Conditions Treated


Patella tendinitis (sometimes referred to as “jumper’s knee”) is an overuse injury that affects the tendon connecting the kneecap to the shin bone.Patella tendinitis occurs when you place repeated stress on your patellar tendon, often when you suddenly increase the intensity or frequency of your workouts. Although patella tendinitis is most common in athletes whose sports involve frequent jumping (for instance, basketball, soccer, and volleyball players), anyone can suffer from this condition. Patella tendinitis may be accompanied by bursitis, which can result in pain when you move or put pressure on the area.


The symptom of patella tendinitis is pain between the kneecap (patella) and the area where the tendon attaches to the shin bone. The pain may:
• Feel sharp during activity and persist as a dull ache at rest
• Increase with intensity of activity
• Make going up and down stairs painful
• Become a constant ache that can make it difficult to sleep at

MSSPT’s approach to treating patella tendinitis

Your treatment at SSPT will focus on reducing the strain on your tendon and then gradually building up the tendon’s strength. Your treatment may include:
• Joint and soft tissue mobilization
• Modalities such as ultrasound electrical stimulation to help to
provide pain relief
• Therapeutic activities and exercises to stretch the inflexible
muscles, especially the quadriceps, that can contribute to the
strain on your patellar tendon
• Education on proper body mechanics to help you learn to better
distribute the force you exert during physical activity

If your knee pain occurs laterally (that is, on the outside edge of the knee), you may be suffering from iliotibial band, or ITB, syndrome. ITB syndrome occurs when the ligament that extends from the outside of the pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of the femur. Distance runners are especially susceptible to ITB syndrome, which generally causes a sharp, burning pain in the knee that often begins 10 to 15 minutes into a run. Initially, the pain goes away with rest, but in time it may persist when you walk or go up and down stairs.

Contributing factors

Contributing factors for ITB syndrome include:
• Pregnancy
• Biomechanical problems such as unequal leg length or weak
hip abductors
• Exercising on concrete surfaces or uneven ground
• Increasing the intensity or duration of exercise too quickly
• Wearing worn or ill-fitting shoes
• Excessive uphill or downhill running

MSSPT’s approach to treating ITB syndrome

Your SSPT physical therapy for ITB syndrome may include:
• Modalities such as ultrasound to help control the inflammation and assist healing
• Manual therapy techniques to increase the mobility in the tight structures
• Assessment and guidance about appropriate footwear
• Education about behaviors that reduce the stress on the knees
• Exercises to strengthen other muscles to alleviate continued stress on ITB

A wide variety of disorders result in knee disease that causes pain, limits  motion, and restricts a person’s ability to participate in daily activities. Manual physical therapy and knee replacement surgery can relieve pain and restore function. Physical therapy before surgery Studies have shown that patients with osteoarthritis of the knee who were treated with manual physical therapy and exercise experienced significant improvements in their perceptions of pain, stiffness, and functional ability. These studies also found that fewer patients in the treatment group required knee replacement surgery.

Knee replacement surgery

If you require knee replacement surgery, the primary goal of this surgery is to relieve pain. The primary goal of physical therapy following knee replacement surgery is to restore function.

MSSPT’s approach to therapy following knee replacement surgery

Joint replacement surgery requires that you take an active role in
your preoperative and postoperative care and rehabilitation.

Your SSPT physical therapy for knee replacement surgery may include:
• Gait training
• Modalities to help decrease swelling and pain
• Exercises to increase range of motion, strengthen muscles, and improve balance and circulation
• Education about behaviors that reduce the stress on the knees

The anterior cruciate ligament (ACL) has several functions in the knee. It prevents the lower leg from moving forward on the upper leg, it prevents hyperextension of the knee, it helps stabilize the knee in side-to-side movements, and it helps control the amount of rotation of the lower leg at the knee joint. A hard twist or excessive pressure on the ACL can tear it, causing the knee to give out so that it can no longer support the body. Injuries to the ACL occur frequently in sports that involve sudden changes in direction, such
as soccer, basketball, and volleyball Unless an injured ACL is accurately diagnosed and treated, the cushioning cartilage in the knee could be seriously damaged. Without this cushion, the thighbone and the shinbone would rub against each other, leading to further damage.

