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Chondromalacia Patella (Patellofemoral Syndrome) Chondromalacia patella facts • Chondromalacia patella is the most common cause of chronic knee pain. • Chondromalacia patella has also been called patellofemoral syndrome. • The pain of chondromalacia patella is aggravated by activity or prolonged sitting with bent knees. • Abnormal "tracking" allows the kneecap (patella) to grate over the lower end of the thighbone (femur), causing chronic inflammation and pain. • Treatment involves improving the alignment of the patella during contraction of the thigh muscle. What is the chondromalacia patella? Chondromalacia patella is abnormal softening of the cartilage of the underside the kneecap (patella). It is a cause of pain in the front of the knee (anterior knee pain). Chondromalacia patella is one of the most common causes of chronic knee pain. Chondromalacia patella results from degeneration of cartilage due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). This process is sometimes referred to as patellofemoral syndrome. What causes chondromalacia patella? The patella (kneecap) is normally pulled over the end of the femur in a straight line by the quadriceps (thigh) muscle. Patients with chondromalacia patella frequently have abnormal patellar "tracking" toward the lateral (outer) side of the femur. This slightly off-kilter pathway allows the undersurface of the patella to grate along the femur, causing chronic inflammation and pain. Certain individuals are predisposed to develop chondromalacia patella: females, knock-kneed or flat-footed runners, or those with an unusually shaped patella undersurface. What are the symptoms and signs of chondromalacia patella? The symptoms of chondromalacia patella are generally a vague discomfort of the inner front of the knee, aggravated by activity (running, jumping, climbing or descending stairs) or by prolonged sitting with knees in a moderately bent position (the so called "theater sign" of pain upon arising from a desk or theater seat). Some patients may also have a vague sense of "tightness" or "fullness" in the knee area. Occasionally, if chronic symptoms are ignored, the associated loss of quadriceps (thigh) muscle strength may cause the leg to "give out." Besides an obvious reduction in quadriceps muscle mass, mild swelling of the knee area may occur. How is chondromalacia patella diagnosed? Chondromalacia patella is suspected in a person with anterior knee pain, especially in teenage females or young adults. With manual compression of the kneecap while the quadriceps muscle is tightened, there can be pain. This is referred to as the positive "shrug" sign. Generally, there is no associated swelling (knee joint effusion). X-rays or MRIs may be done to confirm the inflammation on the posterior part of the patella And Now You Know

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Definition The heel bone is the largest bone in the foot and absorbs the most amount of shock and pressure. A heel spur develops as an abnormal growth of the heel bone. Calcium deposits form when the plantar fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Heel spurs can cause extreme pain in the rearfoot, especially while standing or walking. Cause Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis. Treatment and Prevention The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation, and allow the condition to heal. Other common treatments include physiotherapy, stretching exercises, losing weight, wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. Heel cradles and heel cups provide extra comfort and cushion to the heel, and reduce the amount of shock and shear forces experienced from everyday activities. Consulate with our therapist today!

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Whether you’re a professional Football player, an amateur athlete or someone who’s just active, an injury can happen at any time. An injury that can happen if you participate in an activity that involves a lot of cutting and twisting is the tearing of your ACL and/or MCL What is an ACL and MCL? The Anterior Cruciate Ligament (ACL) is a ligament located towards the inner knee that is crucial for proper movement. ACL injuries commonly cause knee instability that damages other ligaments. This injury is seen most commonly in athletes, and the injuries range from mild, such as small tears, to severe, where the ligament is completely torn. The Medial Collateral Ligament (MCL) is a band of tissue, which is also found inside your knee. It connects your thighbone to the bone of your lower leg. The main job for the MCL is to keep the knee from bending inward. Injuries also vary from mild to severe, but are not as severe as an injury to the ACL. Injuries Torn ACLs are most often related to high impact sports or when the knee is forced to stop suddenly after running at high speeds. ACL failure has been linked to heavy or stiff-legged landings. Women who play sports are more prone to ACL injuries than men, mainly because of the differences in anatomy, general muscle strength and reaction time of muscle contraction and coordination. You can tear your MCL during activities that involve quick twisting, bending or changing direction quickly. The MCL is most often torn when the outside of the knee is hit inward. Treatment Since an injury to the ACL is more serious than an injury to the MCL, the recovery time differs. Treatments for both injuries require physical therapy and sometimes the use of a knee brace, but the extent of these varies greatly. Injuries to the ACL increases the risk of other injuries to the knee, so sports with cutting and twisting motions are strongly discouraged. Unfortunately the knee will be more susceptible to injuries in the future. Patients, who frequently participate in sports like Football, often need surgery. MCL tears can be treated depending on their severity. Resting, the use of ice, taking anti-inflammatory medicine and possible use of crutches can treat mild to moderate injuries. More moderate injuries may require the injured to wear a hinged knee brace, which locks the knee in place until the ligament heals, and reduced the amount of weight put on the leg. Severe injuries may require wearing the hinged brace for a few months and limiting the use of the leg for a longer period of time. The most important thing for a patient to remember is to trust the care of their Physiotherapist. Being patient and keeping an open communication with the therapist is essential to help them help you during recovery.

