Spine & Sports Medicine Services and Conditions - Rehabilitation Institute of Chicago

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Spine & Sports Medicine Services and Conditions

Sports medicine services we offer

  • Physical Medicine & Rehabilitation (Physiatrist) consultations/evaluations
  • Spinal Interventions (epidurals, facet joint, sacroiliac joint injections)
  • Joint Injections (viscosupplementation, cortisone injections)
  • Electrodiagnostics (Electromyography and Nerve Conduction Studies – EMG)
  • Physical Therapy
  • Occupational Therapy
  • Functional Capacity Evaluations
  • Acupuncture
  • X-ray
  • Diagnostic Ultrasound
  • Prosthetics and Orthotics

Musculoskeletal problems we treat

Below are some of the most common problems or issues that patients seek help with when they visit the rehabilitation team at the Rehabilitation Institute of Chicago. However, if you have questions about a diagnosis, please consult with your physician and/or make a referral to come to RIC.

Pinched Nerve

Pinched Nerve

What is it?

A pinched nerve has many potential causes: tight or small canal for the nerves to run through (spinal stenosis), wear and tear changes in the facet or zygapophysial joints (little joints in the back of the spine) or wear and tear changes in the disc (the flexible segment between the spine bones that allows our spines to twist and bend). Sometimes the disc can have wear and tear on it causing the inside (nucleus pulposus) toothpaste-like substance to ooze outside of the outer walls of the disc (annulus fibrosus), causing a “disc herniation,” This disc herniation can cause irritation of the nerve as it passes by, thereby causing arm pain (if the disc problem is in the neck) or leg pain (if the disc problem is in the low back).

What are the symptoms?

Usually the pain is a shooting sensation that may be accompanied by numbness and tingling. If the problem is in the neck, it worsens by turning the neck in certain directions. If the problem is in the low back, worsens with prolonged sitting, prolonged standing, bending over, lifting or walking. If the nerve irritation is more severe, it may be accompanied by weakness. Progressive weakness or bowel/bladder incontinence (losing control of urine or stool) requires immediate medical evaluation.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a pinched nerve, such as poor posture or core muscle strength. Pinched nerves may require further evaluation with other tests, such as MRIs, CT scans, or electrodiagnostic tests (electromyography and nerve conduction studies – EMG/NCS).

What does the rehabilitation team do to treat it?

A combination of medications, modification of activity, pillows, icing, heat and doing exercises as prescribed are the key to rehabilitating a pinched nerve. It is important to rehabilitate a pinched nerve with posture exercises, strengthening the muscles that control the spine as well as addressing any poor ergonomic setups. Guided progressive slow return of activity is also important in preventing a relapse. Sometimes a steroid (corticosteroid or cortisone) injection into the epidural space (the tissues around the inflamed nerve) can be helpful to alleviate pain in order to advance your exercise program. Surgery can be considered to alleviate the compression if the pinched nerve pain continues to persist after other treatments. Luckily, with the aggressive non-operative approach that physiatrists can offer, surgery is not often needed. If surgery is indicated, your physiatrist will recognize it and can direct you to a spine surgeon.

Neck Pain

Neck Pain

What is it?

Neck pain has many potential causes: tense or tight muscles where we hold our stress, wear and tear changes in the facet or zygapophysial joints (little joints in the back of the spine) or wear and tear changes in the disc (the flexible segment between the spine bones that allows our spines to twist and bend).

What are the symptoms?

Pain in the neck frequently bothers people most during neck motions, such as looking backward while driving a car in reverse. Nighttime pain is frequent because it is difficult to get the neck into a comfortable and properly supportive position while sleeping. With the advent of the information age, many people complain of neck pain while working on the computer or cradling a phone in their neck.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing neck pain, such as poor posture. Frequently, neck pain can be diagnosed with other tests, such as MRIs or CT scans.

What does the rehabilitation team do to treat it?

A combination of medications, modification of activity, pillows, icing, heat and doing exercises as prescribed are the key to rehabilitating neck pain. It is important to rehabilitate neck pain with posture exercises, strengthening the muscles around the shoulder blade as well as addressing any poor computer or ergonomic setup. Sometimes a steroid (corticosteroid or cortisone) injection can be helpful to alleviate pain in order to advance your exercise program. A special procedure, radiofrequency neurotomy, can also be considered in neck pain that persists. Guided progressive slow return of activity is also important in preventing relapse.

Rotator Cuff Problems

Rotator Cuff Problems

What are they?