MSSPT’s approach to treating ACL injuries

The goals of therapy for ACL injuries are to decrease pain and swelling, increase range of motion and strength, and return to normal function.

Your SSPT therapy for ACL injuries may include:

• Modalities such as ultrasound to help control the
inflammation and assist healing
• Manual therapy techniques to increase the mobility in the
tight structures
• Exercises to improve balance and coordination
• Education about behaviors that reduce the stress on the
knees, including proper landing techniques

If you have an existing condition, please contact our clinic to book an appointment

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Hip and Thigh Conditions     

The “hamstring” is actually a group of three muscles that work with the
quadriceps to straighten (extend) the leg at the hip and bend (flex) the leg at
the knee. The quadriceps muscles are usually much more powerful than the
hamstring muscles. As a consequence, the hamstring may become fatigued
faster than the quadriceps, leading to a hamstring strain. Hamstring strains usually cause acute pain and occur during strenuous activity; however, they can develop over days or weeks. Like calf strains, hamstring strains often take a long time to recover and the rate of recurrence is high. But the long-term outcome after a hamstring strain injury is usually excellent and complications are few.

Risk factors

Hamstring injuries are easier to prevent than to cure. Factors that increase
the risk of calf and hamstring strains include:
• Previous hamstring injury
• Increasing age
• Sudden change in direction acceleration or deceleration
• Poor strength and flexibility
• Calf or hamstring muscle fatigue
• Muscle strength imbalance between the quadriceps and
• Inappropriate or inadequate warm-up

MSSPT’s approach to treating a hamstring strain

The treatment of a hamstring strain depends on the severity of the injury.
When physical therapy is initiated, treatment for your hamstring strain may
• Modalities such as electrical stimulation, ice, or ultrasound to help
reduce pain
• Gait analysis and instruction in proper biomechanics
• Joint and soft tissue mobilization
• Therapeutic exercises to restore flexibility and strength

A wide variety of disorders result in hip disease that causes pain, limits motion, and restricts a person’s ability to participate in daily activities. Manual physical therapy and hip replacement surgery can relieve pain and restore function.

Hip replacement surgery

If you require hip replacement surgery, the primary goal of this surgery is to relieve pain. The primary goal of physical therapy following hip replacement surgery is to restore function.

MSSPT’s approach to therapy following hip replacement surgery

Joint replacement surgery requires that you take an active role in your preoperative and postoperative care and rehabilitation.

Your SSPT physical therapy for hip replacement surgery may include:
• Assistive devices to limit pain while walking
• Modalities to help decrease swelling and pain
• Exercises to increase range of motion, strengthen
muscles, and improve balance and circulation
• Education about behaviors that reduce the stress on the

Shoulder Conditions      

The rotator cuff muscles are responsible for raising, lowering, and rotating
the shoulder. Rotator cuff muscles and tendons can tear as a result of trauma,
activities involving repeated overhead motion, or weakness and degeneration
associated with aging. Most rotator cuff tears produce no symptoms, but
some can lead to major pain and disability requiring treatment.

Common symptoms

Symptoms of rotator cuff tears include:
• Pain that increases with movement such as reaching overhead or lifting
• Deep ache at night that makes the shoulder painful to lie on
• Loss of strength
• Atrophy
• Decreased range of motion when reaching behind the back or across the body
• Complete inability to even hold arm up

MSSPT’s approach to treating rotator cuff tears

Therapy can help relieve pain and restore function whether your rotator cuff
injury requires surgery or not.

Your SSPT therapy for a rotator cuff tear may include:
• Modalities such as ultrasound, electrical stimulation, or iontophoresis
• Joint and soft tissue mobilization
• Exercises to help improve posture and stretch and strengthen muscles
• Education about body mechanics and proper posture to alleviate stress on the rotator cuff muscles

Shoulder tendinitis is inflammation of the rotator cuff and/or biceps tendon. It is generally a result of the wearing process, overuse activities, degenerative disease, poor posture, or acute injury. Shoulder tendinitis may be accompanied by bursitis, which can cause pain when you move or put pressure on the area.