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Tennis elbow is a painful condition caused by overuse of the "extensor" muscles in your arm and forearm, particularly where the tendons attach to rounded projections of bone (epicondyles) on the outside or lateral aspect of the elbow. The muscles you use to grip, twist, and carry objects with your hand all attach to the "lateral epicondyle" at the elbow. That's why a movement of the wrist or hand can actually cause pain in the elbow. Prolonged use of the wrist and hand, such as when using a computer or operating machinery —and, of course, playing tennis with an improper grip or technique—can lead to tennis elbow. It can happen to athletes, non-athletes, children, and adults. It occurs more often in men than women, and most commonly affects people between the ages of 30 and 50. Symptoms of tennis elbow can occur suddenly as a result of excessive use of the wrist and hand for activities that require force, such as lifting, twisting, or pulling. Forceful activities—like pulling strongly on a lawn mower starter cord—can injure the extensor muscle fibers and lead to a sudden onset of tennis elbow. More commonly, though, symptoms of tennis elbow develop gradually over a period of weeks or months as a result of repeated or forceful use of the wrist, hand, and elbow. If you work as a grocery store cashier, you might have symptoms of tennis elbow as a result of repetitive (and often too forceful) typing—combined with continuous lifting of grocery bags. Your symptoms may include: Pain that radiates into your forearm and wrist Difficulty doing common tasks, such as turning a doorknob or holding a coffee cup Difficulty with gripping activities Increased pain when you use your wrist and hand for lifting objects, opening a jar, or gripping something tightly, such as a knife and fork Stiffness in the elbow Weakness in the forearm, wrist, or hand The First 24 to 48 Hours For the first 24 to 48 hours after acute onset of your pain, treatment includes: Resting the arm by avoiding certain activities and modifying the way you do others Using 10-20 minute ice treatments Using elastic bandages or supports to take the pressure off of the painful muscles Our Physiotherapist will decide if you should use a brace or support to protect your muscles while the area is healing. Depending on severity, our therapist may recommend that you consult with another health care provider for further testing or for consideration of additional treatment such as medication. In rare cases, treatments such as cortisone injection or surgery might be needed. Our Physiotherapist can help you determine whether you need a referral to another health care provider. Our Physiotherapist can design a specific treatment program to speed your recovery. There will very likely be exercises and other treatments that you will be expected to do at home. Our Physiotherapist also might use special physical therapy treatments to help relieve pain, such as manual therapy, special exercises, and ice or heat treatments or both. For an "acute" case of tennis elbow—one that has occurred within the past few weeks— it's important to treat as early as possible. Left untreated, tennis elbow may become chronic and last for months and sometimes even years. This is especially true if treatment is focused only on relieving pain and not on correcting the muscle weakness and bad habits that might have led to your condition in the first place. Consult with our experienced Physiotherapist for more information

