The rotator cuff is an essential group of muscles that stabilize the shoulder during overhead movements such as the tennis serve. These muscles are commonly injured by tennis players and weakness of the rotator cuff can lead to multiple shoulder pathologies such as impingement (subacromial pain syndrome), biceps tendinopathy, and glenohumeral joint sensitivity. The muscles...
Our prior posts on tendon injuries have described the structural changes that take place with chronic symptomatic tendinopathies. The disorganization of tendon fibers and the body’s attempts to heal the injured tendon are best viewed on ultrasound or MRI imaging. MRI is a very sensitive tool, but lacks specificity meaning a positive finding may or...
Achilles Tendinopathy is a common injury to the lower leg found in runners, jumping athletes, and sedentary individuals. In our previous blog posts on Achilles Tendinopathy we have described the impact of this diagnosis on the active population. Physical Therapy remains the gold standard for conservative care focusing on restoring joint mobility and strength to...
Achilles tendinopathy is the most common tendon injuries seen in our Boulder Physical Therapy practice. Patients often present with pain along the mid portion of the achilles tendon during walking, hiking, running, or jumping activities. The greatest risk factors for this condition include a loss of ankle flexibility (dorsiflexion) and calf weakness. Both of these...
In the achilles tendinopathy (artist formally known as tendonitis) research two main themes have emerged. First, there is little to no evidence to support the use of injections of any kind into an injured tendon. Authors have advocated against steroid injections due to the risk of tendon rupture outweighing any potential benefits. Studies have also...
A recent clinical practice guideline was published advising clinicians and patients on the management of achilles tendon injury (tendinopathy). These guidelines are based on both the available medical research and medical opinions from experts in the field. The Journal of Orthopedic and Sports Physical Therapy reported the following for management of mid portion achilles tendinopathy...
Our understanding of tendon pain and injuries has changed significantly over the last two decades and has driven changes in Physical Therapy treatment selection. As a profession we have moved away from a rest and immobilization approach and replaced it with an active approach designed to first strengthen the tendon’s muscle and secondly heal or...
Customized foot orthotics based off a clinical examination, plaster or foam cast have been utilized for decades in order to treat overuse injuries of the foot, ankle, knee, hip and even spine. These orthotics are usually not covered by insurance and usually run into the hundreds of dollars compared to an off the shelf model....
One of things I enjoy about the profession of Physical Therapy is its’ constantly changing nature of the medical evidence behind what we do. Often I come across a new article or research report, which challenges my previous line of thought about an injury or treatment and requires me to change. Achilles Tendinopathy is commonly and...
Poor movements patterns at the shoulder blade (scapular dyskinesis) is quickly becoming the over pronation of the upper extremity. Although associated with a number of shoulder diagnoses including rotator cuff tears, tendinopathy, and impingement many questions remain. We observe these patterns of movement in both strong and weak individuals, as well as, those with and...
