What We Treat

  • Function of ACL

    The anterior cruciate ligament (ACL) is one of the main stabilizing ligaments in the knee. It prevents the tibia (shin bone) from sliding forward relative to the femur (thigh bone) and provides important rotational stability during cutting, pivoting, and jumping activities.

    How the ACL Can Be Injured

    ACL injuries often occur during sports or high-demand activities that involve:

    • Sudden deceleration, cutting, or pivoting movements

    • Landing awkwardly from a jump

    • Direct contact or collision to the knee

    • Hyperextension injuries

    Injuries can range from a sprain to a complete tear. In many cases, a full tear may require surgical reconstruction using graft tissue from either the patient (autograft) or donor tissue (allograft).

    Typical Symptoms

    • A “pop” sound or sensation at the time of injury

    • Rapid swelling of the knee joint

    • Feeling of instability or the knee “giving way”

    • Pain and loss of range of motion

    • Difficulty returning to sport or activity

    Rehabilitation Phases

    Phase 1: Protection & Acute Recovery

    • Control pain and swelling, restore gentle range of motion, and protect the graft/repair

    Phase 2: Early Strength & Mobility

    • Focus on quadriceps activation, gradual weight-bearing, and restoration of knee motion

    Phase 3: Strength & Neuromuscular Control

    • Progressive strengthening of the quadriceps, hamstrings, hips, and core; re-establishing balance and control

    Phase 4: Advanced Strength & Functional Training

    • Higher-level strengthening, running progression, and controlled agility work

    Phase 5: Return to Sport/Performance

    • Sport-specific drills, plyometrics, and cutting/pivoting activities to ensure readiness for full return to competition

  • Function of Achilles Tendon

    The Achilles tendon is the thick, strong band of tissue at the back of your ankle that connects your calf muscles to your heel bone. It’s what helps you push off the ground when you walk, run, or jump. Without it, movements like going up on your toes or sprinting would be very difficult.

    How It Can Be Injured

    An Achilles tear often happens suddenly, sometimes with a “pop” or snapping sensation, followed by pain and difficulty walking. Common causes include:

    • A sudden push-off, sprint, or jump

    • Quick changes in direction

    • Stepping into a hole or misjudging a landing

    • Overuse and wear-and-tear over time

    Rehabilitation Protocol for PARS / SpeedBridge

    While formal guidelines are still evolving, rehabilitation typically progresses through these phases:

    Phase 1: Protection & Early Healing

    • Brace: Locked in slight plantar flexion or extension to minimize tendon tension

    • Weight-bearing: Generally non-weight-bearing for the first two weeks

    Phase 2: Controlled Motion

    • Heel wedges or progressive lowering in the boot to gradually bring ankle toward neutral

    • Weight-bearing: Transition to partial and then full weight-bearing, often with crutches

    Phase 3: Strength & Mobility

    • Exercises: Begin calf raises (double-leg progressing to single-leg), balance work, light resistance exercises, and core/hip strengthening

    • Boot Removal: Typically phased out based on strength and comfort

    Phase 4: Functional Recovery

    • Agility & plyometric drills: Light jumping, timed hops, and sport-specific activities

    Phase 5: Return to Full Activity

    • Running, cutting, complete training drills, and return to sports when strength and functional assessments are met

  • Function of Ankle Ligaments

    The ankle joint is stabilized by a network of ligaments that connect bone to bone and control the limits of motion. The lateral ligament complex — especially the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL) — resists excessive inversion and anterior translation of the talus. When these structures are overstretched or torn, mechanical stability and proprioceptive feedback are affected.

    Mechanism of Injury

    Ankle sprains most commonly occur when the foot is forced into excessive inversion and plantarflexion, such as landing awkwardly from a jump, sudden cutting or pivoting, or stepping onto an uneven surface. A “pop” may be felt at the time of injury, followed by pain, rapid onset edema, and ecchymosis along the lateral ankle.

    Rehabilitation Stages

    The timeline depends on the grade of injury — Grade I (mild), Grade II (partial tear), or Grade III (complete tear). Regardless of severity, the goals are to protect healing tissue, restore range of motion, progressively load the injured ligaments and musculature, and retrain proprioception to reduce recurrence.

