Lower Body Injuries


Hip Pain and Injuries:

 

Labral tears:

  • The labrum of the hip joint is the ring of cartilage supporting the weight bearing surfaces of the joint.  The labrum can be torn via bony abnormalities (FAI) or from twisting, compressive, or pounding forces through the hip joint.
  • Often labral tears occur in sports such as: running, golf, hockey and soccer. 
  • People will complain of a “catching”, a “popping” or a sensation of “getting stuck”.  They will also complain of deep joint pain at the hip joint.

 

 

Femoroacetabular impingement (FAI):

    • This condition occurs when the bones of the hip joint do not fit together perfectly causing a “pinching” in the hip during certain positions.  Over time, this pinching or compression causes damage to the hip joint creating bone spurs (bumpy surfaces) and / or tears to the labrum. 
    • There are 3 different kinds of FAI resulting from either an abnormality of the head of the femur (long leg bone) or the acetabulum (cup surface of the hip joint).  The 3rd type of FAI is a combined FAI. 
    • People will often complain of pain with activities requiring twisting, pivoting and bearing weight on the joint but sometimes the main symptom is a dull pain throughout the hip area.

 

    • We specialize in conservative treatment as well as pre and postoperative care for the above conditions.

    Click here for more information on labral tears and FAI

     

     

    Muscle strains and overuse injuries

    Hip flexor
    • Hip flexor strains often occur from explosive sports activities resulting in small to large tears in the muscle fibers.  These injuries often hurt with hip flexion i.e., moving the injured leg forward or the knee to the chest.
    • Hip flexor strains are often treated successfully with physical therapy but click here to learn more.

     

     

    IT band injuries:
    • The ITB is the main stabilizer of the outside of your upper leg.  The IT band can become tight from overuse activities such as running and cycling and often occur due to a muscle imbalance.
    • The IT band can create a “snapping” sensation as you bend and relax your hip or knee joint.  It can also cause a deep pain in your hip or a radiating pain through your knee joint as it crosses both of these main joints in your leg.
    • Our specialists can put you on an excellent maintenance program to avoid future problems as well as keeping you on the go when pain exists. 
    Click here to learn more.

       

       

      Gluteal injuries and weakness:
      • The glute muscles (buttocks) are comprised of the gluteus maximus, minimus and medius.  These muscles all serve crucial purposes for our ability to lift objects, create powerful movements with our lower body, and stabilize our pelvis to help our spine.
      • The glute maximus is one of your biggest power generators.  This muscle can be torn or strained due to a forceful blow directly to the muscle or, more commonly, from a sudden explosive force.
      • Glute medius injuries or weakness can lead to knee or hip and low back pain.  We can put you on a program to address your muscular control of this muscle and its strength.

Click here to learn more.

Click here for glute med exercises to help with this form of knee pain or see one of our specialists today!

 

 

Pre and postoperative care for total hip replacement (arthroplasty) – THA

 

Knee Pain and Injuries:



ACL Injury and / or Reconstruction:

  • ACL tears and strains occur from a sudden stop or a pivoting force often during sports activities but can occur in daily life as well.  These injuries can also occur from landing “back seat” during ski landings.
  • Often the patient will report a popping and sudden instability in the joint and the joint will swell significantly.  If you have sudden pain after a fall or incident come in and get an evaluation ASAP to help determine the next best step for you.
  • It possible to strain the ACL without tearing it!  Physical therapy is very successful at returning people with ACL strains back to his or her favorite activities.
  • If the ACL requires repair, there are many excellent surgeons in our area who can be of service.  Physical therapy can help prior to the surgical intervention as the saying goes “the stronger you are going in, the faster you recover coming out!”
  • Your therapist will follow the surgical doctor’s protocol and will work hard with you to get you back out there!

 

Click here to learn more about ACL sprains and tears as well as surgical options.

