and control excess forward and backward motion of the knee. The MCL and LCL are on the medial and lateral sides of the knee and control against excess medial and lateral motion. Tears to the ligaments of the knee cause pain, swelling and warmth over the injured site and can cause feelings of instability in the joint. During ACL reconstruction surgery, a graft is used to replace the ligament. Most commonly your own tissues are used to create an ‘autograft ‘such as your patellar tendon or a hamstring tendon. Another option is an ‘allograft’ which is tissue from a cadaver donor. Typically, two to three small holes are made over your knee joint, the graft is placed inside the joint and is then secured to the top and bottom knee bones with hardware such as screws or staples.

The menisci (2 per knee) are ‘C-shaped’ pieces of cartilage between the femur and tibia bones that allow for smooth motion of the knee and distribute weight evenly across the knee joint. Injury to the menisci often causes catching and locking of the knee as well as pain with twisting the knee, squatting or stair climbing. Meniscus tears commonly do well with proper rehabilitation but in cases where non-surgical methods have been unsuccessful over several months, surgery may be performed. During the surgical procedure, small incisions are made in the knee and based on the severity and location of the meniscus tear, the tear is either ‘cleaned up’ with removal of the torn piece of cartilage and debris (meniscectomy) or the tear is repaired using sutures or anchors.

Beginning physical therapy as soon as possible is paramount in regaining your strength and range of motion, decreasing pain and swelling and ensuring proper wound healing so that you can return to full function. Based on your condition and goals, your physical therapist will work together with you to build a treatment plan to safely and effectively return you to your best self.

4. Bunionectomies are a common foot surgery to correct bunions that are severe enough to impact daily function. Bunions are a foot deformity characterized by lateral deviation of the great toe (towards the other four digits). It may be caused by joint instability in the foot, wearing tightly fitting shoes over a long term or a combination of these and other factors. Symptoms include pain when walking, joint redness, pain and irritation at the base of the big toe and possible shift of the big toe toward the lateral side of the foot. Surgical procedures are designed to correct several factors associated with the bunion and may be based on the patient’s health, age, lifestyle and activity level. Procedures may include:

  • removing the bony enlargement at the base of the big toe
  • realigning the first metatarsal and straightening the big toe relative to adjacent toes
  • correcting arthritic changes and realigning the cartilaginous surfaces of the big toe
  • fusing two adjoining metatarsal bones side by side in a “Syndesmosis Procedure”

Beginning physical therapy as soon as possible is paramount in regaining your strength and range of motion, decreasing pain and swelling and ensuring proper wound healing so that you can return to full function. Based on your condition and goals, your physical therapist will work together with you to build a treatment plan to safely and effectively return you to your best self.

5. Ankle/Foot Sprains and Fractures commonly occur due to falls, blunt force trauma and sports injuries. Several ligaments in the foot/ankle are prone to sprains though the most common sprain occurs to the anterior talofibular ligament (ATFL) located on the outside of the ankle. Fortunately, most ankle sprains need only a period of protection and a proper rehabilitation plan to heal. Tissue healing takes approximately four to six weeks and even a complete ligament tear can heal without surgery if immobilization and rehabilitation are a part of your early interventions.  In severe cases where injuries fail to respond to months of rehabilitation, surgical reconstruction is performed. In this procedure, the torn ligament is repaired with sutures or the use of other ligaments or tendons in the foot/ankle to repair the damage.

The most common fractures include those to the metatarsals (often the fifth, i.e. ‘stress fracture’), the talus, the calcaneus and distal tibia or fibula (ankle bones).  Depending on the severity of the fracture, patients are either immobilized to allow the bones to heal or have surgical fixation to realign the fracture for optimal healing. As with most injuries, whether surgery was performed or not, beginning physical therapy as soon as possible is paramount in normalizing gait, preventing weakness and stiffness to the injured site and surrounding areas, regaining strength and range of motion, decreasing pain and swelling and ensuring proper wound healing so that you can return to full function. Based on your condition and goals, your physical therapist will work together with you to build a treatment plan to safely and effectively return you to your best self.

6. TMJ (temporomandibular joint) Dysfunction occurs as a result of problems with the jaw joint, facial muscles and dysfunction of the joints and muscles of the neck and upper back leading to poor posture. The temporomandibular joints (TMJ) are hinge joints connecting the lower jaw to the skull and are located just in front of the ear. These joints allow you to chew, talk and yawn and are controlled by surrounding muscles. There are several causes of TMJ dysfunction including problems with the muscles of the jaw, the joint itself and its components, injury such as blunt trauma or whiplash, grinding or clenching the teeth, poor posture and weakness and/or restriction of the muscles and joints of your neck and upper back. Common symptoms include:

  • Pain in the jaw joint area, face, neck and upper shoulders
  • Pain in or around the ear when talking, chewing or opening your mouth wide
  • Inability to open your mouth wide or ‘locking’ of the jaw when open or closed
  • Popping, clicking or grinding sounds in the jaw joint when chewing or opening/closing your mouth
  • headaches, neck or upper back/shoulder pain, earaches, hearing difficulty, dizziness and ringing in the ears (tinnitis)

Physical therapy will focus on any limitations in the movement of the temporomandibular joint and upper spine joints and will address the function of the facial muscles and neck/upper back muscles to ensure proper strength, flexibility, posture and joint alignment. Based on your condition and goals, your physical therapist will work together with you to build a treatment plan to safely and effectively return you to your best self.