Patient Education

Achilles Tendon Injuries/Pain

• Joining the muscles of the lower leg to the heel of the foot, the Achilles tendon is both very important and very vulnerable to damage. Sometimes, this tendon can be stretched beyond its limit and become inflamed, tear, or rupture.
• Damage to the Achilles tendon is generally due to overuse, with pain appearing gradually at first then growing more constant until exercise/activity is too painful to continue with. Weak calf muscles are also to blame; should the calf muscle become tired, it tightens and shortens, heightening the risk for damage to the Achilles tendon. A sudden increase in training, speedwork, or hill runs lead to Achilles tendon damage.
• The obvious treatment for Achilles tendonitis is to scale back your level of training. Stretch your calves after exercise while they are still flexible. The best thing to do is keep an eye on your muscle’s soreness and balance your training with that in mind.

ACL (Anterior Cruciate Ligament) Sprain / Rupture / Tear

• The ACL, along with the PCL, are involved in knee stabilization.
• A sprain or a rupture may occur when the foot is planted and the knee twists to change direction. Generally, a “pop” in the knee is a common characteristic of such damage, followed by immediate swelling. Loss of stability and a limited range of motion are also symptoms of ACL damage.
• If the damage is not severe, immobilization and RICE (rest, ice, compress, elevate) may be enough to prevent further injury. However, should the ACL tear completely, surgery may be the only option to returning to an active lifestyle.

Ankle Sprains

• This very common ankle injury results from the stretching/tearing of ligaments around the ankle joint. Ankle sprains may result from weight being applied to the foot while in an inverted or everted position, like when running or jumping on an uneven surface. The foot may roll in or out, stretching the ligaments. Sometimes a loud snap or pop is heard at the time of the sprain.
• Treating ankle sprains is usually a matter of the RICE plan (rest, ice, compress, elevate). Anti-inflammatory medicine may be used to control swelling for the first 7-10 days.

Anterior Tibialis (Shin) / Shin Splints

• Pain localized around the front of the lower leg, along the tibia, are collectively known as shin splints. These injuries occur from continuous stress or jarring of the bones, muscles, and joints without appropriate periods of rest.
• Overtraining or running on hard surfaces are common causes of shin splints, especially among beginning runners.
• RICE is the common method of treatment, used to control pain and inflammation. Returning to physical activity is gradual; non-weight bearing activity like cycling or swimming are recommended at first.

Biceps Tendon Tear at the Elbow

• Injury to the biceps tendon can occur when the arm is forced to straighten. The tendon is typically pulled from its attachment point near the elbow. Since the biceps work with other muscles crossing the elbow joint, these other muscles will still allow the arm to perform all the normal actions usually commanded by the biceps; however, strength will be reduced, particularly in twisting motions.
• To see if you have damaged your biceps tendon, physicians generally look for swelling in front of the elbow, weakness bending the elbow or twisting the forearm against resistance, bruising, or a gap created by shortening of the biceps tendon on the front of the elbow. When the tendon disconnects, there is usually the sound of a “pop” in the elbow. Swelling is likely.
• Non-surgical treatment involves rest and a gradual return to normal activity. This will result in a significant loss of power, as the biceps are not repaired. Surgery, combined with post-op rehabilitation and exercises, give a greater chance for a full-strength recovery.

Bunions

• Bunions are painful swelling of the soft tissue and bone enlargement over the inside of the ball of the big toe. This may give an appearance of the big toe turning in towards the other toes; in extreme cases it may appear to lie across them.
• Pronation is a key factor in being prone to bunions. If you have pain around the ball of the big toe, you may not only have a bunion, but you may have difficulty or even be unable to wear certain types of shoes.
• Using foam, keep the big toe and its partner separate. 1cm of foam should be sufficient. If that does not help, a podiatrist can offer an orthotic device for your feet or suggest surgery in serious cases.

Carpal Tunnel Syndrome

• This is a common source of hand numbness and pain. The carpal tunnel, a narrow structure in the wrist, carries several nerves into the hand. Increased pressure on a nerve entering through the tunnel may cause this numbness and pain. Other causes include heredity, hand use over time, repetitive motions using the wrist, hormonal changes, or medical conditions like diabetes. Sometimes, there is no known cause.
• Symptoms begin gradually and experiencing numbness/tingling and pain in the hand are common. If caught early, carpal tunnel syndrome can be treated without surgery. Wearing a brace at night to keep the wrist in a natural position and a splint during the day are common practice. Anti-inflammatory medicines may also be recommended. Surgery is recommended on a case-by-case basis, considering the severity of the condition.

