Pain centered around the elbow that may or may not radiate down or up the arm could be a condition commonly known as tennis elbow or golfer’s elbow. Ironically, while it is a common ailment of athletes, it can also be caused by any repetitive motion so it is often seen in professional painters, those who work at a computer, construction workers, cooks, etc. Typically pain is felt or is increased up to several hours following the offending activity.

The condition is more technically known as epicondylitis and although it does involve the inflammation identified by the “itis” in its name, there is more to it. Your doctor may also refer to it as tendonitis, which is an inflammation of the tendon. That is often the case, however, a more accurate diagnosis identifies the overuse of the tendon. This overuse and repetitive motion results in microtears of the tendon, a condition called tendonosis. 

While we’re busy defining terms, there is a difference between tennis elbow and golfer’s elbow even though they both cause pain of the elbow region. Tennis elbow is lateral epicondylitis, meaning it affects the outside of the elbow. This pain is felt throughout the elbow, forearm, wrist, and sometimes even parts of the hand. Golfer’s elbow, on the other hand, is medically referred to as medial epicondylitis and affects the inside of the elbow, also radiating down the forearm and wrist or up to the upper arm.

Epicondylitis is most common in people ages 35-50. Those under age 35 showing symptoms may be evaluated for growth plate issues or other causes. Those over 50 could have other causes as well, such as misalignment. For this reason, it’s important to be diagnosed by a medical professional. 

Epicondylitis can often be treated with rest, ice, and anti-inflammatory medication. Sometimes these efforts alone will reverse the problem within a few days, or it could take up to one year. 

Adding physical therapy to your toolbox of remedies can reduce healing times and make your recovery more comprehensive. Physical therapy can help increase strength, improve flexibility, and rejuvenate healing blood flow. The first step of treatment is evaluation. This involves a discussion of your work and leisure activities and a physical evaluation of your movement and use of muscles, tendons, and ligaments in the elbow area. Your therapist may also identify seemingly unrelated problems such as misalignment in the shoulder, upper back, or neck regions.

If your therapist thinks it is too soon to initiate strengthening, he or she might start with techniques to reduce inflammation and pain. These may include E-stim, massage, ice, tape, straps, braces, relaxation, or shockwave and laser therapy.

Once your therapist decides you’ve reached the right level of healing, it’s time to introduce new exercises to improve flexibility and strengthen muscles from the tips of your fingers up your arm. These will likely include stretching of the hands, wrists, and forearms. Your therapy will also include customized exercises to strengthen muscles that work in conjunction with your tendons. Since epicondylitis is caused by repetitive motion, your physical therapist can help you retrain your body towards different movements to resist future occurrences. 

With the proper evaluation, therapy, and training, epicondylitis can completely heal, leaving you to crush that golf drive or smash the squash shot. If you think epicondylitis is holding you back, call Encore Physical Therapy to set up an appointment today.

You may have heard of it; you may have suffered from it. Plantar Fasciitis (PLAN-tur fas-e-I-tis) is a very common condition defined by an inflammation of the tissues that run along the bottom of the foot, connecting the heel to the toes. Pain is typically felt in the front part of the heel and arch of the foot. The pain is common when rising in the morning or after long bouts of inactivity. It can also strike as a result of long periods of standing or following exercise, making it a common complaint of runners and other athletes. 

Our bodies naturally try to avoid pain so without realizing it you may be changing your running style, working stance, or walking gait. This can result in strain to other body parts like your knees, back, or other parts of your foot. Continued trauma to the plantar fascia can also cause heel spurs, tiny calcium deposits that develop on the heel bone. If the condition has progressed to heel spurs, you will likely feel the pain of the calcium deposits stabbing into the padding of your heel. There are also ways to prevent Plantar Fasciitis and especially the continuation of the problem into heel spurs. Wherever you’re at in your relationship with Plantar Fasciitis, an experienced physical therapist can help alleviate the problem. Here are some quick pointers to get you started. 

Home Care

Rest is a critical part of the solution. Avoid standing for long periods whenever possible and give your feet frequent breaks regardless of your activity level.

Maintaining a healthy weight benefits your entire body, including your hardworking feet. While rest and losing weight don’t always go hand in hand, try taking up a low impact option like water aerobics or yoga to stay active sans the impact of running or walking.