    Phase 1: Acute Phase

    • Goals: Decrease inflammation, protect ligamentous structures, maintain mobility in adjacent joints

    Phase 2: Subacute Phase

    • Goals: Restore full dorsiflexion and plantarflexion, initiate strengthening, normalize gait mechanics

    Phase 3: Strengthening & Neuromuscular Control

    • Goals: Improve dynamic stability, advance to functional activities

    Phase 4: Return-to-Activity

    • Goals: Prepare for sport or high-demand activity, restore reactive stability

    Phase 5: Maintenance & Prevention

    • Goals: Prevent re-injury, maintain strength and proprioception

  • What Is Arthritis?

    Arthritis is an umbrella term for conditions that cause inflammation and degeneration within a joint. The most common type seen in orthopedic practice is osteoarthritis (OA) — a progressive breakdown of articular cartilage, leading to joint space narrowing, changes in subchondral bone, and varying degrees of synovial inflammation. Other types include rheumatoid arthritis (RA), an autoimmune-mediated inflammatory disease, and post-traumatic arthritis, which can develop after injury.

    How It Affects the Joint

    When cartilage wears down, the protective cushion between bones is reduced. This can cause:

    • Joint stiffness, especially in the morning or after inactivity

    • Pain with weight-bearing or certain movements

    • Swelling or warmth around the joint

    • Loss of strength and range of motion

    • Functional limitations in walking, climbing stairs, or recreational activities

    Rehabilitation Phases

    While arthritis cannot be “cured,” physical therapy can significantly improve mobility, reduce pain, and help slow functional decline.

    Phase 1: Symptom Management & Protection

    • Goals: Reduce joint irritation, maintain pain-free mobility

    Phase 2: Mobility & Strengthening

    • Goals: Improve joint range of motion and muscular support

    Phase 3: Functional Conditioning

    • Goals: Enhance daily activity tolerance, reduce compensatory patterns

    Phase 4: Long-Term Joint Health

    • Goals: Maintain strength, mobility, and activity participation

  • What is Back Pain?

    Back pain is one of the most common musculoskeletal complaints, affecting the spine’s bones (vertebrae), joints (facet joints), intervertebral discs, muscles, ligaments, and nerves. It can be acute (lasting less than 6 weeks), subacute (6–12 weeks), or chronic (more than 12 weeks). Pain may be localized or radiate into the hips, legs, or feet if nerve roots are irritated.

    Common Causes

    • Muscle strain or ligament sprain from lifting, twisting, or overuse

    • Intervertebral disc injury (bulge or herniation) placing pressure on nerve roots

    • Facet joint irritation from repetitive loading or degenerative changes

    • Spinal stenosis (narrowing of the spinal canal)

    • Poor posture and movement patterns leading to mechanical overload

    Typical Symptoms

    • Localized or diffuse pain in the lower or mid-back

      Stiffness and reduced range of motion

    • Muscle spasms or guarding

    • Pain with prolonged sitting, standing, or certain movements

    • Possible numbness, tingling, or weakness in the legs if nerves are involved

    Rehabilitation Phases

    Phase 1: Acute Phase (Pain Control & Protection)

    • Goals: Reduce inflammation, protect injured structures, maintain gentle mobility

    Phase 2: Mobility Restoration

    • Goals: Improve flexibility of lumbar spine, hips, and thoracic spine

    Phase 3: Strength & Stability

    • Goals: Build core and trunk strength to support the spine

    Phase 4: Functional & Work/Sport-Specific Training

    • Goals: Return to daily and recreational activities without pain

    Phase 5: Long-Term Maintenance

    • Goals: Prevent recurrence through strength, flexibility, and movement habit improvement

  • What Is Cervical Pain?

    Cervical pain refers to discomfort arising from the neck region of the spine, including the vertebrae (C1–C7), intervertebral discs, facet joints, ligaments, and supporting musculature. It can present as localized stiffness and soreness or radiate into the shoulders, upper back, or arms if nerve structures are involved.