Cartilage Regeneration

• Cartilage regeneration is a procedure to remove damaged cartilage cells and inject lab-grown, healthy cells into the damaged joint site.
• Cartilage regeneration is recommended for patients whose cartilage has begun to wear thin – leaving the bones exposed and subject to damage from movement.

Cervical Fracture

• Cervical fractures are more commonly known as broken necks. Your head is supported and attached to your shoulders by seven bones called the cervical vertebrae. Should any of these bones break or fracture, this is what is called a cervical fracture.
• Normally, such an injury is the result of high-impact trauma like automobile accidents. Athletes are also at risk for cervical fractures; any activity where the head could be injured, such as football players spearing one another with their heads or a diver hitting the bottom of a shallow pool carry a risk.
• Treatment varies, taking into account which cervical vertebrae has suffered damage and to what extent. Minor fractures are treated with a neck brace or cervical collar for 6-8 weeks. More severe injuries may require a longer recovery period as well as physical therapy.

Cheekbone Fracture

• This facial fracture can be determined by a few factors: jaw dysfunction, any flattening of the cheek, or any swelling, bruises, or numbness on or around the cheek. Sometimes a fractured cheekbone can be linked with a fractured eye socket, leading to deformed vision or limited eye movement.
• Cheekbone fractures should demand immediate medical care, as surgery may be necessary to stabilize the fracture.

Chondromalacia

• This injury, where the cartilage under the kneecap becomes soft or damaged, is due to wear and tear or arthritis as we age for the most part. In younger athletes, a fall, overuse, knee misalignment, or muscle weakness may lead to chondromalacia as well.
• Runners, skiers, soccer players, and cyclists are at risk for this injury. As for treatment, minor cases can be resolved by avoiding high‐impact exercises and trying more low-impact activities like swimming. In extreme cases, arthroscopic surgery may be recommended.

Chronic Compartment Syndrome

• This condition causes nerve compression and pain in the front of the lower leg for most patients. Excessive muscle swelling during activity may put pressure on blood vessels and nerves, resulting in pain and if the nerves get compressed, numbness in the feet or lower legs.
• Runners experience compartment syndrome more often than other athletes. Often, it is misdiagnosed as shin splints or stress fractures.
• Icing the lower leg after exercise will reduce swelling.

Coccyx / Tail Bone Pain

• Coccyx pain is also called coccygodynia, found more often in females than males. This presents with pain in the tailbone during or after sitting and can be worse when sitting on a soft surface.
• This pain can be the result of an unstable coccyx, or a fall/trauma delivered to the base of the spine. Repetitive strain or overuse from sports like cycling or rowing can be a cause, also.
• As treatment, stretching, strengthening and massages to the muscles around the coccyx are recommended. Sometimes, a steroid injection is given and in rare instances, the coccyx may be removed through surgery.

Concussion

• A concussion is an injury damaging the brain caused by direct or indirect trauma to the skull. There are mild, moderate, and severe concussions but all should be taken seriously.
• Mild concussions generally present with possible memory loss, some mental confusion, a ringing in the ears, and dizziness in addition to pain around the area trauma was sustained. Moderate concussions have a higher chance for memory loss, increased dizziness and imbalance, and nausea/vomiting. Severe concussions include higher rates of all the aforementioned along with loss of consciousness for more than five minutes and a possibility of retrograde amnesia.
• Athletes suffering from concussions should be taken out of their sport completely until fully healed. This means a gradual return to activity when given the green light – starting with walking and stationary cycling and moving up from there.

Degenerative Disc Disease

• DDD is a pathological process where intervertebral discs become progressively disrupted and begins to fail in its functions. This is due to something as common as a lifting accident which results in the dehydration of a spinal disc.
• Treatment can be either surgical, or a combination of physical therapy, chiropractic treatments, or anti-inflammatory medications to provide relief.

Dislocated Knee Cap / Patella

• When the triangle-shaped bone covering the knee slides out of place, it is called a kneecap dislocation. It occurs most often in women and is usually a result of sudden direction changes while running.
• Kneecap dislocation damages your knee joint, so medical treatment should be sought even if pain is minimal, as is often the case with patients who have repeated dislocations and no medical treatment. Unless a bone has broken, the knee will be placed in a cast for around 3 weeks.

Distal Radius Fracture

• This is a break in the larger of the two bones of the forearm. The end toward the wrist is called the distal end. Most distal radius fractures occur from a fall where someone tries to catch themselves with their hands outstretched. Car accidents, biking and skiing are all possible activities where this common injury may occur.
• When the wrist is broken, you will feel immediate pain, tenderness, swelling, and bruising. The wrist my hang in a deformed manner, also.
• Treatments include a cast for non-surgical procedures, or a surgery to correct extreme cases of bone displacement.

