Services offered at Peak Physical Therapy

treatment at Peak Physical TherapyModalities:
   - Cryotherapy
   - Moist Heat
   - Ultrasound
   - E-Stim
   - TENS
   - Cold Laser
   - Iontophoresis
   - Paraffin
Therapeutic Exercise
Therapeutic Activity
Neuromuscular Re-Education
Joint Mobilization
Manual Therapy
Graston Technique®
Kinesotaping®
Therapeutic Massage
Gait Training
Mechancial Traction

 

 

 

 

What We Treat


Adhesive Capsulitis / Frozen Shoulder
frozen shoulder Adhesive capsulitis is the stiffening of the shoulder due to scar tissue, which results in painful movement and loss of motion. The actual cause of adhesive capsulitis is a matter for debate. Some believe it is caused by inflammation, such as when the lining of a joint becomes inflamed (synovitis), or by autoimmune reactions, where the body launches an "attack" against its own substances and tissues. Other possible causes include:

    • Reactions after an injury or surgery
    • Pain from other conditions—such as arthritis, a rotator cuff tear, bursitis, or tendinitis—that has caused you to stop moving your shoulder
    • Immobilization of your arm, such as in a sling, after surgery or fracture

Often, however, there is no known reason why adhesive capsulitis starts.

 


Back Pain
The symptoms of back pain vary a great deal. Your pain might be dull, burning, or sharp. You might feel it at a single point or over a broad area. It might be accompanied by muscle spasms or stiffness. Sometimes, it might spread into one or both legs.

There are 3 different types of back pain:

    • Acute - pain lasting less than 3 months
    • Recurrent – acute symptoms come back
    • Chronic – pain lasting longer than 3 months

Most people who have an episode of acute pain will have at least one recurrence.

Often, back pain occurs due to overuse, strain, or injury. It could be caused by too much bending, twisting, lifting—or even too much sitting. But just as often, the actual cause of back pain isn't known, and symptoms usually resolve on their own.
Although back pain is rarely serious or life threatening, there are several conditions that may contribute to back pain, such as:

    • Degenerative disk disease
    • Lumbar spinal stenosis
    • Fractures
    • Herniated disk
    • Osteoarthritis
    • Osteoporosis
    • Tumors of the spine

Bursitis
bursitis

 

Bursitis is inflammation of the fluid-filled sac (bursa) that lies between a tendon and skin, or between a tendon and bone. The condition may be acute or chronic. Bursitis can be caused by chronic overuse, trauma, rheumatoid arthritis, gout, or infection. Sometimes the cause cannot be determined. Bursitis commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the Achilles tendon and the foot. Chronic inflammation can occur with repeated injuries or attacks of bursitis.

Degenerative Disk Disease

disk disease
Cervical Degenerative Disk Disease

disk disease
Lumbar Degenerative Disk Disease

Your spine is made up of 33 vertebrae that are stacked on top of one another. Between each of these vertebrae is a rubbery piece of cartilage called an "intervertebral disk." Imagine the disk as a tire, with gelatin filling the hole in the tire. The tire is called the "annulus," and the gelatin is called the "nucleus." When we're young—under 30 years of age—the disk is made mostly of gelatin. As we age, and sometimes with injury or excessive wear and tear, we start to lose some of that gelatin, and the volume of the disk decreases, resulting in less space between the vertebrae. The disk becomes flatter and less flexible, leaving less space between each set of vertebrae. Sometimes bone spurs form in response to this degeneration of the disk, making the spine stiff. When the rough surfaces of the vertebral joints rub together, pain and inflammation may result. Nerves may become irritated or compressed.