Signs and symptoms

Signs and symptoms of shoulder tendinitis include:
• Pain in shoulder that is present both with activity and
with rest
• Pain with overhead activities
• Swelling in the front of the shoulder
• Decreased range of motion in the shoulder
• Loss of strength in the shoulder

MSSPT’s approach to treating shoulder tendinitis

Your SSPT therapy for shoulder tendinitis may include:
• Modalities such as electrical stimulation, ultrasound, ice, heat, and iontophoresis
• Joint and soft tissue mobilization
• Exercises to correct posture and regain strength and motion in the shoulder joint
• Education about ways to modify posture and behavior to limit further trauma to the shoulder, as well as the importance of stretching and warming up before activity

People with a “frozen shoulder” experience pain, stiffness, and severely restricted movement of the shoulder. This condition is frequently caused by an injury in which pain leads to lack of use. Rheumatic disease progression and recent shoulder surgery can also cause frozen shoulder.

Contributing factors

Medical conditions and other factors that may increase the risk of frozen shoulder include:
• Diabetes
• Hypothyroidism or hyperthyroidism
• Parkinson’s disease
• Cardiac disease or surgery
• Previous shoulder injury or condition for which the shoulder was immobilized for a period of time

MSSPT’s approach to treating frozen shoulder

Your SSPT therapy for a frozen shoulder may include:
• Modalities such as ultrasound, electrical stimulation, or iontophoresis
• Joint and soft tissue mobilization
• Exercises to increase range of motion, stretch tight muscles, and strengthen weak muscles
• Education about body mechanics

Shoulder dislocation can occur if the shoulder joint moves or is forced out of its normal position. Problems associated with a dislocated shoulder include tearing of the ligaments or tendons that reinforce the joint capsule.

Common signs and symptoms

You may have a dislocated shoulder if your shoulder is:
• Visibly deformed or out of place
• Swollen or discolored (bruised)
• Intensely painful
• Immovable

Shoulder dislocation may also cause numbness, weakness, or tingling near the injury, such as in your neck or down your arm.

MSSPT’s approach to treating dislocated shoulders

Your SSPT therapy for a dislocated shoulder may include:
• Modalities such as ultrasound, electrical stimulation, or iontophoresis
• Joint and soft tissue mobilization
• Exercises that focus on increasing range of motion and strengthening weak muscles to help prevent repeat dislocations
• Education about body mechanics

Ankle Conditions      

Plantar fasciitis is an irritation of the plantar fascia—a thick band of tissue
that starts at your heel bone, runs along the sole of your foot, and then fans
out to the base of your toes that supports the inner arch of your foot. Plantar
fasciitis is most often the result of mechanical overload and excessive strain
that repetitively impacts the plantar fascia, causing tears within the tissue,
inflammation, and/or degenerative tissue changes.


Plantar fasciitis is characterized by an insidious, gradual onset of pain in the
heel. In the acute phases, the pain is worse in the morning or after periods of
bearing no weight. Pain diminishes with activity. Some people experience
aching after long periods of activity. As the condition becomes more severe,
the symptoms may increase and be present when bearing weight, and the
pain may worsen with activity.

Risk factors
Factors that may predispose you to plantar fasciitis include:
• Obesity
• Walking barefoot, or wearing shoes that are improperly fitted and lack well-supported arches and midsoles
• Limited ankle dorsiflexion (flexing your foot so that your toes move toward your shin)
• Tight Achilles’ tendon
• A pes planus (low arch) or pes cavus (high arch) foot type
• Weak plantar flexor muscles (the muscles that work to point your foot) or weak intrinsic foot muscles (the muscles within the foot that work to move the toes and support the arches)

MSSPT’s approach to treating plantar fasciitis

Treatment takes into account how the mechanics above and below the area
of plantar fasciitis pain may influence or contribute to the pain, and may
• Exercises that increase the strength and flexibility of the foot and ankle muscles
• Modalities such as ultrasound or iontophoresis to help decrease
inflammation and pain
• Night splints to help gently stretch the Achilles’ tendon
• Custom foot orthotics
• Joint mobilization and soft tissue release
• Education about proper stretching techniques and activities to avoid
• Video gait analysis

A broken, or fractured, ankle is a common ankle condition that results when excessive stress, twisting, or trauma is placed on the ankle joint. Your ankle joint is made up of three bones: the shinbone (tibia), the lower leg bone (fibula), and the ankle bone (talus). One or more of these bones can break during a fall or blow to your ankle. However, the most common type of broken ankle is a fracture in one of the knobby bumps (each called a malleolus) at the lower ends of the tibia and fibula. These bones help support the joint where your ankle bone connects to your heel bone, which allows your foot to rock from side to side. They’re often injured when your ankle rolls inward or outward.