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Supraspinatus Rupture: This is a painful condition of the shoulder in which there is a tear or rupture of the tendons of the Supraspinatus Muscle. This condition is relatively common and generally extremely painful. This condition is usually developed as a result of a direct blow to the shoulder like when falling on the shoulder or other sporting injuries. In this article, we will discuss about: Causes of Supraspinatus Rupture Symptoms of Supraspinatus Rupture Treatments options available for Supraspinatus Rupture How Do We Define Supraspinatus Rupture? The function of a tendon is to connect muscles to bones and the muscles pull the bones with pulling on to the tendons. When there is any sort of damage to the tendons in trying to move the tendon the muscles pull a part of the tendon away form the bone resulting in fraying and soreness of the point of attachment. Over time, the tendon completely disconnects from the bone and this condition is called a Tendon Rupture. This results in loss of mobility of the joint. Usually, the tendons are quite strong but its attachment to bone is pretty weak and is the first to give way. Tendon Rupture is pretty common in shoulders as it is one of the joints which is very frequently used in everyday life and is prone to this condition. When the tendon rupture takes place in the Supraspinatus Muscle, which is one of the rotator cuff muscles, it is called as Supraspinatus Rupture. Causes of Supraspinatus Rupture Studies indicate that there are at least three important factors which may cause a Supraspinatus Rupture. Some factors can be attended to with the help of exercises while other factors need surgery to correct the problem. These three factors are: Degeneration with Aging: The Supraspinatus Tendon tends to get weak as the individual ages and becomes prone to tears. Most of Supraspinatus Ruptures have been found in people above the age of 40 but individuals involved in the sporting field or are involved in motor vehicle accidents which can cause direct trauma to the shoulders can also develop this condition. Shoulder Girdle Structure: The individual shape of bony structures play a vital role in determining whether a tendon is able to move freely or gets impinged between structures with frequent elevation of arms. Shoulder Biomechanics: As stated, the Supraspinatus Muscle is a part of the muscles that constitute the rotator cuff which facilitates stability to the shoulder. In case, the other rotator cuff muscles are not providing enough stability to the joint with range of motion then the Supraspinatus Muscle becomes prone to a rupture. Apart from the above mentioned factors, Supraspinatus Rupture also occurs with sporting activities which involve powerful throwing like baseball etc. Also, people working in occupations which require heavy lifting overhead are also prone to Supraspinatus Rupture. Symptoms Of Supraspinatus Rupture Some of the Symptoms of a Supraspinatus Rupture are: Excruciating pain in shoulders Severe pain in the shoulder with rotation of the arms Severe pain in the shoulders when moving the arms sideways Diagnosis of Supraspinatus Rupture In order to diagnose a Supraspinatus Rupture, the physician will begin with a detailed physical examination of the shoulders and will ask the individual to move the arm in different directions to assess for range of motion. The physician will then look for any palpable tenderness or deformity in the shoulder area. The physician will also check the strength of the arm to look for any sort of muscle weakness. For A Confirmatory Diagnosis The Treating Physician Will Order The Following Imaging Studies: X-rays: Since x-rays are not sensitive enough to show deeper areas of the shoulder it may reveal a normal study. MRI Scan/Ultrasound: These studies are more sensitive and the physician will be able to look at the deeper structures of the rotator cuff and confirm the diagnosis of a tendon tear. The scans will also reveal the quality of the muscles and tendons of the shoulders. Treatment For Supraspinatus Rupture Supraspinatus Ruptures can be treated both surgically as well as conservatively. In cases if the rupture is pretty small, then conservative management with physical therapy is the best route to go. Physical therapy is also used for individuals with extremely large tears which cannot be repaired via surgery. Conservative option is best for people who want to prolong or even if possible avoid surgical procedure due to the prolonged recovery phase post procedure. If conservative treatments fail to provide adequate relief of symptoms, then surgery is the route to go but the success of the surgery depends on the extent of the tear and the condition of the muscles. The surgical procedure is done using arthroscopic technique in which an arthroscope which is an instrument with a miniature camera attached to it is inserted in the shoulder via small incisions and the internal structures are observed to look for damage and once identified the damage is repaired. Postsurgery, the tendon will take up to four months to completely heal but the healing process again depends on the following factors: The tendon should be of adequate thickness in order to hold the sutures. The affected individual should limit his motion during the healing phase. Smoking needs to be absolutely avoided as it impairs healing. Studies reflect that medium sized Supraspinatus Ruptures heal in about 75% of cases with the recovery period being about six months before the individual can return to normal activities.

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Your sciatic nerve begins at your spinal cord, goes through your hips and buttocks, and then branches down each leg. This nerve is the body’s longest nerve and one of the most important ones, as it has a direct effect on your ability to control and feel your legs. When this nerve is irritated, you will experience sciatica. Sciatica is a sensation that can manifest itself as a moderate to excruciating pain that you feel in your back, buttocks, and legs. You may also feel weakness or numbness in these areas. Sciatica is a symptom caused by an underlying injury to the nerve or to an area that impacts the nerve, such as your vertebrae (the bones in the neck and back). What Causes Sciatica? Sciatica can be caused by a number of conditions that involve the spine and that can affect the nerves running along your back. Other times, the cause is an injury, such as falling or spinal/sciatic nerve tumors. Consult with our therapists' today!

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The most common and effective treatment in chiropractic care is the chiropractic adjustment or spinal manipulative therapy. Adjustments are a very safe, painless manual procedure. Our therapists (physiotherapist, chiropractor,massage therapist, acupuncturist) will work in conjunction with each other for a better thorough, multi-faceted treatment program designed to address your health issues quickly and effectively. Give us a call today to book an appointment!

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