 

 

Meniscal tears:

  • Meniscal tears often occur from a twisting force or compressive force in the knee and are extremely common sports injuries.  Click here to learn more.
  • Your meniscus is a c-shaped cushion sitting on top of your tibia (shin bone) and helps the knee to absorb shock forces during life and sport activities. 
  • Meniscal tears can often be treated conservatively without any negative impact later on in life.  The meniscus is important because it guards our knees from wear and tear.  It is better to keep more of your meniscus in  your knee if you can!
  • We offer pre and postoperative rehabilitation as well as nonoperative / conservative care.

 

 

Arthritis / Wear and Tear:

  • With the active population in Park City and the surrounding towns we consider ourselves specialists in the conservative (non-operative) care of arthritis
  • Arthritis occurs when the joint surfaces rub on each other and begin to cause spurring (excess bone growth) of the joint surfaces.  This can occur between the patella (kneecap) and the femur (leg bone) or in the knee joint itself (tibiofemoral joint).  Click here to learn more.
  • This wear and tear often occurs later in life however younger individuals who are more active can develop arthritis as well.  People often complain of an achy joint, stiffness, swelling, pain with weight bearing tasks, and sometimes a “locking” or “catching” in the knee joint.
  • If you find yourself one of the people who requires more advanced care (injections, medication) we are happy to help guide you to the right providers for this process.
  • Pre and postoperative surgical care for scopes (debridement) and total knee replacement (arthroplasty) – TKA

 

 

 

Patellofemoral pain syndrome (PFPS) and chondromalacia (growing pains):

  • PFPS aka “Runner’s Knee” or “Jumper’s Knee” – occurs from overuse injuries and during growth spurts in adolescents and children.  Generally this occurs in young women but can occur in males as well. 
  • PFPS describes pain at the knee joint due to biomechanical changes during movement.  Patients will typically complain of stiffness, pain with bending, pain with running, pain with stairs, and pain with first getting up from a seated position.
  • PFPS is often due to tracking issues at the knee joint (bad alignment).  When the knee bends the patella will move laterally (to the outside) in its track causing pain and a “clicking” sensation. 
  • PFPS can also be due to muscular imbalances pulling the kneecap laterally and physical therapy is a very successful way to treat these mechanisms.
  • Chondromalacia refers to damage to the cartilage on the underside of the patella (kneecap).  Generally, this damage becomes painful once it reaches the bone underneath the cartilage or due to inflammation caused in the surrounding tissues.

Click here for more information on PFPS.
Click here for glute med exercises to help with this form of knee pain or see one of our specialists today!

 

 

Knee sprains:

  • Knee sprains can occur to the medial collateral ligament (MCL) the ACL (see above), the posterior cruciate ligament (PCL) and / or the lateral collateral ligament (LCL) depending on the forces undertaken at the time of injury.
  • These injuries can be identified and treated successfully in physical therapy.  Come in for an evaluation to learn more and create better stability at your knee joint.

 

 

 

Muscle strains to the thigh

    Quad strain:
    • The quadratus muscle group consists of 4 muscles running down the front of your thigh: rectus femoris, vastus lateralis, vastus medialis oblique (VMO) and vastus intermedius.
    • These muscles are a powerful group of hip and knee flexors which can be quite painful when injured.  Injury often occurs due to sudden explosive movements but can also occur from overuse and over stretching.

    Hamstring strain:
    • The hamstring group includes three muscles: biceps femoris, semitendinosus, and semimembranosus.  These muscles work to flex your knee such as during the swing phase of gait and also stabilize you in standing positions.
    • Hamstring strains can become chronic injuries if not properly managed so be sure to follow your therapist’s recommendations for rest and activity modification.  Hamstring injuries can be very tricky and it is best to come in for an evaluation as soon as you can!

    Click here to learn more about various muscle strains.

     

     

    Knee and thigh contusions (bruising):

    Contusions (bruising) can occur due to a blow or impact to the muscle body in sport or accidents.  Often physical therapy can help to decrease pain, stiffness and teach you good management techniques for home when one of these occurs.