Risk factors

Risk factors include:
• Obesity
• Participation in high-impact sports
• Use of faulty sports equipment or improper techniques
• Occupations that put you at risk of falling from a height
• Home environments that are cluttered or poorly lit
• Certain conditions such as osteoporosis or neuropathy

MSSPT’s approach to treating ankle fractures

MSSPT believes that any foot or ankle injury requires medical attention.
Prompt realignment and treatment of any ankle or foot fracture is key to complete healing.

Your physical therapy for an ankle fracture may include:

• Modalities such as ultrasound or electrical stimulation
• Exercises to stretch, strengthen, and restore range of motion
• Education about behaviors that reduce the stress on your joints

A sprained ankle results when the ligaments that connect the bones of the
foot are stretched beyond their normal limits, causing fibers and small blood
vessels to tear. Sprained ankles can occur in the heat of a game or even from
a simple misstep while walking. Without proper strengthening exercises and
rehabilitation, the ankle joint may remain unstable following a sprain.

Risk factors

Although anyone can sprain an ankle, certain factors increase the risk:
• Previous ankle injuries and resulting instability
• Weak lower leg muscles
• Lack of, or extreme, flexibility in the ankle joint
• Incorrectly fitted shoes
• Inadequate warm-up
• Poor balance
• Excessive stress caused by obesity or abrupt change in direction
• Inherited flaws in joint design
• Increasing age

MSSPT’s approach to treating ankle sprains

The goals of physical therapy for ankle sprains are to decrease pain and
swelling, increase range of motion, increase strength, and return you to
normal function.

Depending on the severity of the sprain, your physical therapy may include:
• Modalities such as ultrasound or electrical stimulation
• Brace or taping to provide support
• Exercises to restore stability, strength, and balance

Our therapists also educate patients in ways to prevent future ankle sprains,
such as wearing appropriate footwear, avoiding activities on slippery or
uneven surfaces, warming up adequately, and keeping leg muscles strong.

Hand Conditions      

Boutonniere deformities often are the result of an injury such as
jamming your finger, but they also may be from inflammatory
disorders such as rheumatoid arthritis. The term “boutonniere”
refers to the position the finger rests in after it is injured—that is,
bent down at the middle joint and extending upward at the end
joint of the finger.

MSSPT’s approach to treating Boutonniere injuries
Proper and timely therapy can often prevent the need for surgical
repair of the injured tendons. Your treatment may include:
• Custom splinting to extend the middle joint and flex the end joint
• Edema management techniques
• Guidance on appropriate range of motion techniques
• Therapeutic modalities to decrease pain and inflammation

Along the paths that nerves follow are anatomic areas of narrowing. When a nerve compresses for an extended period as it passes underneath or through one of these narrow regions, it can become agitated and inflamed. Unless steps are taken to relieve the pressure being exerted upon it, the nerve can begin to die. In carpal tunnel syndrome (CTS), the median nerve compresses within the carpal tunnel, the space at the base of the wrist formed by eight carpal bones and a ligament. Highly repetitive hand or finger movements—and sometimes systemic or hormonal factors—can cause this condition.

Signs and symptoms

Carpal tunnel syndrome has distinctive signs and symptoms that include:
• Numbness and tingling in the hand or fingers
• Night pain
• Decreased sensation in the thumb, index, and middle finger
• Reduced dexterity of the hand or fingers
• A feeling of swollen fingers
• Reduced grip strength

MSSPT’s approach to treating CTS

SSPT’s treatments for carpal tunnel syndrome focus on relieving pressure on the median nerve as it passes through the carpal tunnel in your wrist.