Frozen Shoulder

• Also known as adhesive capsulitis, this inflammatory condition causes limited motion in the shoulder joint. This is generally caused by injury or disease, common risk factors include diabetes, lung disease, heart disease, or stroke.
• Anti-inflammatory medication is usually prescribed to control pain and swelling. Movement is restored with gentle stretching exercises; very rarely is surgery necessary.

Ganglion Cyst

• This is a lump of firm, spongy swelling in the wrist, found on the top of the joint bones or surrounding a tendon. There is no known cause, but women are more susceptible than man in getting ganglion cysts.
• Presents with fluctuating wrist pain where constant movement reduces the pain felt. Treatment usually consists of sucking the fluids from the cyst, injecting corticosteroids for temporary relief, or surgery to remove the cyst altogether. Often, the cyst is not painful and no treatment is necessary.

Gastrocnemius (Calf) / Calf Strains

• Similar to Achilles tendonitis, calf strains occur when the muscle of the lower leg is torn away from the Achilles tendon. This injury happens mainly during acceleration or changes in direction; internal bleeding will cause visible bruising in the foot and ankle.
• Treating calf strains starts with the RICE method to keep the blood from pooling in the foot. Anti-inflammatory medicine will reduce pain. Eventually, the tendon will reattach, but until then the calf is more prone to injury as it is shorter. Physical Therapy is usually recommended.

Groin Pull

• A groin pull occurs when the muscles of the inner thigh are stretched beyond their limits. Acute pain and swelling/bruising are common, generally when the injury is set off by a sudden change in direction while running or quick starts and stops. Field or court sports carry a heightened risk factor.
• RICE is the general treatment plan for most groin pulls. For up to two weeks, avoid activities that may aggravate the injury further.

Hamstring Tear/Pull

• Most common among runners, hamstring injuries involve the muscles running down the back of the leg from the pelvis to the lower leg bones. Commonly, doing too much too soon, poor flexibility, poor muscle strength, muscle imbalances and muscle fatigue are all common causes for hamstring injuries.
• For treatment, the RICE method is used to control pain and swelling along with anti-inflammatory medication. Physical Therapy is usually recommended. A stretching and strengthening program can also help rebuild the injured muscle’s strength.

Heel Spurs

• A heel spur is the result of chronic inflammation of the plantar fascia, called plantar fasciitis. Essentially, a heel spur is a growth of bone on the bottom of the heel due to neglecting treatment for plantar fasciitis.
• Treatment is generally started by taping the foot, anti‐inflammatory medication to control pain and swelling, and possibly cortisone injections. Physical therapy may also be used and in rare instances, surgery.

Hernia

• A hernia is when parts of the internal tissue bulge through a weakness in the abdominal wall. This brings a risk of strangulation to these internal tissues and may cause intestinal blockage or cut off the blood supply.
• A doctor must be seen for treatment of any suspected hernias. Surgery is almost always required to correct the hernia.

Herniated Disk

• Also called a “slipped” or “ruptured” disk along the spinal column; common for neck, lower back, arm, or leg pain. These disks assist the spine in absorbing shock as well as help with the flexibility of the back.
• A herniated disk can result from a number of things as you age. Common causes of a herniated disk include improper methods of lifting objects (using your back instead of legs), repetitive strenuous activities and excess body weight placing pressure on the disks. The disks can grow weaker through activities like smoking as well.
• Pain can be centralized in either the lower back or the neck.
• In the lower back, you may experience weakness in one leg, a feeling of numbness or “pins and needles” in one leg or buttock, a burning pain in the neck, or a loss of bladder/bowel control.
• In the neck, you will experience the same feelings, but centralized in one arm instead of one leg. Also, the burning sensations will be felt in the arm or shoulder in addition to the neck. Nonsurgical treatment is effective in 90% of patients. Rest and over-the-counter pain relievers may be all that is necessary to fix the issue. Sometimes, anti-inflammatory or muscle relaxants are helpful as well. Cold compresses placed for no more than 20 minutes at a time may be utilized, as well as gentle heat compresses after any spasms settle. Limit physical activity and sitting for long periods of time. Should these methods fail, regular injections of a cortisone-like drug may be used to lessen nerve irritation and increase physical therapy participation.
• Surgical treatment may be required if a significant loss of function is felt by a patient. Depending on the size and location of the herniation, either microdiskectomy or laminectomy will be performed.