Disk degeneration might occur throughout several regions of the spine, or it might be limited to one disk. When it's part of the natural aging process, the degeneration does not always lead to pain. For some people, however, it can cause a great deal of pain and disability.
You are more likely to develop DDD if you:

    • Smoke
    • Are obese
    • Do heavy physical work
    • Don't get very much exercise

Falls
Falls can diminish your ability to lead an active and independent life. About one third of people over the age of 65 and almost half of people over the age of 80 will fall at least once this year. There usually are several reasons for a fall. Physical therapists can help you reduce your risk of falling by:

    • Assessing your risk of falling
    • Helping you make your home as safe as possible
    • Educating you about the medical risk factors linked to falls
    • Designing individualized exercises and balance training


Fibromyalgia

The cause of fibromyalgia is unknown, but it's thought to be due to changes in how the nervous system processes pain. It might be triggered by trauma, surgery, infection, arthritis, or major emotional stress, or it may develop gradually over time. People with conditions such as rheumatoid arthritis, systemic lupus erythematosis, or ankylosing spondylitis are more likely to develop fibromyalgia.

Fibromyalgia isn't just one condition; it's a complex syndrome involving many different factors. With fibromyalgia, you may have:

    • Widespread pain, often a dull achiness, on both sides of the body above and below the waist  
    • Spots on your head, neck, chest, shoulders, elbows, hips, or knees that are tender to a firm touch; these “tender points” may move around or come and go
    • Muscle stiffness, especially in the morning
    • Headache
    • Thinking and memory problems
    • Fatigue
    • Depression
    • Anxiety
    • Pain or cramps in the abdomen or pelvis
    • Irritable bowel syndrome
    • Irritable bladder syndrome
    • Difficulty sleeping; waking unrefreshed
    • Temporomandibular (jaw joint) pain
    • Numbness or tingling

Often, stress can make your symptoms worse.


Fractures
fractures

 

A fracture is the medical term for a broken bone. Fractures occur when the physical force exerted on the bone is stronger than the bone itself. Your risk of fracture depends, in part, on your age. Broken bones are very common in childhood, though children's fractures are generally less complicated than fractures in adults. As you age, your bones become more brittle and you are more likely to suffer fractures from falls that would not occur when you were young.

 

 

 

 

 

 

 

 


General Weakness
Weakness is a lack of physical or muscle strength and the feeling that extra effort is needed to perform daily activities that require you to move your arms, legs, or other muscles. General weakness is usually a symptom of something else, rather than a condition in and of itself.

Headaches

headachePain of any type that occurs in any part of the head is called a headache. There are many different types of headaches, with just as many causes.

The International Headache Society describes several different categories of headache:

    • Tension-type
    • Migraine and cluster
    • Secondary headaches from an underlying condition, such as fever, infectious disease, sinus disorder, or in rare cases, a tumor or more serious illness
    • Cranial neuralgias, facial pain, and other headaches

Most headaches are harmless and resolve on their own, although severe headaches that recur frequently can affect your ability to do your daily activities and can reduce your quality of life.

There is effective treatment for almost every type of headache. The challenge lies in determining the type of headache, its cause, and in developing an appropriate treatment plan that will reduce both its frequency and intensity. Physical therapists can help determine the type of headache you have and are experts in managing pain from tension-type headaches.

Tension-type headaches (also called muscle-spasm headaches) are the most common types of headaches in adults. They may be the result of a neck or jaw problem, poor posture, fatigue, or stress.

A problem in the neck, head, or jaw--such as an injury or arthritis--can lead to tension in the muscles at the back of the head and to increased pressure on the nerves to the face and head. Poor posture can cause these muscles to become overworked, which can trigger a headache.


Herniated Disk
herniated diskYour spine is made up of 33 vertebrae (bones) that are stacked on top of one another. Between each vertebra is a cushion-like piece of cartilage called an "intervertebral disk." Imagine the disk as a tire, with gelatin filling the hole in the tire. The rubbery outer part is called the "annulus,” and the gelatin is called the "nucleus." When we're young—under 30 years of age—the disk is made mostly of gelatin. As we age, we start to lose some of that gelatin. The disk becomes flatter and less flexible, making it easier to injure. In some cases, the gelatin can push out through a crack in the rubbery exterior and lead to a herniation (bulge) or rupture (tear).

