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American Physical Therapy Association
American Society Of Hand Therapists
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Explanation of Various Injuries and Their Treatment |
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Knee Arthritis This type of arthritis is caused by the wear and tear on the cartilage that is found inside the knee joint. Elderly individuals are more prone to the effects of knee arthritis which include pain with changing weather conditions, limits in the range of knee motion, stiffness of the knee joint, and swelling. Ligament Damage Damage to the anterior cruciate ligament (ACL) can be another source of knee pain. The ACL serves the purpose of preventing the tibia from sliding past acceptable ranges. ACL damage causes the knee to become unable to support the weight of an individual during certain motions and as a result, collapses and falls can occur. The posterior cruciate ligament (PCL) keeps the tibia from moving to far in the backward direction. Car crashes can be a common cause of PCL injuries as the knee impacts with the dashboard. Medical collateral ligaments (MCL) run from the end of the femur to the tibia and are subject to damage that can cause knee pain. Cartilage Weight is distributed onto the various parts of the knee via the medial tibia plateau and the lateral tibia plateau which are composed of cartilage. These can be torn when the knee joint is flexed and there is an awkward twist of the knee. These injuries occur to athletes and to the elderly more than the average person. Treatment Knee injuries can be treated with steroids such as cortisone or by non-steroidal anti-inflammatory medications that serve to inhibit the body's production of prostaglandins which are responsible for swelling. These drugs can be taken by mouth, systemically, or injected. Most non-steroidal treatments are available without the need for prescription. Hot and cold compresses can be used to reduce swelling of the knee and improve blood flow that can help to expedite the healing process. Stretching can help to prevent knee injuries from occurring as well as treat existing injuries by improving the range of motion of the healing tissue. Doctors recommend stretching for 20 minutes prior to physical activity and advise individuals to hold their stretches, rather than bouncing, which can, in itself, cause damage.
The rotator cuff is comprised of four muscles that are assigned the task of helping to stabilize the shoulder, as well as move the arm during rotation and elevation. The four muscles that make up the rotator cuff are the supraspinatus, infraspinatus, teres minor, and the subscapularis. How the Muscles Work The supraspinatus is found inserted into the tuberosity of the humerus and serves the purpose of elevating the shoulder joint. The infraspinatus is used during the rotation of the shoulder joint while the teres minor assists in this motion. The subscapularus is inserted into the lesser tuberosity of the humerus and assists with the elevating motion of the arm. Injury Injuries can often occur to the rotator cuff, requiring surgery. The rotator cuff may then need physical therapy in order to recover full range of motion. Many times, baseball pitchers will suffer rotator cuff injuries because of the stress placed on their throwing arm. These injuries are usually prompted by excessive shoulder use over extended periods of time and strike younger people less frequently than the elderly. Treatment Most rotator cuff injuries do not require surgery. They can be treated with exercises designed to strengthen the rotator cuff muscles, anti-inflammatory medicines, and cortisone injections. When surgery is required, there are various methods that allow doctors to clean out the damaged area and in some instances a small camera is inserted to give the surgeon a better view of the area being treated. Therapy Physical therapists will help patients with rotator cuff injuries by walking them through stretching exercises designed to expedite the healing process, alleviate pain, and improve range of motion. Proprioceptive strengthening can help patients develop a sense of stability within their shoulder. Ultrasound devices can be used to transmit high frequency waves that penetrate deep into muscles to improve blood flow in the affected area which helps to increase healing. Cold and hot compresses can be used to stimulate blood flow and curb the effects of swelling. These therapeutic measures can be combined or used separately in order to help patients recover from their rotator cuff injury. Carpal Tunnel Syndrome Carpal tunnel syndrome is caused by the compressing of the median nerve that is found in the wrist. This pressure causes wrist and hand pain. The median nerve is responsible for the impulses that control the hand and fingers as it travels down the arm into the hand from the spine. The transversal carpal ligament forms the covering that protects the median nerve. When this nerve becomes pinched, there is pressure that builds up that causes pain. Symptoms Those suffering from carpal tunnel syndrome might have sensations of tingling, pain and even numbness in their fingers. Pain usually appears during the evening hours and can usually be relieved by shaking the hand. Doctors generally diagnose carpal tunnel by using two tests. The Tinel test is performed by a physician tapping the median nerve while observing the reaction of the patient. If this tapping causes pain or discomfort then carpal tunnel syndrome may be the cause of the pain. The second test is called the Phalen test and involves the patient pushing their hands against one another for approximately one minute. If signs of pain or discomfort appear it is a sign of carpal tunnel syndrome. 80 percent of those that suffer from carpal tunnel syndrome are over 40 years old and most are involved with activities that induce repetitive motion of the wrist on a day to day basis. Treatment and Therapy Anti-inflammatory medications such as Advil or Motrin can be used to relieve symptoms. There are wrist braces designed to keep the wrist in a position that causes the least amount of stress on the median nerve and can be worn to help prevent movements that can cause pain. This brace can be especially effective during the evening hours when pain tends to be at its highest. Cortisone injections are sometimes prescribed. Cortisone is injected directly into the wrist and works for 80 percent of the patients who use this treatment method. If carpal tunnel syndrome continues to cause severe pain after all other options have been exhausted, then open surgery or surgery aided by a small camera can be preformed in order to make a tiny incision in the sheath that surrounds the median nerve. This tiny incision allows for pressure to be relieved and can alleviate pain. The entire procedure is brief, usually 15 minutes, and very effective. Hip Replacement Hip replacements can be a viable alternative for individuals who suffer from pain caused by hip problems. These problems are more common in elderly individuals as their bodies have been worn down over time. Athletes are especially susceptible to hip injuries that could lead to hip replacements. Golf legend Jack Nicklaus has had hip replacement surgery. Surgery It is estimated that 300,000 people undergo hip replacement surgery each year the common cause of which usually stems from an arthritis problem called osteoarthritis. Rheumatoid arthritis and osteonecrosis are other causes of surgery, but are less common than osteoarthritis. Anti-inflammatory medications, physical therapy exercises, and the use of walking devises are used prior to hip replacement operation to relieve pain and, in some cases, eliminate the need for surgery altogether Replacement Hips There are many different types of hip replacements available for medical professional's use. The latest hip replacement is made of ceramic material and performs well under contained experimentation, but due to the lack of long term research little is known about the long term stability and effectiveness of ceramic hip replacements. The most commonly used and widely tested hip replacement is made of a metal stem and cup with a plastic spacer. These metal hip replacements have a good track record of success as 90 percent function properly 10 years after surgery and 80 percent provide adequate results 20 years after surgery. Most patients are put under general anesthesia during the hip replacement procedure which lasts approximately two hours. If a hip replacement fails, there will likely be a revision hip replacement. These revision hip replacements are designed to replace the synthetic hip that is already in an individual's body. Hip Replacement Recovery Physical therapy begins almost immediately after surgery as patients are allowed to exercise the legs to some degree the day after surgery. After several weeks, normal walking patterns are resumed and patients are usually cleared to return to everyday activities provided that these activities do not place undue amounts of stress on the hip. Some hip replacement patients choose to exercise in pools that take the weight off their legs. This allows them to exercise their legs and improve the range of motion with their new hip without placing painful weight on the new hip.
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