High Tibial Osteotomy

• High Tibial referred to the upper portion of the tibia (shin) that forms the bottom half the joint of the knee.
• A High Tibial Osteotomy is an operation that corrects a disproportionate amount of weight being distributed on the inside or outside of the joint.
• The procedure involving cutting the bone and either adding or removing parts of bone to evenly distribute weight on the knee.

Hip Pointer Injury

• A hip pointer injury causes bleeding into the abdominal muscles due to an acute injury to the iliac crest of the pelvis. The pain is intense, felt when walking, laughing, coughing, or even breathing deeply. This injury comes about due to a direct blow to the iliac crest, generally from sports like football or soccer.
• Treatment mainly involves resting for up to 2 weeks, with ice or medication to help reduce the pain.

Hip Replacement

• Also called arthroplasty, hip replacement replaces parts of the hip joint with artificial parts called prostheses. Hip replacement is generally necessary for patients suffering from osteoarthritis of the hip joint.
• Before surgery is recommended, anti-inflammatory medications and/or an exercise program to strengthen the hip joint muscles may be prescribed.
• Should surgery be the only option, physical therapy is required once the procedure is complete.

Iliopsoas Rupture

• The iliopsoas is the powerful muscle used to lift the knee up, starting at the lower back and inserts into the thigh bone. Usually, ruptures of this muscle occur at the tendon where the muscle inserts into the thigh bone.
• Symptoms for an ruptured iliopsoas include sudden pain in the groin that returns when you lift your knee to your chest, and weakness in lifting the knee up.
• Treating an iliopsoas rupture includes using RICE therapy, use of crutches if necessary, and possibly some physical therapy and rehabilitation.

Iliotibial, or "IT," Band Pain

• Knee pain felt on the outside of the knee or lower thigh is referred to as IT Band Pain. Inflammation of the iliotibial band, running along the outside of the thigh, generally occurs due to overuse and is most common in runners. Other causes include training errors like running only on one side of an uneven road, or biomechanical abnormalities like overpronation of the foot or bowed legs.
• Treatment begins with the RICE method, followed by physical therapy. Anti-inflammatory medication and rest are also common treatment options.

Jawbone (Mandibular and Maxillary) Fracture

• The lower jaw bone, the mandibular, can get fractured from direct trauma and is common in almost all athletic sports. It usually fractures in more than one place and usually presents with some of these factors: teeth misalignment, a segment of teeth moving independently, or bruising on the floor of the mouth.
• Urgent medical attention is required for manibular fractures. The victim should be placed in a position to promote breathing while making sure there is no tooth or bone debris in their mouth. Surgery is often the only answer to stabilize this fracture.
• The upper jaw bone, the maxillary, can also get fractured from sudden trauma. There will be bruising, problems with biting due to a misaligned jaw, and a lengthening of the face. This injury is also urgent and will require surgery as soon as possible, taking all the aforementioned precautions.

Kyphosis

• Kyphosis is a postural syndrome based in the upper back and neck. World cyclists and baseball catchers are at the highest risk level for kyphosis, as they have to hold a certain posture for extended periods of time. In kyphosis, there is a muscle imbalance with the pectoral and posterior neck muscles being tight and the muscles of the upper back and deep neck flexors being weak. This may result in exceptionally rounded shoulders and a chin pointing forward.
• Kyphosis presents with burning or aching in the upper back and neck, with pain felt during prolonged periods of standing or sitting that eases with movement.
• Treatment for kyphosis generally includes some massage therapy and a few strengthening exercises to correct any muscle imbalances.

Lordosis

• Lordosis is when the lower back curves inwards more than it should, otherwise known as an exaggerated lumbar curve. This places stress on other parts of the spine, resulting in pain.
• This imbalance and exaggeration can be attributed to different muscles around the hip and spine becoming tight while others grow weak and stretched. Muscles that are tight will require stretching exercises and muscles that are weak will require strengthening.

Low Back Pain

• An extremely common occurrence that usually resolves itself within a few weeks for many people. Sometimes, however, lower back pain can be severe and persistent in nature.
• The lower back serves primarily as a power center for the body’s movement. It assists in motions such as turning, bending, twisting, and provides the means for people to stand, walk, and lift. As you may have guessed, a properly functioning lower back is pivotal to daily activity.
• Lower back pain has numerous causes, making pinpointing a common cause difficult. Many times, lower back pain is due to the aging of the vertebrae disks. Other times, excessive stress from heavy lifting, arthritis of the spine, problems with the tendons or ligaments around the spine, or malpositioning of the vertebrae may be to blame. Occasionally, there is no cause associated with lower back pain.
• There are a multitude of surgical and nonsurgical treatments for severe lower back pain, but a few preventative tips could save you from a lot of pain down the road: exercise regularly, lift objects properly (using the legs instead of the back), maintain a proper body weight, avoid smoking, and keep good posture and refrain from slouching.