There are four rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and teres minor) in each shoulder that help keep the “ball” (or humeral head) in the “socket” (or glenoid). Since the shoulder is a joint with a lot of flexibility that can move in all directions, the rotator cuff muscles help stabilize this joint through motion. The rotator cuff muscles and/or tendons can get torn from trauma or excessive wear and tear, frequently pushing up or impinging against another bone of the shoulder (the acromion), causing pain.

What are the symptoms?

Usually the pain is in the shoulder and frequently just below the outside of the shoulder, worsening with arm movement, especially during overhead activities or while getting dressed. Pain is often experienced while trying to sleep on one's side.

What does the rehabilitation team do to diagnose them?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a rotator cuff problem. Frequently, rotator cuff problem can be diagnosed with other tests, such as diagnostic ultrasound or MRIs.

What does the rehabilitation team do to treat them?

A combination of medications, modification of activity, icing and doing exercises as prescribed are the key to rehabilitating a rotator cuff problem. It is important to rehabilitate the shoulder with posture exercises, strengthening the muscles around the shoulder blade as well as the rotator cuff muscles. Sometimes a steroid (corticosteroid or cortisone) injection can be helpful to alleviate pain in order to advance your exercise program. Guided progressive slow return of activity is also important in preventing a relapse. If the rotator cuff is completely torn or aggressive non-operative techniques are unsuccessful, surgery may be considered.

Shoulder Labral Tears

Shoulder Labral Tears

What are they?

There is a layer of cartilage (labrum) in the shoulder that helps keep the “ball” (or humeral head) in the “socket” (or glenoid). Since the shoulder is a joint with a lot of flexibility that can move in all directions, the labrum helps stabilize this joint through motion. The labrum can tear from trauma or excessive wear and tear, frequently creating relative instability in the shoulder. This instability can cause the rotator cuff muscles to be overworked, causing inflammation of the rotator cuff (see above) and pain in the shoulder.

What are the symptoms?

Usually the pain is in the shoulder and frequently deep inside the shoulder with some pain just below the outside of the shoulder. It worsens with arm movement, especially during overhead activities or while getting dressed. A lot of times this may be accompanied by a painful clicking or clunking sensation in the shoulder.

What does the rehabilitation team do to diagnose them?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a labral problem. Frequently, labral problems can be diagnosed with other tests, such as MRI arthrogram.

What does the rehabilitation team do to treat them?

A combination of medications, modification of activity, icing and doing exercises as prescribed are the key to rehabilitating a labral problem. It is important to rehabilitate the shoulder with posture exercises, strengthening the muscles around the shoulder blade as well as the rotator cuff muscles. Sometimes a steroid (corticosteroid or cortisone) injection can be helpful to alleviate pain in order to advance your exercise program. Guided progressive slow return of activity is also important in preventing relapse. If aggressive non-operative techniques are unsuccessful, surgical repair can be considered.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

What is it?

Carpal tunnel syndrome is an irritated or pinched median nerve that runs through the wrist in order to move the muscles of the thumb and provide sensation to the thumb, index and middle fingers. Inflammation and/or friction can build up between the median nerve and neighboring finger tendons in this canal of the wrist called the carpal tunnel. Risk factors include diabetes, pregnancy and repetitive motion of the hands and fingers.

What are the symptoms?

Usually the pain is a shooting sensation that is accompanied by numbness and tingling. It is usually worse at night or with prolonged writing, use of a computer mouse or typing. Sometimes it feels better when you “shake out your hands.” If the nerve irritation is more severe, it may be accompanied by weakness and increased incidents of dropping things. Significant weakness may require surgical consultation.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and a nerve test, electromyography and nerve conduction studies – EMG/NCS to diagnose this problem. Sometimes risk factors can be identified that put your body at risk for developing carpal tunnel syndrome, such as diabetes, pregnancy or poor ergonomic setup.

What does the rehabilitation team do to treat it?

A combination of medications, modification of activity, proper fitting wrist splints and doing tendon-gliding exercises as prescribed are the key to rehabilitating carpal tunnel syndrome. It is important to address any poor ergonomic setups. Sometimes a steroid (corticosteroid or cortisone) injection near the median nerve in the wrist can be helpful to alleviate pain in order to advance your exercise program. Surgery may be considered to alleviate the compression if there is significant thumb muscle weakness or if the carpal tunnel syndrome symptoms are just not going away despite other treatments. Luckily, with the aggressive non-operative approach that physiatrists can offer, surgery is not often needed. If surgery is indicated, your physiatrist will recognize it and can direct you to a hand surgeon.