Herniated disks are most common in the neck (cervical spine) and low back (lumbar spine). In the low back, disks may become damaged by excessive wear and tear or an injury.

Your risk for developing a herniated disk increases due to:

    • Age – most herniated disks occur in people who are 30 to 50 years of age as a result of age-related disk degeneration. Herniated disks are less common after the age of 50, however, because with aging there is less fluid to push out of the disk
    • Obesity – increased weight results in increased pressure on the disks
    • Occupation – jobs that are physically demanding and involve repetitive tasks such as lifting, pushing, pulling, and twisting place additional stress on the disks
    • Low levels of physical activity – people who are not physically active are less able to handle physical demands

Joint Pain
Joints form the connections between bones. They provide support and help you move. Any damage to the joints from disease or injury can interfere with your movement and cause a lot of pain. Many different conditions can lead to painful joints, including osteoarthritis, rheumatoid arthritis, bursitis, gout, strains, sprains, and other injuries. Joint pain is extremely common. In one national survey, about one-third of adults reported having joint pain within the past 30 days. Knee pain was the most common complaint, followed by shoulder and hip pain, but joint pain can affect any part of your body, from your ankles to your shoulders. As you get older, painful joints become increasingly more common.

Joint Replacement
joint replacements

 

Joint replacement surgery is removing a damaged joint and putting in a new one. A joint is where two or more bones come together, like the knee, hip, and shoulder. The surgery is usually done by an orthopaedic surgeon. Sometimes, the surgeon will not remove the whole joint, but will only replace or fix the damaged parts.

 

 

 

 


Labral Tear

labral tearAn unstable shoulder joint can be the cause or the result of a labral tear. "Labral" refers to the glenoid labrum—a ring of cartilage that surrounds the base of the shoulder joint. Injuries to the labrum are common, can cause a great deal of pain, and may make it hard to move your arm. A labral tear can occur from a fall or from repetitive activities or sports that require you to use your arms raised above your head. Some labral tears can be managed with physical therapy; in severe cases, surgery may be required to repair the torn labrum.

The glenoid labrum provides extra support for the shoulder joint, helping to keep it in place. A labral tear occurs when part of this ring is disrupted, frayed, or torn. Tears may lead to shoulder pain, an unstable shoulder joint, and, in severe cases, dislocation of the shoulder. Likewise, a shoulder dislocation can result in labral tears.

When you think of the shoulder joint, picture a golf ball (the head of the upper-arm bone, or humerus) resting on a golf tee (the glenoid fossa, a shallow cavity or socket located on the shoulder blade, or scapula). The labrum provides a rim for the socket (golf tee) so that the humerus (golf ball) does not easily fall off. If the labrum is torn, it is harder for the humerus to stay in the socket. The end result is that the shoulder joint becomes unstable and prone to injury.

Because the biceps tendon attaches to the shoulder blade through the labrum, labral tears can occur when you put extra strain on the biceps muscle, such as when you throw a ball. Tears also can result from pinching or compressing the shoulder joint when the arm is raised overhead.

There are 2 types of tears:

    • Traumatic labral tears usually happen because of a single incident, such as a shoulder dislocation or an injury from heavy lifting. People who use their arms raised over their heads—such as weight lifters, gymnasts, and construction workers—are more likely to have traumatic labral tears. Activities the force is at a distance from the shoulder, such as striking a hammer or swinging a racquet, also can create shoulder joint problems.
    • Nontraumatic labral tears most often occur because of muscle weakness or shoulder joint instability. When the muscles that stabilize the shoulder joint are weak, more stress is put on the labrum, leading to a tear. People with nontraumatic tears tend to have more "looseness" or greater mobility throughout all their joints, which might be a factor in the development of a tear.