    Common Causes

    • Muscle strain from prolonged or awkward postures

    • Cervical facet joint irritation from repetitive motion or degenerative changes

    • Disc bulge or herniation compressing a nerve root

    • Whiplash-type injuries from rapid acceleration-deceleration

    • Age-related changes such as cervical spondylosis or arthritis

    Typical Symptoms

    • Localized neck pain and stiffness

    • Reduced range of motion, especially with rotation or side bending

    • Muscle tightness or spasms in surrounding musculature

    • Headaches originating from the neck (cervicogenic headaches)

    • Numbness, tingling, or weakness in the upper extremities if nerve involvement is present

    Rehabilitation Phases

    Phase 1: Acute Phase

    • Focus on symptom reduction, gentle mobility, and protection of irritated structures

    Phase 2: Subacute Phase

    • Gradual restoration of motion, improved postural control, and initiation of cervical and upper quarter conditioning

    Phase 3: Strength & Stability Phase

    • Development of deep neck flexor and scapular stabilizer endurance to improve support for the cervical spine

    Phase 4: Functional Restoration Phase

    • Return to full daily, occupational, or athletic activity with proper movement patterns and tolerance to sustained positions

    Phase 5: Maintenance Phase

    • Long-term focus on postural awareness, flexibility, and strength to reduce recurrence risk

  • What is a Disc Herniation?

    A disc herniation occurs when the inner gel-like material of an intervertebral disc (nucleus pulposus) pushes through a weakened or torn outer layer (annulus fibrosus). This displacement can place pressure on nearby nerve roots or the spinal cord, leading to localized and/or radiating symptoms. Disc herniations can occur in the cervical, thoracic, or lumbar spine, with the lumbar region being most common.

    Common Causes

    • Repetitive bending, lifting, or twisting under load

    • Sudden heavy lifting or awkward movement

    • Age-related degeneration reducing disc hydration and elasticity

    • Traumatic injury to the spine

    • Prolonged postural strain increasing disc pressure

    Typical Symptoms

    • Localized spine pain at the level of the herniation

    • Radiating pain into the arm (cervical) or leg (lumbar), known as radiculopathy

    • Numbness, tingling, or weakness in the affected limb

    • Pain aggravated by sitting, bending, or coughing/sneezing

    • Reduced spinal range of motion and possible muscle spasms

    Rehabilitation Phases

    Phase 1: Acute Phase

    • Focus on pain reduction, protection of the injured disc, and maintaining gentle, symptom-free mobility

    Phase 2: Subacute Phase

    • Gradual restoration of spinal motion, improved postural alignment, and controlled reintroduction of activity

    Phase 3: Strength & Stability Phase

    • Development of core and spinal stabilizer endurance to reduce segmental stress

    Phase 4: Functional Restoration Phase

    • Progression toward full daily, work, or sport-specific activity with proper movement strategies

    Phase 5: Maintenance Phase

    • Long-term spine health through sustained strength, flexibility, and postural control to prevent recurrence

  • What is Golfer’s Elbow?

    Golfer’s elbow, medically known as medial epicondylitis, is an overuse injury involving the tendons that attach to the medial epicondyle of the humerus (the bony bump on the inside of the elbow). These tendons are part of the forearm’s flexor-pronator muscle group, which control wrist flexion and forearm pronation. Repetitive stress or excessive loading can cause microscopic tears, tendon degeneration, and inflammation in this region.

    Common Causes

    • Repetitive gripping, wrist flexion, or forearm pronation

    • Overuse from sports such as golf, baseball (pitching), tennis (topspin), and throwing events

    • Occupational activities requiring repeated tool use, typing, or lifting

    • Poor mechanics during sports or work tasks that overload the tendon

    Typical Symptoms

    • Pain and tenderness on the inside of the elbow, just below the medial epicondyle

    • Stiffness, especially in the morning or after periods of inactivity

    • Weakness in grip strength

    • Pain with wrist flexion, forearm pronation, or gripping activities

    • Discomfort that may radiate into the forearm or wrist

    Rehabilitation Phases

    Phase 1: Acute Phase

    • Focus on symptom reduction and protection of the irritated tendon while maintaining general arm mobility