Low Back Pain

Low Back Pain

What is it?

Low back pain has many potential causes: tense or tight muscles were we hold our stress, wear and tear changes in the facet or zygapophysial joints (little joints in the back of the spine) or wear and tear changes in the disc (the flexible segment between the spine bones that allows our spines to twist and bend). A combination of these wear and tear changes sometimes leads to spinal stenosis, which is narrowing of the canal where the nerves run.

What are the symptoms?

Pain in the low back frequently bothers people most with trunk motions, such as bending over to put on socks, putting dishes in the dishwasher, picking up a child, getting out of the car, walking or running. Pain accompanying being seated for a long time often bothers people with disc problems and can interfere with work or driving. Pain during prolonged standing or walking often interferes with day-to-day life with people that have spinal stenosis for facet joint pain. It is often difficult to get the low back into a comfortable and properly supportive position while sleeping and is sometimes associated with a shooting pain into the leg (“sciatica”), which may be related to irritation of the nerves around the spine.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing low back pain, such as poor posture, tight muscles and relatively weak core muscles. Frequently, low back pain causes can be diagnosed with other tests, such as MRIs or CT scans or electrodiagnostic tests (EMGs).

What does the rehabilitation team do to treat it?

A combination of medications, modification of activity, icing, heat and doing exercises as prescribed are the key to rehabilitating neck pain. It is important to rehabilitate low back pain with posture exercises, strengthening the muscles around the hip girdle as well as addressing any posture issues. Sometimes a steroid (corticosteroid or cortisone) injection can be helpful to alleviate pain in order to advance your exercise program. A special procedure, radiofrequency neurotomy, can also sometimes be considered in low back pain that persists. Guided progressive slow return of activity, especially emphasis on gradual strengthening and endurance is also important in preventing relapse.

Core muscles

Having strong muscles that stabilize the spine are important in maintaining good musculoskeletal health. These muscles form a stabilizing box surrounding the spine and include the abdominal muscles (in front of the spine), the pelvic floor muscles (in bottom of the spine), the diaphragm (on top of the lumbar spine), and back muscles (in back of the spine). Strong core muscles can take up some of the stress on the joints, discs and ligaments of the spine, thereby putting less wear and tear forces on the spine. It is thought that strong core muscles stabilize the spine so that our arms and legs can move fluidly without causing undue stress on the spine.

Herniated Disc

Herniated Disc

What is it?

A disc herniation involves wear and tear changes in the disc (the flexible segment between the spine bones that allows our spines to twist and bend). Sometimes the disc can have wear and tear on it causing the inside (nucleus pulposus) toothpaste-like substance to ooze outside of the outer walls of the disc (annulus fibrosus), causing a “disc herniation.” This disc herniation can cause irritation of the nerve as it passes by, thereby causing arm pain (if the disc problem is in the neck) or leg pain (if the disc problem is in the low back).

What are the symptoms?

Usually the pain is near the spine and may be accompanied by shooting pain, numbness, and tingling. If the problem is in the neck, it is usually worsens from turning the neck in certain directions. If the problem is in the low back, it is usually worse with prolonged sitting, bending over, or lifting. If the nerve irritation is more severe, it might be accompanied by weakness. Progressive weakness or bowel/bladder incontinence (losing control of urine or stool) requires immediate medical evaluation.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a herniated disc, such as poor posture or poor core muscle strength. Because the flexible segment between the bones does not show up on x-ray, disc herniations may require further evaluation with other tests, such as MRIs or CT scans. If nerve function needs to be evaluated, electrodiagnostic tests (electromyography and nerve conduction studies – EMG/NCS) may be performed.

What does the rehabilitation team do to treat it?

A combination of medications, modification of activity, pillows, icing, heat and doing exercises as prescribed are the key to rehabilitating a disc herniation. It is important to rehabilitate a disc herniation with posture exercises, strengthening the muscles that control the spine as well as addressing any poor ergonomic setups. Guided progressive slow return of activity is also important in preventing relapse. Sometimes a steroid (corticosteroid or cortisone) injection into the epidural space (the tissues around the inflamed nerve) can be helpful to alleviate pain in order to advance your exercise program. Surgery may be considered to alleviate the compression if the disc herniation pain continues to persist. Luckily, with the aggressive non-operative approach that physiatrists can offer, surgery is not often needed. If surgery is indicated, your physiatrist will recognize it and can direct you to a spine surgeon.

Spinal Stenosis

Spinal Stenosis

What is it?