Low Back Sprains & Strains

• A sprain in the lower back can occur when a sudden forceful movement injures a ligament that had previously grown stiff or weak.
• Treatment options include activity modification, anti-inflammatory medications, and a possible rehab program.

Mallet Finger (Baseball Finger)

• When the extensor tendon of a finger is damaged, the deformity known as a mallet finger will occur. Also called baseball finger, as the most common cause of injury comes from a ball or other object striking the tip of the finger or thumb. This damages the thin tendon used to straighten the finger.
• Usually, symptoms include a swollen, bruised finger that droops noticeably. Blood may collect beneath the nail; the nail may even detach from beneath the skin fold at its base.
• For nonsurgical treatment, the application of ice should be immediate and then a splint may be applied to hold the fingertip straight, usually up to eight weeks. Surgical repair may be necessary for large fractures or major joint misalignment.

Meniscus Tears / Injuries

• Menisci are small pieces of cartilage acting as cushions in the knee joint. They are on the outside (lateral) and inside (medial) of the joint.
• Forcefully rotating the knee while bearing weight is a common way these menisci can be injured or torn. Sports like soccer or football are activities where meniscus injury is common.
• An injured or torn meniscus can cause moderate to severe pain when the leg is extended and the knee is straight; sometimes pain can be very severe should a torn meniscus fragment catch between the femur and tibia.
• Swelling at the time of injury is common though it may delay a few hours as the joints become inflamed. The meniscus may click or pop, the knee may lock or feel weak as further symptoms of injury.

Metacarpal Injuries

The metacarpals are the long bones found in the hand. These can be subject to many injuries, most commonly a fracture. This happens due to punching a solid object or falling on an outstretched thumb. Fractures in the fourth and fifth metacarpals are also called Boxer’s Fracture. Common treatment for a fracture is a splint worn for a few weeks.

Neck Sprain

• Most often associated with a whiplash injury, neck sprains can also occur during sports or anytime the ligaments connecting the cervical vertebrae are stretched or torn beyond their limits due to a fall or sudden impact.
• Once the injury is evaluated and confirmed as a sprain, RICE therapy is recommended along with a cervical collar due to the length of time needed for a full recovery.

Nerve Root Pain

• Damage to the nerve root, known as radiculopathy, can be the root of considerable back pain because a nerve root becomes irritated. This is generally caused by a disc herniation or bone spurs due to a degenerated disc.
• Radiculopathy presents with pain, numbness, tingling, or weakness down the leg or arm (lumbar or cervical radiculopathy, respectively) due to an irritated nerve root.
• Anti-inflammatory medications or corticosteroids may be employed to provide temporary relief.

Osgood-Schlatter Disease (Knee Pain)

• This is an overuse injury found amongst adolescents, centralized at the knees. Inflammation of the tendon below the kneecap will cause pain, swelling, and tenderness below the kneecap.
• Treatments focus on reducing the pain and swelling. This means anti-inflammatory medication and the wrapping of the knee until the adolescent can return to physical activities without discomfort. Sometimes, symptoms may worsen and several months of rest will be recommended, followed by a conditioning program. Usually, symptoms disappear on their own once the child completes their growth spurt, around age 14 and 16 for girls and boys, respectively.

Osteoarthritis

• Osteoarthritis is the most common form of arthritis and is known as “wear and tear” arthritis, as cartilage in joints becomes damaged and worn away with time, resulting in stiffness of joints and infrequent inflammation/swelling.
• Exercise is the recommended course of treatment to control the symptoms and keep the joints strong and flexible.

Osteochondritis Dissecans

• A disruption of the joint, usually the knee, where the affected bone and cartilage loosen and cause pain. Eventually, this may turn into osteoarthritis. Osteochondritis Dissecans is most common in active adolescents and young adults.
• Treatment options vary according to the severity of each case. If cartilage fragments have not broken loose, they may be fixed in place with pins and screws through surgery. If the fragments have broken loose, a bone graft may be necessary to fix the fragments into position.

Osteoporosis

This is the thinning of the bones that occurs naturally over time for most people. Caused by a
lack of calcium in the diet.