    Phase 2: Subacute Phase

    • Gradual restoration of wrist and forearm range of motion, reduction of tendon irritability, and postural adjustments

    Phase 3: Strength & Stability Phase

    • Progressive loading of the flexor-pronator muscle group and forearm stabilizers to restore tendon capacity

    Phase 4: Functional Restoration Phase

    • Return to sport- or work-specific movements with proper mechanics and tolerance to repetitive loading

    Phase 5: Maintenance Phase

    • Ongoing tendon health through balanced strength, flexibility, and load management to prevent recurrence

  • What are Hip and Knee Replacements?

    Hip and knee replacements, also called total joint arthroplasty, are surgical procedures where damaged or worn-down joint surfaces are replaced with artificial components (prostheses). These procedures are typically performed when joint degeneration causes significant pain, stiffness, or loss of function, most often due to osteoarthritis, rheumatoid arthritis, or traumatic injury.

    • In a hip replacement, the damaged femoral head and acetabular socket are replaced with a prosthetic ball-and-socket system

    • In a knee replacement, the worn surfaces of the femur, tibia, and sometimes patella are resurfaced with metal and polyethylene implants to restore alignment and smooth motion

    Common Causes for Needing a Replacement

    • Progressive osteoarthritis causing cartilage loss and bone-on-bone contact

    • Rheumatoid arthritis or inflammatory joint disease

    • Post-traumatic arthritis after prior injury

    • Avascular necrosis (loss of blood supply to the joint)

    • Severe joint deformity or instability

    Typical Symptoms Before Surgery

    • Persistent joint pain and stiffness

    • Difficulty with walking, standing, or climbing stairs

    • Pain at rest and night pain interfering with sleep

    • Reduced range of motion and loss of independence in daily tasks

    Rehabilitation Phases

    Phase 1: Protection & Early Mobility

    • Focus on pain and swelling management, protection of the surgical site, and safe initiation of basic mobility

    Phase 2: Mobility & Strength Restoration

    • Gradual recovery of range of motion, activation of surrounding muscles, and improvement in functional independence

    Phase 3: Strength & Endurance Phase

    • Progressive strengthening of the hip or knee musculature, improving stability, walking tolerance, and endurance

    Phase 4: Functional Phase

    • Return to daily activities with improved efficiency and safety, working toward normalized gait and confidence in movement

    Phase 5: Maintenance & Long-Term Joint Health

    • Continued strengthening, flexibility, and lifestyle modifications to support the longevity of the prosthetic joint

  • What the Labrum Does

    The labrum is a ring of fibrocartilage that deepens the socket of a joint and provides both stability and shock absorption.

    • In the hip, the acetabular labrum surrounds the socket, creating a seal that maintains joint congruency and distributes load

    • In the shoulder, the glenoid labrum helps stabilize the ball-and-socket joint, providing an anchor point for ligaments and the long head of the biceps tendon

    When the labrum is torn, the joint can lose stability and efficiency. Surgical management may involve labral repair (suturing the torn tissue back in place) or reconstruction/debridement depending on the severity of damage.

    Common Causes

    • Repetitive overhead or rotational sports (e.g., baseball, tennis, swimming)

    • Pivoting and twisting motions in cutting sports (e.g., soccer, basketball, hockey)

    • Hip impingement (femoroacetabular impingement) or structural abnormalities

    • Traumatic dislocations or subluxations of the hip or shoulder

    • Degenerative changes from chronic overload or instability

    Typical Symptoms

    • Deep joint pain (groin pain for hip, shoulder pain for overhead activity)

    • Clicking, catching, or locking sensations within the joint

    • A feeling of instability or “giving way”

    • Loss of range of motion and strength

    • Pain worsened with twisting, pivoting, or overhead movements

    Rehabilitation Phases

    Phase 1: Protection Phase

    • Emphasis on pain and inflammation control, joint protection, and gradual reintroduction of gentle mobility within safe limits

    Phase 2: Mobility & Activation Phase

    • Restoration of controlled range of motion and early activation of stabilizing musculature (hip rotators, gluteals, rotator cuff, scapular stabilizers)

    Phase 3: Strength & Stability Phase

    • Progressive strengthening to restore dynamic joint stability, including surrounding musculature to offload the repaired labrum

    Phase 4: Functional Phase

    • Return to controlled functional movements such as squatting, pivoting, or overhead reaching with proper mechanics

    Phase 5: Return to Sport/Performance Phase

    • Sport or activity-specific training with emphasis on movement efficiency, joint stability, and recurrence prevention

  • What is a Joint Dislocation?

