Lateral epicondylitis

This can occur with repetitive use of the forearm muscles for work, sports, or leisure activity. The muscles that you use to grip, twist, and carry objects attach long the outside aspect of the elbow. This is why a movement in the wrist or hand can cause pain in the elbow. People between the ages of 30 to 50 are affected more often.

What are the symptoms of lateral epicondylitis?

  • Pain in the forearm and wrist
  • Difficulty doing common tasks such as turning a door knob
  • Difficulty gripping objects
  • Increased pain when you use your hand and wrist to do such things as opening a jar, lifting an object, or gripping something tightly.
  • Stiffness in the elbow
  • Weakness in the forearm, wrist, or hand

How can a Physical Therapist help?

  • Instruction on modifying your activity to reduce stress to the muscles and tendons for joint protection.
  • Instruction on the proper use of cold therapy to reduce inflammation and decrease symptoms
  • Instruction in the use of splints or bracing to support the joint to allow for healing.
  • Use manual therapy techniques such as soft tissue mobilization to assist in symptom reduction and tissue repair
  • Instruction in strengthening exercises to promote greater joint stability and muscle health
  • Instruction in range of motion exercises to promote increased flexibility

Patella femoral syndrome

Patella femoral pain syndrome refers to pain in the front of your knee and around the knee cap. The symptoms are associated with weakness, tightness, and stiffness in the muscles around the knee. It can also be from an abnormality in how the lower leg is aligned from the foot to the hip. These conditions can affect how the patella glides smoothly on the femur causing friction and pain. Patella femoral syndrome occurs in people who are physically active, or who have suddenly increased their level of activity.

What are the symptoms associated with Patella femoral syndrome?

  • Pain is worse when walking up or downs hills, steps, or uneven surfaces
  • Pain increases with activity and improves with rest
  • You may experience pain or discomfort with prolonged sitting and having the knee bent.
  • May experience a "cracking" or "popping" when you bend or straighten the knee

How can a Physical Therapist help?

  • Instruction on strengthening exercises for the hip and knee musculature to give you increased joint stability
  • Instruction on flexibility exercises for the calf, knee, and hip to promote greater muscular health
  • Proper assessment of the foot that may be directly affecting your knee joint. Some patients may require the use of a shoe orthotic to help minimize the stress and impact being placed on the knee joint


Is a stress fracture of the lumbar spine. This injury occurs in about 12% of the general population, and usually affects the 5th lumbar vertebrae. Spondylosis is a common cause of low back pain experienced in late childhood and early adolescence. Active teenagers involved in sports that require lifting heavy work loads, repeated bending of the spine, and twisting of the trunk are most at risk.


Is the forward slippage of a vertebrae over the vertebrae beneath it. Because the mechanism of injury, age related factors, and symptoms are very similar, these terms are often described together.

Signs and symptms:

  • Low back pain with or without leg pain
  • Muscle spasms in your low back, buttock, and thighs
  • Difficulty or pain with walking or prolonged standing
  • Symptoms that are relieved by sitting, slouching, or bending forward.
  • Pain with sports or manual labor
  • Pain with bending backwards, twisting, or throwing
  • Decreased flexibility of the leg muscles

How can a Physical Therapist help?

  • Education and instruction on joint safety and modifying activity to avoid painful movement patterns
  • Help you reduce and manage pain and symptoms
  • Educate you on proper flexibility and core strengthening exercises to improve joint stability and muscle health

Carpal Tunnel Syndrome

Is a common condition of the wrist and hand that can affect the use of your arm. It is caused by pressure on the median nerve which is at the base of your wrist. Because of the demands that people place on their hands and wrists, this condition affects about 1 in 20 Americans. Fortunately, Physical Therapy treatment can often help relieve pain and numbness of the hand and wrist, and restore normal functional use.

Signs and symptoms:

  • Burning, tingling, "pins and needles", or numbness in the hand or wrist
  • Symptoms often more noticed at night initially, but increase during the day as the condition worsens
  • Weakness in the hand and wrist

How can a Physical Therapist help?

  • Education on proper wrist and hand support to avoid prolonged bent wrist positions.
  • Education on proper neck and upper back posture.
  • Education on exercises for strength and flexibility of the hand and wrist muscles.
  • Instruction on the use of heat/cold therapy for symptom relief.
  • Edcuation on the use of proper splinting at night to support the wrist.
  • Ergonomic training on the proper height of chairs, desks, keyboards, and monitors that directly affect the management of your symptoms.

Ankle Sprain

Ankle sprains are common injuries that occur when the foot twists or turns beyond its normal range of motion. This causes the ligaments of the ankle to be overstretched or torn. The outer ankle ligaments are the most commonly injured. An ankle sprain typically takes between 2 to 8 weeks to heal. Recurrent ankle sprains affect approximately 73% of people. It is estimated that nearly 23,000 Americans experience ankle sprains daily. Of all sport related injuries, ankle sprains account for nearly 45% of them.

What are the symptoms?

  • Pain
  • Swelling
  • Inability to stand or walk
  • Throbbing
  • Stiffness

How can a Physical Therapist help?

  • Educate you on the proper use of cold therapy to manage the swelling and symptoms
  • Instruct you on better joint safety and support
  • Teach you exercises for joint stability and strength
  • Use various treatment methods to control pain and swelling such as manual therapy, modalities, and flexibility exercises
  • Instruct you on the proper gait sequencing to facilitate a normal cadence
  • Work on improving your standing balance skills
Wednesday the 5th. Copyright 2012, Three Rivers Hospital