Patella Tendonitis

• The patellar tendon joint the kneecap to the shinbone. Should this tendon come under a large amount of stress or strain, micro-tears and collagen degeneration may occur. This is common in sports involving rapid changes of direction or jumping movements, giving this injury the alternate title of Jumper’s Knee.
• Symptoms of Jumper’s Knee include pain at the bottom and front of the kneecap, aching and stiffness after training, pain in contracting the quadriceps muscles, and possible calf weakness.
• Treating patella tendonitis is different based on the level of injury. Icing the injury is good when pain is only present after training. If pain is continuous or even chronic, decreasing the stress placed on the tendon is necessary and in bad cases, ceasing activity completely. Rehab may be required for serious cases.

Pinched Nerve

• A pinched nerve is generally described as pain in the neck that radiates into the shoulders and arms. Tight muscles, disc damage, or the formation of excess bone deposits are all explanations for such an injury. The pain may also radiate up into the head and sometimes cause dizziness or headaches.
• Normally, treatment for a pinched nerve consists of rest, anti-inflammatory medications, and a neck brace to help the muscles relax and recover.

Piriformis Syndrome

• A common cause of sciatica, piriformis syndrome is when the piriformis muscle becomes tight or cramps, putting pressure on the sciatic nerve. Over time, this will produce an aching in the leg and pain in the lower back.
• While the shortening of the muscle and compression of the nerve are common cases of piriformis syndrome, overuse of the gluts and other hip muscles can be factors.
• Treatment includes stretching and strengthening excercises.

Plantar Fasciitis

• This is an overuse injury affecting the sole of the foot. This means an inflamed fascia that connects your heel bone to the base of your toes. Planta Fasciitis is most common in women, overweight individuals, or if you have a job requiring large amounts of walking or standing on hard surfaces. Risk is heightened if you walk or run for exercise.
• May become chronic if not treated. Symptoms to look out for include a mild pain at the heel bone often called a “stone bruise”. It is more likely to be felt after exercise or after arising from a midday lunch break.
• Treating Plantar Fasciitis is simple: rest is the most important. Keep weight off of the afflicted foot and apply ice for twenty minutes a few times each day as needed. There are also some home exercises that can be done to treat the injury.

Plica Syndrome

Occurs when bands of remaining synovial tissue are irritated by overuse or injury. Normally, synovial plicae combine to form one large synovial cavity, but if the process is incomplete, plicae remain as folds or bands of tissue within the knee.

Prepatellar (Kneecap) Bursitis

• People who spend a lot of time on their knees are at risk for prepatellar bursitis – swelling in the front of the knee due to the inflammation of the bursa, a small lubricating sac located in front of the kneecap. Jobs requiring constant kneeling, like carpet layers, plumbers, roofers, or gardeners, or athletics where falls on the knee are common such as football or wrestling, heighten the risk for this injury. Those with rheumatoid arthritis or those who have been in an automobile accident are also at higher risk.
• Generally, pain is felt during the activity but not at night. The kneecap is tender and warm to the touch. There is also swelling on the kneecap’s front. Treating these symptoms is a matter of rest, icing the injury, elevating the affected leg(s), and taking appropriate anti-inflammatory medications. Significant swelling may prompt your physician to drain the bursa with a needle.

Quadricep Tear/Pull

• A pulled or torn quadriceps causes pain in the front of the thigh; acute pain occurring during activity like sprinting. This injury comes about from strength imbalance between the quads and the hamstring. This imbalance is not uncommon with runners, who tend to strengthen their hamstrings far more than their quadriceps.
• For treatment, use the RICE method and anti-inflammatory medication if necessary. Normal activity can be resumed in 3 weeks, at most.

Rectus Femoris Injury

The rectus femoris is part of the quadriceps muscle group and crosses the hip joint acting as a powerful knee extensor when the hip is extended but is weak when the hip is flexed. Common injuries to this muscle include quadriceps strain, contusions, or a rupture of the rectus femoris tendon.

Rotator Cuff Tear

A deep ache will be felt along with the preceding symptoms. Torn rotator cuffs should be evaluated by a physician – arthroscopic surgery may be necessary. This is minimally invasive and patients undergoing the procedure can return home the very same day as the procedure.

Rotator Cuff Injuries

Injuries may have swelling, bleeding, or bruising from the swollen muscle pressing against the nearby bone. Several months may be needed for the injury to fully heal in that state. Continued activity will worsen this condition.

Runner’s Knee (Patellofemoral Pain)

• Despite its name, patellofemoral pain is not attributed solely to runners. Any athletic activity placing heavy stress on the knee carries the risk for patellofemoral pain. A number of conditions cause pain around the front of the knee and are placed under this umbrella terminology: anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella.
• Runner’s knee generally follows a few common symptoms: a dull, aching pain near the kneecap, pain walking up or down stairs, while kneeling or squatting, or while sitting with bent knees for a long period of time. A few causes include kneecap malalignment, dislocation, excessive training, tightness or weakness of thigh muscles, or flat feet.
• Should you be diagnosed with Runner’s knee, utilize the RICE formula before seeking any more extreme treatment options. Reconditioning may be necessary and in extreme cases, arthroscopy or realignment surgery.