Your treatment may include:
• Modalities such a hot and cold treatments and ultrasound to help reduce swelling and relieve symptoms
• Custom splints to immobilize the wrist and help relieve discomfort
• Therapeutic gliding exercises to relieve pressure on the median nerve, help loosen and stretch the carpal ligaments, and encourage blood flow
• Education on activity modification

Cubital tunnel syndrome occurs when the ulnar nerve in the elbow region becomes compressed or entrapped. It is the second most common nerve entrapment in the upper extremity. Although this condition may arise following local trauma, it is most often spontaneous and the largest contributing factor is elbow position during sleep. The problem may also occur when you stretch the nerve or perform repetitive activities that involve reaching overhead or bending your elbow.

Symptoms of cubital tunnel syndrome include:
• Pain in the elbow which may radiate down the arm
• Night pain
• Numbness in the arm extending to the small and ring fingers
• Weakness of the small muscles in the hand

MSSPT’s approach to treating cubital tunnel syndrome
SSPT’s treatments for cubital tunnel syndrome focus on relieving pressure and irritation to the ulnar nerve at the medial epicondyle of the elbow.

Your treatment may include:
• Custom splints that allow cushioning over the nerve and prevent maximal elbow flexion
• Education on activity modification and body mechanics
• Therapeutic modalities to relieve inflammation and pain
• Therapeutic exercises that assist the nerve to glide normally

DeQuervain’s tenosynovitis causes pain in the wrist, forearm, and thumb and is a result of irritation of the tendons that move the thumb sideways away from the palm. Pain is worsened with particular positions and movements of the wrist.

SSPT’s approach to treating DeQuervain’s tenosynovitis

SSPT’s treatment for DeQuervain’s tenosynovitis focuses on decreasing the irritation to the tendons that move the thumb sideways from the wrist.

Your treatment may include:
• Custom splints which supports both the wrist and thumb
• Education on activity modification and body mechanics
• Therapeutic modalities to relieve inflammation and pain
• Therapeutic exercises to regain function once inflammation subsides

Spinal Conditions       

Back pain is the body’s natural response to injury or degenerative conditions of the spine. It is a common condition that affects 8 out of 10 people during their lives.1 Most back pain resolves over time; however, fifty percent
of people will experience a recurrence of their back pain during their lifetime. Fortunately, research has shown that early education about your condition and conservative treatment can help reduce your pain and risk of recurrence.

Acute pain vs. chronic pain

Acute back pain is commonly described as sharp and severe, but it may also be characterized by a dull ache. The pain tends to come on suddenly but improves with time and conservative treatment. Acute back pain may be accompanied by nerve symptoms that cause pain in one or both legs. Chronic back pain describes pain that lingers more than three months. Chronic pain is commonly described as a deep, aching, dull or burning pain and may be accompanied
by numbness, tingling, and/or weakness that extends into the extremities.

Symptoms are persistent and psychosocial factors become more important and must be addressed.

Common causes of back pain

Back pain is most commonly caused by the muscles, ligaments, and joints (such as the facets and/or the disk joint) in your back. The pain may be most severe immediately after injury, or it may worsen gradually over a
few hours. Overstretched muscles (strains) or ligaments (sprains), and irritation of the joints that cause back pain, may be the result of activities such as improper lifting and bending, sports injury or fall, sleeping position, poor sitting or standing posture, and reaching forward. People who suffer from back problems may also be experiencing mechanical pain. In these instances, a specific part of their spine, such as an intervertebral disk, a ligament, or a joint, is irritated or damaged and is not working correctly. Spinal causes of mechanical back pain include herniated disk, arthritis, and spinal stenosis.
During pregnancy, the hormone relaxin is produced. This hormone can cause the joints in the lumbar spine and the sacral/iliac joint to become hypermobile and predispose women to lower back pain. Stress and muscle tension can
also cause or excaberate back pain during pregnancy.

Risk factors
Certain factors can increase a person’s risk of having back pain. These factors include increasing age, poor physical fitness, excess weight, diabetes, poor posture, and improper body mechanics.

MSSPT’s approach to treating back pain

Physical therapy treatment can provide relief for people suffering from both acute and chronic back pain. Our therapists assess the cause and type of pain in order to determine the most effective treatment for you.
Pain that is the result of strains and sprains will usually resolve with a conservative course of treatment within two to six weeks (provided there are no serious underlying medical conditions). If you experience chronic pain, it may be difficult to completely eradicate the pain; however, you can learn to manage and control your pain.