    A joint dislocation occurs when the bones forming a joint are forced out of their normal alignment. This results in a loss of congruency between the joint surfaces and can damage surrounding structures such as ligaments, tendons, cartilage, muscles, and neurovascular tissues. The shoulder is the most commonly dislocated joint, but dislocations can also occur in the hip, elbow, knee, ankle, and fingers.

    Common Causes

    • High-energy trauma such as falls, motor vehicle accidents, or direct blows

    • Sports injuries involving twisting, pivoting, or contact

    • Extreme range of motion forcing the joint beyond its normal limits

    • Underlying joint laxity or instability predisposing to recurrent dislocations

    Typical Symptoms

    • Visible deformity or abnormal positioning of the joint

    • Intense pain at the time of injury

    • Swelling, bruising, and loss of motion

    • Weakness or numbness if surrounding nerves are affected

    • A sense of instability or fear of movement after initial dislocation

    Rehabilitation Phases

    Phase 1: Protection Phase

    • Emphasis on pain and swelling control, joint protection, and safe reintroduction of mobility once the joint is stable

    Phase 2: Mobility & Activation Phase

    • Restoration of controlled motion within the joint’s safe range and activation of stabilizing musculature

    Phase 3: Strength & Stability Phase

    • Progressive strengthening of dynamic stabilizers (e.g., rotator cuff, scapular stabilizers, hip/gluteal muscles) to reduce risk of recurrence

    Phase 4: Functional Phase

    • Return to controlled movement patterns required for daily activities, work, or sport with focus on joint control

    Phase 5: Return to Sport/Performance Phase

    • Full restoration of high-level activity with emphasis on proper mechanics, power, and confidence to reduce re-injury risk

  • Function

    The collateral ligaments (MCL and LCL) and the posterior cruciate ligament (PCL) play crucial roles in stabilizing the knee.

    • The medial collateral ligament (MCL) resists valgus stress and helps stabilize the inside of the knee

    • The lateral collateral ligament (LCL) resists varus stress and stabilizes the outside of the knee

    • The posterior cruciate ligament (PCL) prevents the tibia from moving backward relative to the femur and provides central knee stability

    When injured or torn, these ligaments may require either primary repair (suturing the torn ends back together) or reconstruction (replacing the ligament with graft tissue). The type of procedure depends on injury severity, chronicity, and associated damage to other knee structures.

    Common Causes of Injury

    • Direct blows to the knee (common in contact sports)

    • Hyperextension or hyperflexion injuries

    • High-energy trauma, such as motor vehicle accidents

    • Rotational forces combined with varus or valgus stress

    • Combined ligament injuries involving the ACL or meniscus (Often called “Unhappy Triad”)

    Typical Symptoms

    • Localized pain and swelling along the injured ligament

    • Joint instability or “giving way” during activity

    • Difficulty with cutting, pivoting, or deceleration movements

    • Loss of motion and functional strength

    Rehabilitation Phases

    Phase 1: Acute/Protection Phase

    • Focus on pain and swelling control, graft/repair protection, and early gentle motion within safe limits

    Phase 2: Subacute Phase

    • Gradual restoration of range of motion, improved quadriceps and hip activation, and progressive weight-bearing as tolerated

    Phase 3: Strength & Stability Phase

    • Progressive strengthening of the quadriceps, hamstrings, and hip musculature; restoration of dynamic stability

    Phase 4: Functional Phase

    • Return to higher-level activities such as running, cutting, and pivoting under controlled conditions

    Phase 5: Return to Sport/Performance Phase

    • Full integration into sport-specific movements with restored strength, neuromuscular control, and confidence

  • What is a Muscle Strain?