Ligament Tears
acl tearIf an injury causes these ligaments to stretch too far, they may tear. The tear may occur in the middle of the ligament, or it may occur where the collateral ligament attaches to the bone, on either end. If the force from the injury is great enough, other ligaments may also be torn. The most common combination is a tear of the MCL and a tear of the anterior cruciate ligament (ACL). The ACL runs through the center of the knee and controls how far forward the tibia moves in relation to the femur.MCL tears are more common than LCL tears, but a torn LCL has a higher chance of causing knee instability. One reason for this is that the top of the shinbone (called the tibial plateau) forms a deeper socket on the side nearest the MCL. On the other side, near the LCL, the surface of the tibia is flatter, and the end of the shinbone can potentially slide around more. This difference means that a torn LCL is more likely to cause knee instability.

 


Meniscal Tear
  • The meniscus is a rubbery, C-shaped piece of cartilage that cushions your knee. Each of your knees has 2 menisci (plural of meniscus); one on the inner (medial) part of the knee, and the other on the outer (lateral) part. Together they act to absorb shock and stabilize the knee joint.

A meniscal tear typically is caused by twisting or turning quickly on a bent knee, often with the foot planted on the ground. Although meniscal tears are common in those who play contact sports, anyone at any age can tear a meniscus. When people talk about having torn cartilage in their knee, they usually are talking about a meniscal tear.


Patellofemoral Pain
knee painPatellofemoral pain syndrome refers to pain at the front of the knee, in and around the kneecap. (The kneecap, or patella, is the triangle-shaped bone at the front of the knee joint. The pain usually is accompanied by tenderness along the edges of the patella.

Current research indicates that PFPS is an "overuse syndrome," which means that it may result from repetitive or excessive use of the knee. Other contributing causes may include:

    • Weakness, tightness, or stiffness in the muscles around the knee
    • An abnormality in the way the lower leg lines up with the hip, knee, and foot

These conditions can interfere with the ability of the patella to glide smoothly on the femur (the bone that connects the knee to the thigh) during movement. The friction between the under-surface of the patella and the femur causes the pain and irritation commonly seen in PFPS.
PFPS often occurs in people who are physically active or who have suddenly increased their level of activity, especially when that activity involves repeated knee motion, running, stair climbing, squatting, or repeated carrying of heavy loads. If you are older, you might have age-related changes that cause the cartilage on the under-surface of the patella to wear out. The result is pain and difficulty completing even the simplest daily tasks without pain.

Usually, patellofemoral pain is worse when you walk up or down hills or stairs and on uneven surfaces. This pain tends to increase with activity and improve with rest. You also may:

        • Feel pain after sitting for long periods of time with the knee bent
        • Occasionally hear or feel a "cracking" or "popping" when you bend or straighten your knee

Pelvic Pain

pelvic painPelvic pain is felt in the lower abdomen, pelvis, or perineum and is considered to be "chronic" when it lasts for more than 6 months.

Pelvic pain can be caused by:

    • Pregnancy and childbirth, when changing hormone levels can affect the muscles and cause the joints to become more "loose"
    • Pelvic joint problems
    • Muscle weakness or imbalance within the muscles of the pelvic floor, trunk, or pelvis
    • Lack of coordination in the muscles that control the bowel and bladder
    • Tender points in the muscles of the pelvic floor
    • Pressure on one or more nerves in the pelvis
    • Weakness in the muscles of the pelvis and pelvic floor
    • Scar tissue after abdominal or pelvic surgery, such as a C-section or episiotomy (incision), or as a result of a tear in the vaginal area
    • Disease
    • Pelvic organ prolapse, a shift in the position of the pelvic organs

Plantar Fasciitis

plantar fascitisPlantar fasciitis is a condition causing heel pain. Supporting the arch, the plantar fascia, a thick band of tissue connecting the heel to the ball of the foot, can become inflamed or can tear. You experience pain when you put weight on your foot—particularly when taking your first steps in the morning. The pain can be felt at the heel, or along the arch and the ball of the foot.