Stenosis is another word for narrowing. Spinal stenosis occurs when the canal that the spinal cord and spinal nerves run through is narrow or tight. It becomes tight because of wear and tear changes in the facet or zygapophysial joints (little joints in the back of the spine) and/or wear and tear changes in the disc (the flexible segment between the spine bones that allows our spines to twist and bend). This narrowing of the spine can cause irritation of the nerve as it passes by, thereby causing arm pain (if the stenosis problem is in the neck) or leg pain (if the stenosis problem is in the low back).

What are the symptoms?

Usually the pain is a shooting sensation that may be accompanied by numbness and tingling. If the problem is in the neck, it is worse with turning the neck in certain directions. If the problem is in the low back, it is worse with prolonged standing and walking. If the nerve irritation is more severe, it may be accompanied by weakness. Progressive weakness or bowel/bladder incontinence (losing control of urine or stool) requires immediate medical evaluation.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing symptoms of spinal stenosis, such as poor posture, poor flexibility or poor core muscle strength. Because the nerves do not show up on an x-ray, spinal stenosis may require further evaluation with other tests, such as MRIs or CT scans. If nerve function needs to be evaluated, electrodiagnostic tests (electromyography and nerve conduction studies – EMG/NCS) may be performed.

What does the rehabilitation team do to treat it?

A combination of medications, modification of activity, pillows, icing, heat and doing exercises as prescribed are the key to rehabilitating a spinal stenosis. It is important to rehabilitate spinal stenosis with posture exercises, flexibility training and strengthening of the muscles that control the spine as well as addressing any poor ergonomic setups. Guided progressive slow return of activity is also important in preventing relapse. Sometimes a steroid (corticosteroid or cortisone) injection into the epidural space (the tissues around the inflamed nerve) can be helpful to alleviate pain in order to advance your exercise program. Surgery may be considered to alleviate the compression of spinal stenosis if the pain continues to persist. Luckily, with the aggressive non-operative approach that physiatrists can offer, surgery is not often needed. If surgery is indicated, your physiatrist will recognize it and can direct you to a spine surgeon.

Sacroiliac Joint Pain

Sacroiliac Joint Pain

What is it?

Sacroiliac joint pain is a common cause of low back pain. The sacroiliac joint is the joint between your tail bone (sacrum) and the hip bone (ilium). The sacroiliac joint is a very stable joint that only moves very slightly. It can become inflamed, however, when the pelvis is “off level” or is “a little crooked.” There are many causes for this but it is frequently seen during pregnancy, after trauma, after repetitive stress on the joint, after spinal fusion surgery or with certain types of arthritis.

What are the symptoms?

Usually it is located in the low back, pelvis and buttock, sometimes referring pain into the groin or down the leg. It is frequently worse with running, prolonged walks, sitting or rolling over in bed.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing sacroiliac joint pain, such as poor core muscle strength or leg length problems. Sacroiliac joint problems may require further evaluation with other tests to rule out other causes of low back pain, such as MRIs or CT scans. If nerve function needs to be evaluated, electrodiagnostic tests (electromyography and nerve conduction studies – EMG/NCS) may be performed. It is common that radiographic tests are basically normal when people have sacroiliac joint problems. If a problem of the deep pelvic floor muscles is suspected, consultation with one of our pelvic floor muscle specialists may be required.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing, medications and doing exercises as prescribed are the key to rehabilitating sacroiliac joint pain. Frequently hip and gluteal strengthening exercises and leg flexibility exercises are prescribed. Guided progressive slow return of activity is also important in preventing relapse. Sometimes a steroid (corticosteroid or cortisone) injection into the sacroiliac joint can be helpful to alleviate pain in order to advance your exercise program. Fortunately, surgery is rarely used to treat this problem.

Piriformis Syndrome

Piriformis Syndrome

What is it?

Piriformis syndrome is a less common cause of buttock and leg pain. The piriformis muscle is one of the small buttock muscles that help stabilize the pelvis. It runs between your tail bone and the outside of your hip (greater trochanter). It is frequently seen with problems of the sacroiliac joint and pelvic floor muscle dysfunction. The piriformis can become inflamed, however, when the pelvis is “off level” or is “a little crooked.” When the piriformis and neighboring muscles (gemelli, obturators) are inflamed, the nearby sciatic nerve (the nerve that travels down the back of your leg) can also become irritated. There are many causes for this but it is frequently seen during pregnancy, after trauma and after repetitive stress on the gluteal muscles.