    A muscle strain, or a “pulled muscle,” happens when the fibers of the muscle are stretched too far or torn. Strains can be mild, like just overstretching, or more severe, with partial or even complete tears. They’re most common in the hamstrings, quads, calves, and back, but they can happen anywhere.

    How it happens

    • Usually from a sudden burst of movement like sprinting, cutting, or jumping

    • Lifting something heavy with poor mechanics, overstretching

    • When a muscle is just too fatigued to handle the load

    What it feels like

    • Sharp pain right at the moment it happens

    • Swelling, bruising, or cramping in the muscle

    • Tender to touch

    • Weakness

    • Severe cases: small gap in the muscle where the fibers tore

    Rehabilitation Phases

    Phase 1: Protection & Recovery

    • Calm things down, control pain and swelling, and keep gentle movement so the muscle doesn’t stiffen up

    Phase 2: Mobility & Activation

    • Start to get normal range of motion back and re-engage the muscle in a safe way

    Phase 3: Strength & Endurance

    • Build strength gradually, focusing not just on the injured muscle but also the surrounding ones

    Phase 4: Functional Training

    • Progress to more dynamic and controlled movement patterns that mimic real-life activity or sport

    Phase 5: Return to Sport/Performance

    • Get back to explosive movements, sprinting, or sport-specific skills with confidence and reduced risk of re-injury

  • What is your Plantar Fascia?

    The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel bone to your toes. Its job is to help support your arch and absorb forces when you walk, run, or jump. When this tissue gets irritated or overloaded, it can become inflamed and painful.

    How it happens

    Plantar fasciitis often comes from repetitive stress to the foot — like running, standing for long periods, or walking on hard surfaces. It’s also more common if you have tight calves, flat feet, high arches, or if your footwear doesn’t give enough support.

    What it feels like

    You can have sharp heel pain with your first steps in the morning or after sitting for a while. It can ease up as you move, but usually comes back with prolonged activity. Over time, the pain can become more constant and interfere with daily movement.

    Rehabilitation Phases

    Phase 1: Calm It Down

    • Reduce irritation, manage pain, and address any swelling

    Phase 2: Restore Mobility

    • Improve flexibility in the foot and calf to reduce strain on the plantar fascia

    Phase 3: Strength & Support

    • Strengthen the small foot muscles and the calf to give better support to the arch

    Phase 4: Functional Training

    • Work on movement patterns like walking, running, or jumping in a controlled way

    Phase 5: Return to Activity

    • Safely get back to full activity or sport with confidence and reduced risk of recurrence

  • What is the Rotator Cuff?

    The rotator cuff is a group of four muscles and tendons that surround the shoulder joint. Their main job is to keep the ball of your upper arm bone (humerus) centered in the shoulder socket while also helping you lift and rotate your arm. A rotator cuff tear happens when one of these tendons is partially or completely torn.

    How it happens

    Tears can occur from a single traumatic event, like falling on an outstretched arm or lifting something heavy overhead, but they’re often the result of gradual wear and tear over time. Repetitive overhead activities, poor posture, and age-related changes in tendon quality all play a role.

    What it feels like

    • Pain with overhead reaching, lifting, or sleeping on the affected shoulder

    • Weakness or difficulty raising arm

    • Severe tears: there may be a significant loss of strength and function

    Rehabilitation Phases

    Phase 1: Calm It Down & Protect

    • Focus on reducing pain and irritation while protecting the injured tendon

    Phase 2: Mobility

    • Restore smooth, pain-free motion in the shoulder joint and surrounding tissues

    Phase 3: Strength & Control

    • Rebuild rotator cuff and scapular strength to improve stability and reduce compensations

    Phase 4: Functional Training

    • Progress into movements that match daily activities, work tasks, or sport-specific patterns

    Phase 5: Return to Performance

    • Get back to higher-level overhead use, lifting, or sport with confidence and full function

  • What is Sciatica?