Your therapy for back pain may include:
• Education about your condition
• Advice about early activity
• Joint and soft tissue mobilization
• Stabilization and stretching exercises
• Trigger point dry needling
• Manual traction
• Ergonomic and posture body mechanics advice
• Electric nerve stimulation (or TENS)
• Ultrasound

Overuse, such as too many hours hunched over a desk or a steering wheel, often triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Even minor activities such as reading in bed or gritting your teeth can strain neck muscles.

Signs and symptoms

Symptoms of cervical strain may include:
• Muscle discomfort in the neck, upper back, or shoulders
• Difficulty turn or bending neck
• Pain that travels down into the shoulder or arm
• Numbness or tingling in the arm, hand, or fingers
• Muscle weakness in arm and decreased grip strength
• Headaches

MSSPT’s approach to treating cervical strain

Your SSPT therapy for cervical strain may include:
• Modalities such as ultrasound, electrical stimulation, and heat or ice packs to help increase neck mobility and decrease inflammation, muscle spasm and pain
• Joint and soft tissue mobilization
• Exercises to help improve posture, stretch tight muscles, and strengthen weak muscles
• Education about body mechanics to minimize strain on the neck and prevent future occurrences

Headaches are often caused by disorders of the neck or physical and emotional tension. Studies show that cervical headaches account for between 15% and 20% of all chronic and recurrent headaches. Cervical headaches may stem from abnormal mobility of the upper cervical joint, the upper back joint (or thoracic 4th vertebra), or the temporomandibular (or jaw) joint.
Cervical headaches are the most common persistent symptom following neck trauma; poor sitting posture and stress are also often associated with headaches of cervical origin.

MSSPT’s approach to treating headache

The successful management of headaches relies on an accurate diagnosis of their origin. At SSPT, our therapists evaluate your symptoms and look for patterns that indicate the cause of your headache.

Your SSPT therapy may include:
• Manual therapy to increase joint range of motion and cervical and thoracic mobility, decrease muscle tightness, and release musculoskeletal trigger points to restore pain-free cervical mobility
• Modalities such as ultrasound, electrotherapy, and heat treatment
• Instruction in relaxation techniques
• Education about posture and movement to restore neutral joint and muscle position at rest and to facilitate pain-free and stress-free movement patterns
• Self-management activities designed to help you maintain normal, pain-free mobility and function

The vertebrae of the spinal column are separated by disks made of cartilage. The inner portion of each disk is soft, enabling the disk to act as a shock absorber to cushion the surrounding vertebrae during movement. Injury or wear and tear with age can cause disks to degenerate and allow
the soft inner portion of the disk to rupture through the outer layer. Pain results when this ruptured portion compresses or irritates a nerve root.

Risk factors 

Factors that increase the risk of causing a herniated disk include:
• Improper lifting
• Smoking
• Obesity
• Repetitive strenuous activities
• Weak spinal support structures

Common symptoms

Symptoms of herniated disks, which may be intermittent or constant and long-lasting, include:
• Pain that radiates down one leg or arm
• Leg weakness and difficulty lifting the front part of the foot
• Loss of bowel or bladder control
• Numbness or tingling in one leg or arm

MSSPT’s approach to treating herniated disks

Therapy can help relieve pain and restore function whether your herniated disk injury requires surgery or not.

Your SSPT therapy for a herniated disk may include:
• Modalities such as electrical stimulation, ultrasound, traction, or iontophoresis
• Joint and soft tissue mobilization
• Bracing
• Ice or heat
• Exercises to help improve posture, strengthen muscles, increase flexibility, and help with weight loss
• Education about proper posture and lifting techniques

The neck contains bones, joints, tendons, ligaments, muscles, and nerves. Because the neck is so mobile and less protected than the rest of the spine, it is vulnerable to injury and disorders that produce pain and restrict motion. Neck pain, when experienced, may originate from any of the structures in the neck. It may also come from or cause pain in areas near the neck, such as the
shoulder, jaw, head, and upper arms.