     

     

    Foot and Ankle Injuries:

     

      Lateral Ankle Sprains (Inversion):
    • A sprain to the outside ligaments of the ankle occurs when the ankle rolls in, such as when landing a jump during basketball or when missing a curb / tripping and the ankle rolls in under your body.
    • The lateral ankle sprain is the most common ankle sprain to occur.  A bone bruise on the inside of the ankle can occur with this injury due to compressive forces.
    • If you do not rehabilitate a sprained ankle it can become a long term problem so it is best to have your injury evaluated by a professional.  Physical therapy can also assist with early management for pain and swelling.

Click here to learn more.

 

 

Medial Ankle Sprains (Eversion):

  • A sprain to the inside ligaments of the ankle occurs when the ankle rolls out.  This injury is much less common but can be associated with a fracture of the smaller long bone in your leg, the fibula. These injuries do very well with physical therapy to assist with pain, swelling, instability and eventually a strengthening program. Click here to learn more about this rare injury.

 

High Ankle Sprain:

A high ankle sprain occurs with a rotational force through a fixed foot.  Often it occurs in a highly flexed position i.e., pushing off as a lineman. Although this is a rare injury, it is most common in impact sports such as football and is often associated with lower leg bone fractures. Click here to learn more information about high ankle sprains.

 

 

“Weak Ankles”:

  • Ankle instability can occur due to a history of several rolled or sprained ankles or can be due to a congenital (born with it) weakness of the muscles or ligaments.  These injuries are common in females as well as athletes with a history of several sprained ankles.
  • A stabilization program can be a great way to prevent future injury, arthritis of the ankle and foot, and pain!  Come in and see one of our physical therapists for an evaluation and to create a plan of care to address this instability.

 

 

Ankle Fractures:

  • Ankle fractures or breaks can occur to any of the bones of the ankle – tibia, fibula and the talus (sits between the two lower leg bones).  These fractures can often heal well without surgery but there are times where a surgical appointment may be necessary.
  • Patients are often required to wear a boot for the first 6-8 weeks to allow the bone to heal.  After the fracture has stabilized physical therapy can help bring back strength and power to the lower body as well as restoring balance and range of motion.  Scar tissue can be a persistent problem after immobilization (casting / boot) and your physical therapist is here to help.
Click here for more information on ankle fractures.

 

 

Foot Fractures:

  • Foot fractures can occur in a variety of ways from an impact to the foot to overuse to a sudden explosive movement.
  • A stress fracture of a foot bone is essentially a deep bruise to the bone.  If these are properly treated with rest and physical therapy long term deficits can often be avoided.  If stress fractures are not properly treated they can transition to “true fractures” which is a break in the bone.  Stress fractures are common in running and jumping sports due to the amount of impact through the long bones of the foot.
  • Foot fractures vary depending on the location on your foot however we are lucky to be surrounded by excellent ankle and foot doctors.  Our staff is well versed in foot and ankle fractures and are here to help you every step of the way!
Click here to learn more about foot fractures and stress fractures.

    We have a wide range of services available for pre and postoperative care for ankle reconstruction surgeries, fusions, and debridements.  Come in to discuss your case today.

     

     

      Plantar fasciitis

      • The plantar fascia is the strong band of tissue running along the bottom of your foot.  This band of tissue provides support for the arch and connects the calcaneus (heel bone) to the toes. 
      • Inflammation of this tissue is the most common cause of heel and foot pain!
      • Characteristics of PF include: foot pain that is the worst in the AM and decreased ability to walk / move in the morning.
      • Your physical therapist can help teach you how to strengthen the small muscles of your foot and ankle, the right footwear to prevent pain, splints that may help and can complete the soft tissue required to decrease inflammation and restore balance to your foot and ankle.
      Click here to learn more about plantar fasciitis.