    Sciatica refers to pain that travels along the path of the sciatic nerve, which runs from your lower back through your hips, glutes, and down the back of your leg. It’s not a diagnosis on its own, but rather a symptom of something irritating or compressing the nerve — most commonly a disc herniation, spinal stenosis, or tight muscles around the nerve.

    How it happens

    Anything that puts pressure or irritation on the sciatic nerve can trigger symptoms. That could be a disc pushing on the nerve root, narrowing of the spine from arthritis, or muscle tension (like in the piriformis).

    What it feels like

    • Sharp, burning, or shooting pain that radiates from the low back into the leg

    • Numbness, tingling, or weakness

    • Symptoms usually follow a predictable pattern down the leg depending on which part of the nerve is involved

    Rehabilitation Phases

    Phase 1: Calm It Down

    • Focus on reducing nerve irritation and controlling pain

    Phase 2: Restore Mobility

    • Work on safe motion in the spine and hips to take pressure off the nerve

    Phase 3: Strength & Stability

    • Strengthen the core, hips, and legs to support the spine and improve posture

    Phase 4: Functional Movement

    • Train movement patterns like bending, lifting, and walking in a controlled way

    Phase 5: Return to Activity

    • Gradually get back to higher-level activity, work demands, or sport with confidence and less risk of recurrence

  • What are Shin Splints?

    Shin splints, medically called medial tibial stress syndrome, are an overuse injury that affects the muscles, tendons, and bone tissue along the inner edge of the shin (tibia). They’re common in runners, dancers, and anyone who suddenly increases the intensity or volume of their training.

    How it happens

    Shin splints usually develop from repetitive stress on the shinbone and surrounding tissues. Contributing factors include sudden increases in activity, running on hard or uneven surfaces, non-ergonomic shoes or tight calves and weak supporting muscles.

    What it feels like

    • Pain along the inside of the shin that worsens with activity and may improve with rest

    • Mild swelling, tenderness to touch, or a dull ache that becomes sharper during exercise

    Rehabilitation Phases

    Phase 1: Calm It Dow

    • Reduce pain and irritation while temporarily adjusting activity to prevent further stress

    Phase 2: Restore Mobility

    • Improve flexibility in the calves, ankles, and foot muscles to reduce load on the tibia

    Phase 3: Strength & Support

    • Strengthen the calves, foot intrinsic muscles, and surrounding lower leg muscles to absorb impact better

    Phase 4: Functional Movement

    • Gradually return to running, jumping, or sport-specific movements with proper mechanics

    Phase 5: Return to Full Activity

    • Resume higher-level training or sport safely, with strategies to prevent recurrence

  • What Is Tendinitis and Tendinopathy?

    Tendinitis and tendinopathy are conditions that affect the tendons, the thick cords that connect muscles to bone.

    • Tendinitis refers to inflammation of a tendon, usually from acute overuse or sudden overload

    • Tendinopathy is chronic tendon damage or degeneration, which can develop over time from repetitive stress, poor mechanics, or age-related changes

    How it happens

    • Tendon issues often develop from repetitive movements, sudden increases in activity, or sustained stress on a tendon that exceeds its capacity to handle load

    • Common sites include the shoulder (rotator cuff), elbow (tennis or golfer’s elbow), knee (patellar tendon), ankle (Achilles tendon), and wrist

    What it feels like

    • Localized pain, tenderness, or swelling near the tendon

    • Pain may worsen with activity, sometimes improves with rest, and in chronic cases can persist even at rest

    • Weakness or difficulty performing normal movements may also occur

    Rehabilitation Phases

    Phase 1: Calm It Down

    • Reduce pain and irritation while protecting the tendon from further overload

    Phase 2: Restore Mobility

    • Improve flexibility in the tendon, surrounding muscles, and joints to reduce stress

    Phase 3: Strength & Capacity

    • Gradually strengthen the tendon and supporting muscles to handle load safely

    Phase 4: Functional Movement

    • Progress to movements that mimic work, sport, or daily activities

    Phase 5: Return to Activity

    • Safely return to higher-level or repetitive activity with proper mechanics to prevent recurrence

  • What is Tennis Elbow?