Neck pain causes 

Neck pain has various causes, including the following:
• A disk bulge or herniation may cause muscle spasms and guarding, as well as joint stiffness that may be accompanied by pain, numbness, tingling, and muscle weakness down the arm.
• An acute locking of a facet join, for example waking with with a stiff neck, can cause neck pain.
• A motor vehicle, sports, or occupational accident may result in whiplash, where the muscles spasm and guard the joints and may be accompanied by nerve irritability from the inflammation of the joint.
• Poor posture can cause muscle strain or tension resulting in neck pain.
• Diseases such as arthritis or degeneration of the cervical disks can lead to neck pain and stiffness.

MSSPT’s approach to treating neck pain
The goal of therapy for neck conditions is to decrease pain and improve function.

Your SSPT therapy may include:
• Education about posture and body mechanics
• Joint and soft tissue mobilization
• Cervical traction to relax muscles and decrease pressure on the nerve roots
• Exercises to help improve posture, stretch tight muscles, and strengthen weak muscles
• Trigger point dry needling to help relieve pain and facilitate healing
• Cervical collar to help initially quiet the inflammation and muscle spasms
• Ultrasound
• Electrical stimulation

Spinal stenosis is a condition in which the spinal column or the openings where spinal nerves leave the spinal column become narrowed. This narrowing can put pressure on the spinal cord or spinal nerves (at the level where the compression is occurring). Spinal stenosis is commonly
caused by age-related changes in the spine. As a person ages, the disks in the spine become drier and start to shrink; at the same time, the bones and ligaments of the spine swell or grow larger due to arthritis or long-term swelling (inflammation). Spinal stenosis is more common in the
lumbar spine, but it can also occur in the cervical spine.

Signs and symptoms

The signs and symptoms of spinal stenosis depend on which nerves are affected.

Spinal stenosis can cause:
• Pain or numbness in the legs, back, neck, shoulders, or arms
• Limb weakness and a lack of coordination
• Loss of sensation in the extremities
• Problems with bladder or bowel function

Pain is not always present, particularly if you have spinal stenosis in your cervical spine (neck). Symptoms are more likely to be present or get worse when you stand or walk (as these movement cause the spine to extend). They will often lessen or disappear when you sit down or lean forward (as positions place the spine in a flexed position). Frequently, symptoms will be on one side
of the body or the other, and will often worsen over time.

Risk factors
Factors that increase the risk of spinal stenosis include:
• Arthritis of the spine, usually in middle-aged or elderly people
• Bone diseases (for example, Paget’s disease of bone and achondroplasia)
• Herniated or slipped disk, which may have happened in the past
• Injury that causes pressure on the nerve roots or the spinal cord

MSSPT’s approach to treating spinal stenosis

Your MSSPT therapy for spinal stenosis may include:
• Manual “hands-on” lumbar and cervical joint traction
• Lumbar and cervical or thoracic joint mobilization
• Soft tissue mobilization
• Core stability exercises
• Functional posture training and education
• Stretching and exercise programs

Spondylolysis is a stress fracture in one of the spine’s vertebrae. If the stress fracture weakens the bone so much that it cannot maintain its proper position, the vertebra can start to shift out of place. This condition is called
spondylolisthesis. If too much slippage occurs, the bones may begin to press on nerves and surgery may be necessary to correct the condition.

Signs and symptoms
Spondylolisthesis often has no obvious symptoms. When symptoms are present, they may include:
• Pain that spreads across the lower back, feeling like a muscle strain
• Spasms that stiffen the back and tighten the hamstring muscles, resulting in changes to posture and gait

Risk factors

Factors that increase the risk of spondylolisthesis include:

• Genetics (many people are born with the condition)
• Activities that put stress on the bones in the lower back and require overstretching the spine (for example, gymnastics, weight lifting, and football)
• Degenerative diseases such as arthritis

MSSPT’s approach to treating spondylolisthesis

Your MSSPT therapy for spondylolisthesis may include:
• Proper bracing to reduce stress on affected structures
• Modalities such as ultrasound, electric stimulation and heat to reduce pain and muscle spasms
• Exercises to strengthen the abdominal and back muscles
• Education about avoiding activities that do not place your lower back at risk for injury