Sacroiliac Joint Injury

• This joint is located at the bottom of your back, one on either side of your spine and helps make up the rear part of the pelvic girdle. There are twisting forces applied to the pelvic girdle when lower limbs are moved. Sometimes, these forces can cause the sacroiliac joint to get stuck, or one half of the pelvis will glide forwards or backwards, both resulting in inflammation. This is common, especially after pregnancy.
• Pain is centralized either to the left or right of the lower back, ranging from an ache to acute pain restricting movement. Symptoms include having trouble turning over in bed, struggling to put on shoes/socks and pain when getting your legs in and out of the car.
• Rest, anti-inflammatory medications, and electrotherapy for affected tissues is standard procedure, but sometimes leveling the pelvis may be necessary.

Sciatica

• Should you experience pain in your lower back or hip radiating to the back of your thigh and into your leg, you may be suffering from sciatica. This is when a herniated disk presses on the roots
  of the sciatic nerve and it is similar to a bad leg cramp lasting for weeks.
• Sciatica may result from aging, plus any sudden pressure placed on the disks cushioning your spine. Around 85% of patients get better without surgery; bed rest and anti-inflammatory medicine is recommended for a few days. Motion reduces inflammation, so physical activity is recommended. If pain remains for more than three months, surgery to remove part of the herniated disk may be recommended.

Scoliosis

• This is a condition where the spinal curves go from side-to-side, unable to be corrected from simply learning to stand up straight. The appearance of the spine may resemble an “S” or “C” shape and in some cases, the spine may have rotated slightly, causing the shoulders or waist to appear uneven.
• Most cases in children will remain small and only need periodic checkups with an orthopaedist. Should the curve progress, an orthopaedic brace may be utilized to prevent any further progression. If the brace does not keep the curve under control, surgery may be recommended.

Shoulder Dislocation

• Of all sports-related injuries, dislocation of the shoulder joint is most common and typically occurs when the head of the upper arm bone pops from its socket due to either a forceful, sudden impact or an extreme rotation.
• Pain is severe. Soon after the dislocation, the shoulder will swell, grow numb, and feel weak.
• Dislocations are treated by a procedure called reduction to replace the ball of the upper arm bone. The arm is immobilized for weeks as the shoulder repairs itself; physical therapy is recommended afterwards.

Shoulder Separation

• Involves the stretching/tearing of ligaments where the collarbone meets the shoulder blade. This can cause the clavicle to slip forward and detach. Falling on an outstretched hand or an impact to the front of the shoulder are two common causes for shoulder separation.
• Resting and donning a sling are the best methods for treating a separated shoulder. Ice and physical therapy are usually recommended as well. Two or three months may be necessary for a full recovery.

Slipped Disc
Also known as Sciatica. See Sciatica.


Spinal Fusion

This is a surgical method generally used to correct issues with the vertebrae of the spine. By fusing together two or more vertebrae using bone grafts and metallic rods and screws, the spine can become stabilized. Such a method is generally used to treat spinal vertebrae injuries, unstable spines resulting from infection or tumors, abnormal curvatures of the spine like scoliosis or kyphosis, or a herniated disk. Consult your physician to see if this surgery is right for your situation.

Spinal/Neck Injury

• This is a serious injury that may cause paralysis, brought on by major incidents like automobile accidents, bullet/stab wounds, landing directly on the head, or electric shock.
• If there is even an inkling that someone may have suffered a spinal/neck injury, do not move them and call for medical help immediately.

Spondylolysis

• This is an overuse injury where repeated stress to a bone called the pars causes a fracture. Most competitive sports carry a heightened risk for this injury, like gymnastics, dance, soccer, football, and others. Anytime the spine is flexed forward, bent back, or rotated many times, there is a risk for injury.
• Treatment for this injury is not universal; doctors are still trying to come to an agreement. Sometimes, wearing a brace and engaging in physical therapy is recommended, other times electrical stimulation, and in some instances, surgery to correct it.

Stress Fracture

A stress fracture is sometimes referred to as a hairline style of break in a bone caused by
overuse.