    Tennis elbow, medically called lateral epicondylitis, is an overuse injury affecting the tendons that attach to the outside of the elbow (lateral epicondyle). These tendons are part of the forearm extensor muscles, which help extend the wrist and fingers and stabilize the elbow during gripping activities.

    How it happens

    Tennis elbow often develops from repetitive gripping, lifting, or twisting motions. While it’s common in racquet sports, it can also occur with activities like typing, manual labor, or any task that repeatedly stresses the forearm extensors.

    What it feels like

    • Pain and tenderness on the outer elbow, often worsened with gripping, lifting, or twisting movements

    • Weakness in the wrist or hand

    • Difficulty with everyday activities like turning a doorknob or holding a cup

    Rehabilitation Phases

    Phase 1: Calm It Down

    • Reduce pain and irritation while avoiding activities that overload the tendon

    Phase 2: Restore Mobility

    • Improve flexibility in the forearm, wrist, and elbow to reduce tendon stress

    Phase 3: Strength & Support

    • Gradually strengthen the forearm extensors and surrounding muscles to handle load safely

    Phase 4: Functional Movement

    • Progress to movements that mimic sport, work, or daily activities without pain

    Phase 5: Return to Activity

    • Resume high-level or repetitive activities with proper mechanics and confidence

  • Most Common Wrist & Hand Injuries

    1. Wrist Sprains

    A wrist sprain happens when the ligaments supporting the wrist are stretched or torn, usually from a fall onto an outstretched hand or twisting injury.

    Symptoms:

    • Pain

    • Swelling

    • Bruising

    • Limited wrist motion

    Rehabilitation Phases:

    • Phase 1: Protect and reduce pain/swelling

    • Phase 2: Restore wrist mobility

    • Phase 3: Strengthen wrist and forearm muscles

    • Phase 4: Functional movement—lifting, pushing, or sport-specific tasks

    • Phase 5: Return to full activity safely

    2. Scaphoid or Other Wrist Fractures

    Fractures of the wrist bones (commonly the scaphoid) often result from a fall onto an outstretched hand.

    Symptoms:

    • Pain

    • Swelling

    • Tenderness

    • Difficulty gripping

    Rehabilitation Phases:

    • Phase 1: Immobilization and pain control

    • Phase 2: Gentle mobility exercises once cleared

    • Phase 3: Strengthen forearm and wrist muscles

    • Phase 4: Gradual return to functional use

    • Phase 5: Resume full activity with confidence

    3. Carpal Tunnel Syndrome

    Carpal tunnel occurs when the median nerve is compressed as it passes through the wrist, often from repetitive hand or wrist movements.

    Symptoms:

    • Numbness, tingling, or pain in the thumb, index, middle, and part of the ring finger, sometimes with weakness

    Rehabilitation Phases:

    • Phase 1: Reduce nerve irritation and manage symptoms

    • Phase 2: Restore wrist and finger mobility

    • Phase 3: Strengthen forearm and hand muscles, improve nerve glide

    • Phase 4: Functional hand use for work or sport

    • Phase 5: Full return to activity with proper ergonomics and mechanics

    4. De Quervain’s Tenosynovitis

    This is irritation of the tendons on the thumb side of the wrist, often from repetitive gripping or lifting.

    Symptoms:

    • Pain along the thumb and radial wrist, especially with pinching or twisting

    Rehabilitation Phases:

    • Phase 1: Reduce pain and tendon irritation

    • Phase 2: Improve thumb, wrist, and forearm mobility

    • Phase 3: Strengthen thumb and wrist muscles

    • Phase 4: Return to functional gripping and lifting

    • Phase 5: Resume full activity safely

    5. Finger Tendon Injuries

    These include flexor or extensor tendon injuries that affect the ability to bend or straighten fingers.

    Symptoms:

    • Pain

    • Swelling

    • Loss of finger motion

    • Weakness

    Rehabilitation Phases:

    • Phase 1: Protect the tendon and control pain/swelling

    • Phase 2: Gentle motion within safe limits

    • Phase 3: Strengthen finger, hand, and forearm muscles

    • Phase 4: Practice functional tasks—gripping, typing, or sport-specific movements

    • Phase 5: Return to full hand function safely