Plantar fasciitis is a common foot condition. It occurs in as many as 2 million Americans per year and 10% of the population over their lifetimes.
Factors that contribute to the development of plantar fasciitis include:

    • Age (over 40 years)
    • A job, sport, or hobby that involves prolonged standing or other weight-bearing activity
    • Rapid increases in length or levels of activity, such as beginning a new running program or changing to a job that requires a lot more standing or walking than you are accustomed to
    • Decreased calf muscle flexibility
    • Increased body weight (Body Mass Index greater than 30)
    • Tendency to have a flat foot (pronation)

Plantar fasciitis affects people of all ages, both athletes and non-athletes. Men and women have an equal chance of developing the condition.
Treatment generally reduces pain and restores your ability to put weight on your foot again.


Pre & Post Surgical Rehabilitation
Physical therapy may be indicated prior to surgery to maximize joint motion and overall strength and endurance that will assist you in a more speedy recovery post-operatively. Post-operatively, you will be seen by a therapist as soon as it is prescribed by the physician. Treatment goals will be to minimize the adverse effects of the surgery such as pain and swelling as well as to restore normal movement, flexibility and function.

Rotator Cuff Tear

rotator cuff tearThe "rotator cuff" is a group of 4 muscles and their tendons (which attach them to the bone). These muscles connect the upper-arm bone, or humerus, to the shoulder blade. The important job of the rotator cuff is to keep the shoulder joint stable. Sometimes, the rotator cuff becomes inflamed or irritated due to heavy lifting, repetitive arm movements, or a fall. A rotator cuff tear occurs when injuries to the muscles or tendons cause tissue damage or disruption.

Rotator cuff tears are called either "full-thickness" or partial-thickness," depending on how severe they are. Full-thickness tears extend from the top to the bottom of a rotator cuff muscle/tendon. Partial-thickness tears affect at least some portion of a rotator cuff muscle/tendon, but do not extend all the way through.

Tears often develop as a result of either a traumatic event or long-term overuse of the shoulder. These conditions are commonly called acute or chronic:

    • An acute rotator cuff tear is one that just recently occurred, often due to a trauma such as a fall or lifting a heavy object.
    • Chronic rotator cuff tears are much slower to develop. These tears are often the result of repeated actions with the arms working above shoulder level—such as with ball-throwing sports or certain work activities.

People with chronic rotator cuff injuries often have a history of rotator cuff tendon irritation that causes shoulder pain with movement. This condition is known as shoulder impingement syndrome (SIS).

Rotator cuff tears also may occur in combination with injuries or irritation of the biceps tendon at the shoulder, or with labral tears (to the ring of cartilage at the shoulder joint)

 


Shoulder Dislocation

shoulder dislocaitonThe shoulder includes the clavicle (collar bone), scapula (shoulder blade), and humerus (upper-arm bone). The rounded top of the humerus and the cup-like end of the scapula fit together like a ball and socket. A shoulder dislocation can occur with an injury such as when you "fall the wrong way" on your shoulder or outstretched arm, forcing the shoulder beyond its normal range of movement and causing the humerus to come out of the socket. A dislocation can result in damage to many parts of the shoulder, including the bones, the ligaments, the labrum (the ring of cartilage that surrounds the socket), and the muscles and tendons around the shoulder joint.

 

 


Sprains / Strains
Sprains and strains are common injuries that share similar signs and symptoms, but involve different parts of your body. A sprain is a stretching or tearing of ligaments — the tough bands of fibrous tissue that connect one bone to another in your joints. The most common location for a sprain is in your ankle. A strain is a stretching or tearing of muscle or tendon. A tendon is a fibrous cord of tissue that connects muscles to bones. Strains often occur in the lower back and in the hamstring muscle in the back of your thigh.

 


Tendinitis

tennis elbowTendinitis is inflammation, irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone. In many cases, tendinosis (tendon degeneration) is also present. Tendinitis can occur as a result of injury, overuse, or with aging as the tendon loses elasticity. It can also be seen in persons with body-wide (systemic) diseases such as rheumatoid arthritis or diabetes. Tendinitis can occur in any tendon, but some commonly affected sites include the elbow, heel, shoulder and wrist.

 

 

 


 

Courtesy of MoveForward.com