Elbow Conditions       

Lateral epicondylitis (often referred to as “tennis elbow”), is an inflammation of one or more of the tissues (tendons, ligaments, or nerves) in the lateral (outer) side of the elbow and forearm. This condition occurs when the hand and wrist extensor muscles are overused and causes tenderness, pain, and swelling in the elbow and forearm. Lateral epicondylitis is one of several overuse injuries that can affect your elbow, may develop for no obvious reason, and can be caused by activities other than tennis where unaccustomed
strenuous activity involves the arm and hand. The pain of lateral epicondylitis occurs primarily where the tendons of your forearm muscles attach to the bony prominence on the outside of your elbow (lateral epicondyle). Pain can also spread into your forearm and wrist. Pain is worse with activities that include gripping and bending the wrist upward. This condition is similar to golfer’s elbow, but golfer’s elbow occurs on the inside rather than on the outside of your elbow.

The symptoms of tennis elbow include:
• Severe, burning pain radiating from outside of your elbow to your forearm and wrist
• Pain when you extend your wrist or touch or bump the outside of your elbow, gradually worsening over weeks or months
• Discomfort from lifting even very light objects
• A weak or painful grip during certain activities, such as turning a doorknob

MSSPT’s approach to treating tennis elbow

SSPT’s approach to treating tennis elbow focuses on minimizing
inflammation and irritation to the involved tendon. Your treatment may include:
• Custom splinting of the wrist
• Counter-force brace to decrease forceful motions of the forearm muscles
• Education on activity modification and body mechanics
• Therapeutic modalities to relieve inflammation and pain
• Therapeutic techniques to minimize scar formation
• Exercises to gradually strengthen and recondition the involved muscles

When golf pros assess a person’s golf swing, they focus on the movement of the club. When a therapist assesses a patient who plays golf, the therapist focuses on body motion through the swing rather than the club. This enables therapists to evaluate the biomechanics of the golf swing and pinpoint a problem in the swing that may lead to injuries such as golfer’s elbow.
Golfer’s elbow (medial epicondylitis) is pain and inflammation on
the inner side of the elbow. Golfer’s elbow is similar to tennis elbow except that it occurs on the inside, not the outside, of the elbow. Anyone who repeatedly uses the wrists or clenches the fingers can develop golfer’s elbow.

MSSPT’s approach to treating golfer’s elbow
The sooner you begin treatment for golfer’s elbow, the sooner you’ll be able to return to your usual activities. Rest is often advised until the pain in gone. Depending on the severity of your condition, the pain may linger for several months, even if you take it easy and follow instructions to exercise your arm. Sometimes the pain returns or becomes chronic.
While you’re recovering, remember to rest! Sneaking in a round of
golf before your elbow heals won’t help you feel better—it will only prolong your recovery.

Your treatment for golfer’s elbow at SSPT may include:
• Joint and soft tissue mobilization
• Modalities such as electrical stimulation, ice, or ultrasound to help reduce pain
• Therapeutic exercises to stretch and strengthen the elbow
• A progression of activities to gradually ease you back to your daily routine
• A review of your golf swing
• Education on proper body mechanics to avoid future injury

A sore elbow is very common in baseball. The actions involved in pitching a ball generate large forces during the acceleration phase of the throw, increasing the risk of injury to muscle and bone. In young players, repeated throwing can also cause elbow injuries that can damage the growth plate

Causes of Little Leaguer’s elbow 

Little Leaguer’s elbow results from a number of factors. A child’s growth plate is the weakest link— three to five times weaker than ligament and tendon. At the elbow, cocking and acceleration phases associated with pitching cause a stretching stress across theinside of the elbow. This stretch stress can cause an avulsion fracture at the medial epicondyle growth plate.

Signs and symptoms of Little Leaguer’s elbow

Signs and symptoms of Little Leaguer’s elbow may include:
• Pain
• Swelling
• Audible “pop” or “giving way” of the joint
• Inability to straighten the elbow
• Tenderness inside the elbow

MSSPT’s approach to treating Little Leaguer’s elbow

SSPT’s approach to treating Little Leaguer’s elbow involves these
• Immediate rest and avoidance of throwing for 4 to 12 weeks
• Immobilization for 2 to 3 weeks
• Rehabilitation to increase the elbow’s range of motion
• Strengthening exercises for throwing muscles
• Surgery if needed for avulsion or fracture

If you have an existing condition, please contact our clinic to meet our physiotherapists.

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