Achilles tendinopathy is the most common tendon injuries seen in our Boulder Physical Therapy practice. Patients often present with pain along the mid portion of the achilles tendon during walking, hiking, running, or jumping activities. The greatest risk factors for this condition include a loss of ankle flexibility (dorsiflexion) and calf weakness. Both of these...
In the achilles tendinopathy (artist formally known as tendonitis) research two main themes have emerged. First, there is little to no evidence to support the use of injections of any kind into an injured tendon. Authors have advocated against steroid injections due to the risk of tendon rupture outweighing any potential benefits. Studies have also...
Few things remind me of how far we have come as a profession than ultrasound. Early in my career we utilized ultrasound and other modalities to help reduce a patients pain. Initially touted as a medium to deep tissue heating and healing, ultrasound has now fallen out of favor due to the lack of research...
A recent clinical practice guideline was published advising clinicians and patients on the management of achilles tendon injury (tendinopathy). These guidelines are based on both the available medical research and medical opinions from experts in the field. The Journal of Orthopedic and Sports Physical Therapy reported the following for management of mid portion achilles tendinopathy...
Plantar fasciitis (fasciosis) is a painful diagnosis limiting a patient’s ability to stand, walk, or run. The -itis of the name is a misnomer because very few cases of plantar heel pain involve an inflammatory process. Instead, a breakdown of soft tissue fibers and cells is noted in the plantar fascia reflecting the sequential stages...
We have previous discussed the limitations of orthotics to control lower extremity alignment. Another common reason for orthotic use is to control the degree of pronation or flattening of the foot during foot strike in walking and running. The theory believes orthotics are able to impact force absorption by controlling this motion at the foot...
Injuries to our spinal and extremity joints can impact a variety of structures including muscle, ligament, and nervous system receptors. The sensors or proprioceptors are critical in providing real time feedback to our spinal cord and brain on the positions of our limbs. This feedback system is disrupted by injury leading to slower information processing...
Ankle sprains are one of the most common sports injuries we encounter in our Boulder Physical Therapy practice. In our previous blogs we have written on the importance of early interventions such as manual therapy and proprioceptive exercise to help accelerate the recovery after these sprains. Prior research has shown a higher recurrence rate in athletes...
Plantar heel pain or plantar fasciitis is the most common diagnosis explaining pain originating from the bottom of the foot. Previously, orthotics have been thought to improve alignment of the foot and ankle but more recent research has shown the limitations of these interventions. In our previous blog posts, we have described the inability of...
Manual therapy or the passive movements of joints and tissues has been shown to be effective at reducing short term pain for a number of conditions including heel pain. Interventions including joint mobilization and manipulation are commonly provided to patients suffering from heel pain or plantar fasciitis (fasciosis) in order to restore normal mobility to...