Tennis Elbow / Golfer’s Elbow / Tendonitis

• The name is misleading, as Tennis Elbow and Golfer’s Elbow are not limited to the sports they are named after; any repetitive activity can lead to contracting these. When the tendons in the elbow are stretched beyond capacity, they become inflamed and tender.
• Tenderness is heightened when gripping or turning items, like opening a jar. Pain will run from your elbow down to either the thumb (tennis elbow) or pinky (golfer’s elbow) side of your forearm.
• Anti-inflammatory medications are often prescribed for such injuries along with resting the elbow, applying ice, and using a splint or brace for extra support and comfort.

Tibialis Anterior Pain/Injuries

• The tibialis anterior forms the fleshy part of the outside of the shin. Tibialis Anterior Syndrome, also called shin splints, are a common injury, but there is also risk for tendon sheath inflammation brought on by overuse. Running on hard surfaces or sports requiring frequent changes in direction heighten the risk for tendon sheath inflammation.
• Tendon sheath inflammation can present with pain when the foot and toes are bent upward, or swelling/redness over the front of the ankle. General treatment options include resting until pain subsides, icing the injury down, or in more severe cases anti‐inflammatory medications and a plaster cast may be employed.

Tibialis Posterior Pain/Injuries

• Generally, the tibialis posterior muscle can suffer from Tibialis Posterior Syndrome or Tibialis Posterior Tendinopathy. This muscle comes from behind the shin bone and runs into a tendon passing behin the bony bit on the inside of the ankle.
• Inflammation occurs near that tendon in TPS, presenting with pain over the tendon area, pain during exercise, or swelling around the bony bit on the inside of the ankle. Rest and antiinflammatory medication are usually prescribed, though in severe cases a cast or even surgery may be recommended.
• TPT is an overuse injury resulting from the degeneration of the tendon as opposed to inflammation as seen in TPS. TPT presents with pain similar to TPS, but it is worsened through passive eversion or resisted inversion (turning the foot outwards and inwards, respectively). Treatment includes icing the injury, stretching the muscles when possible, and a combination of anti-inflammatory and massage techniques to combat the pain.

Thoracic Spine / Upper Back Pain

• The thoracic spine includes 12 vertebrae that link to your ribcage in order to provide it with stability and protect the organs in the thoracic cavity.
• Upper back pain linked to the thoracic spine area can include inflammation of the muscle attachments to the spine, tight muscles in the upper back, or in adolescent male athletes, Scheuermann’s disease that starts with acute pain in the upper back and may develop into a rounded thoracic spine in later years (known as kyphosis).
• Resting, stretching properly, and heating any enflamed muscles are the standard treatments for upper back pain.

Torn Rotator Cuff / Rotator Cuff Injuries

• The rotator cuff is a cluster of tendons and muscles supporting and stabilizing the arm, allowing it to move as freely as it does. Should these tendons and muscles get damaged, the range of the arm’s motion will be lowered. A tear in these muscles can severely limit motion.
• An aching, weak shoulder when the arm is lifted overhead is sign of rotator cuff injury.
• Less severe injuries may have swelling, bleeding, or bruising from the swollen muscle pressing against the nearby bone. Several months may be needed for the injury to fully heal in that state. Continued activity will worsen this condition.
• Should your rotator cuff be torn, a deep ache will be felt along with the preceding symptoms. Torn rotator cuffs should be evaluated by a physician – arthroscopic surgery may be necessary. This is minimally invasive and patients undergoing the procedure can return home the very same day as the procedure.

Whiplash

• Whiplash results from a forceful impact, usually from behind, causing the head and neck to snap forward and back in an abrupt, violent motion, affecting soft tissues of the neck including ligaments, tendons, and muscles. Contact sports and car accidents are common grounds for whiplash injury.
• Treatment for whiplash begins with RICE therapy, anti-inflammatory medication, and a soft cervical collar, though early movement is being recommended more and more over immobilization.

Wrist Arthroscopy

• Arthroscopy is a minimally-invasive surgical procedure used to diagnose and treat problems inside a joint. The wrist is made up of eight small bones and many connecting ligaments, making it a very complex joint where arthroscopy is a great asset.
• Treatments performed using wrist arthroscopy include a number of conditions, like chronic wrist pain, wrist fractures, ganglion cysts, ligament tears, and carpal tunnel syndrome. After surgery, the wrist should be elevated for a few days, kept clean and dry, and ice should be used to control swelling.

Wrist Sprains

• Typically, sprained wrists occur when patients fall on an outstretched hand, causing the ligaments in the wrist to stretch or tear. This type of injury is common in sports like football, volleyball, snowboarding, or baseball.
• Physical Therapy is usually recommended. Treatment options begin with the RICE therapy, with recommendations for a wrist brace and rehabilitation exercises also common. In rare instances, surgery may be required to repair a torn ligament or if there is a bone fracture.