Treatment of the thoracic spine utilizing joint mobilization or manipulation is a excellent treatment approach to accelerate the recovery of patients dealing with neck, elbow, and shoulder pain. Utilizing a regional interdependence approach where areas adjacent or distant to the site of pain are treated by the physical therapist, in addition to the painful area, lead...
Background Sacroiliac (SI) joint pain is an less common source of low back pain but has a higher incidence pregnant and post partum patients, as well as, after trauma. The incidence of SI pain in patients with low back pain is 13% (9-26%) (1). The majority of patients will report buttock pain (94%), lower lumbar...
My approach to treating ankle sprains has changed dramatically since I began working with athletes in the late 1990s. The PRICE (protection, rest, ice, compression, and elevation) approach has been replaced with a clinically superior movement approach designed to reduce pain and facilitate a return to an exercise program. The PRICE approach was effective to...
Elbow pain on the outside of the elbow is most common in individuals’ aged 30-50 y.o. and effects 1-3% of the general population (Shiri et al. 2006). Risk factors for this condition include blue collar workers utilizing repetitive gripping and manipulation in the work place, smokers, and tennis athletes. This condition has previously been described...
Knee Pain Background Anterior knee pain is a term used to encompass many conditions affecting structures of the knee. The majority of these cases can be attributed to patellofemoral pain syndrome (PFPS) or an abnormal tracking of the patella on the femoral groove secondary to changes in lower extremity alignment, muscle imbalance, or training errors...
Neck Pain Background Information Neck pain affects 10-15% of the population at any one time, with a lifetime incidence of 22-70% (1). Only 6% of patients with neck pain report resolution of symptoms at one year (2). A recent systematic review demonstrated the prognosis from idiopathic neck pain is poor (3) and 50-75% of patients with neck...
Lumbar Spinal Stenosis is a spinal diagnosis found in older adults and involves a narrowing of the canals in which the nerves exit the spine. It can be found in either the central canal of the spine or in the foramen where nerves exit on each side of the spine. Often these patients reports symptoms...
Lateral Elbow Pain and Lateral Epicondylalgia Lateral epicondylalgia, also known as tennis elbow, is an overuse injury involving the common origin tendon of the wrist and finger extensors. Patients with this condition often report pain in the lateral elbow exacerbated by gripping, lifting, or manipu- lating objects with their hands. Previously thought to be a...
Knee Arthritis Background Information Osteoarthritis (OA) costs have risen to 13.2 billion dollars per year and are the leading cause of disability in adults(1). Knee OA is the most common area and leads to mild to moderate disability in >10% of adults over age 552. Up to 70% of older adults have OA changes on...
Shoulder Pain and Impingement Background Shoulder pain is a common source of peripheral joint pain occurring at a prevalence rate of up to 47% across all age groups and is second most common cause of musculoskeletal pain(7,9). Symptoms of shoulder pain account for 33.2% of physician visits in the U.S. and are most frequently associated...