What are the symptoms?

Usually it is located in the buttock and it refers into the back of the leg, accompanied by numbness and tingling. It is frequently worse with running, prolonged walks, sexual intercourse and sitting.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing piriformis syndrome, such as poor core muscle strength or leg length problems. Piriformis syndrome may require further evaluation with other tests to rule out other causes of buttock and leg pain, such as MRIs or CT scans. If nerve function needs to be evaluated, electrodiagnostic tests (electromyography and nerve conduction studies – EMG/NCS) may be performed. It is common that radiographic tests are basically normal when people have piriformis problems. If a problem of the deep pelvic floor muscles is suspected, consultation with one of our pelvic floor muscle specialists may be required.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing, medications and doing exercises as prescribed are the key to rehabilitating piriformis syndrome. Frequently hip and gluteal strengthening exercises and leg flexibility exercises are prescribed. Guided progressive slow return of activity is also important in preventing a relapse. Sometimes a steroid (corticosteroid or cortisone) injection into the sacroiliac joint or near the piriformis can be considered to confirm the diagnosis and perhaps help to advance your exercise program. Fortunately, surgery is rarely used to treat this problem.

Hip Bursitis

Hip Bursitis

What is it?

There are several muscles in the hip that insert on the outside of the hip bone (greater trochanter) that function to keep the pelvis stable when you walk, run or stand on one leg. There is also a muscle that inserts on the front of the hip that functions to bring your knee and thigh upward. When these muscles are overused, they can become inflamed and cause hip pain.

What are the symptoms?

Usually the pain is in the outside of the hip or in front of the hip and sometimes travels to the outside of the thigh. It is usually worse with walking or running. It is often painful while trying to sleep on one's side.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a hip bursitis. Frequently, hip bursitis can be diagnosed with other tests, such as diagnostic ultrasound or MRIs. Occasionally, hip pain can seem like it is hip bursitis, but is really a pinched nerve in the low back.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing and doing exercises as prescribed are the key to rehabilitating hip bursitis. Frequently hip and gluteal strengthening exercises are prescribed, emphasizing balance. Guided progressive slow return of activity is also important in preventing relapse.

Patellofemoral Syndrome

Patellofemoral Syndrome

What is it?

Patellofemoral syndrome is a common problem seen in people with knee pain. Because of biomechanical factors, pressure builds up underneath the knee cap and causes pain and sometimes softening of the cartilage under the knee cap.

What are the symptoms?

Pain is usually located in front of the knee and is worsens with running, sitting with your knees bent for a long time or going up or down stairs. Runners frequently get this pain, which sometimes limits the ability to progress in their training.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Frequently it is necessary for the physiatrist to assess your hip and ankle strength and function to properly understand what biomechanical factors may have put you at risk for this problem.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing, medications and doing exercises as prescribed are the key to rehabilitating patellofemoral syndrome. Frequently hip and gluteal strengthening exercises and leg flexibility exercises are prescribed. Guided progressive slow return of activity is also important in preventing relapse.

Iliotibial Band Syndrome

Iliotibial Band Syndrome

What is it?

Iliotibial syndrome is a common problem seen in people with knee pain. Because of biomechanical factors, friction builds up on the outside of the knee where a taught ligament, the iliotibial band, rubs over a part of the knee bone (lateral femoral condyle).

What are the symptoms?

Pain is usually it is located in outside of the knee and worsens with running, biking, or long walks. Runners frequently get this pain, which sometimes limits the ability to progress in their training.

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. On occasion, diagnostic ultrasound can confirm the diagnosis. Frequently it is necessary for the physiatrist to assess your hip and ankle strength and function to properly understand what biomechanical factors may have put you at risk for this problem.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing and doing exercises as prescribed are the key to rehabilitating iliotibial band syndrome. Frequently hip and gluteal strengthening exercises are prescribed. Guided progressive slow return of activity is also important in preventing relapse.

Stress Fractures

Stress Fractures

What are they?

Stress fractures develop when the bone is experiencing more stress than normal through activities such as heavy running. The bone cells (osteoclasts) that are in charge of breaking the bone down are working faster than the bone cells (osteoblasts) in charge of building new bone material. The stressed bone first responds by swelling, developing into a hairline fracture with repeated stress. Continued abuse of the stressed bone can lead to a full break or fracture.

What are the symptoms?

Depending on which bone the stress fracture develops in, pain may occur in the hip, groin, leg, shin or foot. One will typically feel pain with every running stride, sometimes experiencing this pain while walking or hopping on one leg.

What does the rehabilitation team do to diagnose them?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a stress fracture. Frequently, when stress fractures do not show up on x-rays and other tests, bone scans or MRIs could confirm this diagnosis.

What does the rehabilitation team do to treat them?

Once the diagnosis of stress fracture is clearly established, it is important that you give the appropriate rest to the stressed bone. Your rehabilitation team can help guide you through cross training activities and exercises that addresses the biomechanical problem that put you at risk for this problem.

Shin Splints (medial tibial stress syndrome)

Shin Splints (medial tibial stress syndrome)

What are they?

Your legs and ankles experience a significant amount of stress and shock absorption that accompanies walking or running. The lower leg muscles (posterior tibialis and/or soleus muscles) work to support the arch of the foot and sometimes become inflamed and cause pain. Sometimes people believe that they have shin splints, but really have a more serious stress fracture (see above).

What are the symptoms?

Pain on the inside of the shin, usually noticed with a lot of walking or running. Pain is usually experienced at the beginning of the activity, improves as it gets warmed up and then worsens with excessive activity or even after the activity is completed. If every step hurts, this may be a stress fracture (see above).

What does the rehabilitation team do to diagnose them?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing a medial tibial stress syndrome. Frequently, a stress fracture needs to be discounted, creating the necessity for tests such as bone scans or MRIs.

What does the rehabilitation team do to treat them?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing and doing exercises as prescribed are the key to rehabilitating medial tibial stress syndrome. Frequently calf flexibility and even hip flexibility are prescribed in addition to strengthening exercises. Sometimes advice on proper shoe wear or shoe inserts is appropriate. Guided progressive slow return of activity is also important in preventing relapse.

Plantar Fasciitis

Plantar Fasciitis

What is it?

Your legs and ankles experience a significant amount of stress and shock absorption that accompanies walking or running. There is a bundle of fascia (connective tissue) that runs between your heel bone and the toe region that work to support the arch of the foot, which sometimes becomes inflamed and causes pain at the heel. Sometimes people believe that they have plantar fasciitis, but really have a more serious stress fracture (see above).

What are the symptoms?

Pain on the inside of the heel, usually noticed with a lot of walking or running, frequently when taking the first step out of bed in the morning. Pain is usually experienced at the beginning of the activity, improves as it gets warmed up and then worsens with excessive activity or even after the activity is completed. If every step hurts, this may be a stress fracture (see above).

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Frequently biomechanical imbalances or risk factors can be identified that put your body at risk for developing a plantar fasciitis. Sometimes, a stress fracture of the heel bone (calcaneus) needs to be discounted, creating the necessity for tests such as bone scans or MRIs.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing and doing exercises as prescribed are the key to rehabilitating plantar fasciitis. Frequently calf flexibility and even hip flexibility are prescribed in addition to strengthening exercises. Sometimes advice on proper shoe wear or shoe inserts is appropriate. Guided progressive slow return of activity is also important in preventing a relapse.

Achilles Tendonitis

Achilles Tendonitis

What is it?

Your legs and ankles experience a significant amount of stress and shock absorption that accompanies walking or running. The lower leg calf muscles (gastrocnemius and/or soleus muscles) work to propel you forward when you walk or run. The tendon that these calf muscles insert into on the heel bone (calcaneus) can sometimes become inflamed and cause pain in back of the heel.

What are the symptoms?

Pain on the back of the heel, usually noticed with a lot of walking or running. It usually is painful with beginning activity, gets a little better as it gets warmed up, then it gets worse with excessive activity or even after stopping the activity. If it hurts with every step, it may be a stress fracture (see above).

What does the rehabilitation team do to diagnose it?

A physiatrist will obtain a history, physical examination and x-rays to diagnose this problem. Sometimes biomechanical imbalances or risk factors can be identified that put your body at risk for developing Achilles tendonitis, such as restricted ankle/foot motion and tight calf muscles. Sometimes, a stress fracture or tendon tear need to be discounted, creating the necessity for tests such as bone scans or MRIs.

What does the rehabilitation team do to treat it?

The most important thing to do is address the biomechanical factors that have put you at risk for developing this problem. In addition, a combination of modification of activity, icing and doing exercises as prescribed are the key to rehabilitating Achilles tendinitis. Frequently calf flexibility and even hip flexibility is prescribed in addition to strengthening exercises. Sometimes advice on proper shoe wear or shoe inserts is appropriate. Guided progressive slow return of activity is also important in preventing a relapse.