Exercising or not, invest in supportive shoes for your type of foot. High arches and flat feet are particularly susceptible to irritation. Make sure your footwear has a thick, cushioned sole and good heel support. Also check into orthotic inserts that can provide the right support and cushion to aid in optimal foot health as well as body alignment. Use over the counter pain relievers to reduce both pain and inflammation. 

Ice will also help reduce the inflammation, but note that Plantar Fasciitis can take six months to one year of recovery time. Use a wrap made specifically for holding the ice in the right position while offering a protective layer between the ice and your skin. You can use a frozen bag of peas wrapped in a thin towel for the same effect. Alternately, place your heels into a tray of ice water, keeping your toes above the water level. 

How Physical Therapy Can Help Plantar Fasciitis

Early intervention is the key to a quicker and more complete recovery. If you are having early symptoms of heel or arch pain make and appointment right away and start working towards a solution. 

Your physical therapist will evaluate your condition and recommend exercises to alleviate the inflammation and aid in recovery before the condition worsens. Exercises will likely include stretches that target mobility for your calves, Achilles tendon, and the bottom of your foot. The focus will equally target strengthening the lower leg and foot muscles that provide support. Your PT may also use athletic tape and offer shoe inserts to change support. Likely, treatment will also include exercises that focus on your body alignment.

Although Plantar Fasciitis is a common condition, each person’s situation is different so it’s important to be evaluated by a medical professional who can set you on the right path towards recovery. Call Encore Physical Therapy today to see how we can help.

When it comes to being active, sprains and strains are common unwelcome guests. However, there’s another ailment that may derail your efforts — muscle cramps. Exercise-Associated Muscle Cramps (EAMC) can bring down your game. These intense cramps are a roadblock to regular muscle movement. It’s like a donkey that stops in the road, refusing to move another inch. When you’re relying on your muscles to lunge, stretch, and offer support, EAMC can quickly drive you to the sidelines.

EAMC is very common. Frequently affected areas include the hamstrings, quadriceps, and calves, but EAMC can occur in any muscle, bringing stiffness, soreness, and pain along for the ride.

It affects both sides of the body and can be so intense that an acutely cramped muscle can often be seen through a visual inspection. A trained eye can spy the balled up muscle as you walk across the room. 

What Causes EAMC?

We’d love to give you a definitive answer here, but honestly, the medical community doesn’t know what causes it. Research studies spanning the past 50 years have searched and evaluated, only to find that muscle cramps affect all ages, races, and types of athletes. The type of sport and duration do not appear to be factors either.

Dehydration

One strong correlation found in these studies was the higher incidence of acute athlete cramping in hot climates. It’s believed that the effects of dehydration, including losing electrolytes, may be to blame. When the body’s nerve endings aren’t properly nourished with calcium, magnesium, sodium, etc, they fail to function properly, which in turn interrupts the messages sent to muscles. An overactive nerve results in overstimulation of the muscle, which leaves it in a constant state of contraction — also known as a cramp. This is merely a theory though since athletes in colder climates also get cramps and rehydrating doesn’t seem to help. 

Intensity

Another theory is that intense exercise sends a constant message to the muscle, basically shifting it into persistent go mode. In other words, the message telling the muscle to relax gets intercepted, resulting in cramping. Of course, this is inconsistent since many intense athletes push to their limits and don’t experience cramps at all.

Conditioning

Another common hypothesis revolves around improper conditioning with the thought being that muscle cramps occur because of fatigue and muscle injury. However studies in a controlled environment with participants performing the same activity under the same conditions failed to produce anything more than random exercise-associated muscle cramps.

The Role of Stretching

Experiments are difficult to set up in order to study muscle cramps. After all, they don’t occur on demand and are not repeatable at request either. So while we might not understand what causes them, the one consistently effective solution is stretching. It’s not understood why it works. Perhaps it creates an override for the message that says to contract. Maybe stretching releases chemicals that result in a message to relax the muscle. Whatever it is, when EAMC strikes, finding the right stretch is the most effective tool you have. 

An important note is the EAMC often does not strike while you’re exercising. More often than not, it hits up to eight hours later when you’re trying to relax or participate in a different type of activity. There’s optimistic hope that stretching at the end of your racquetball game or spin class can help keep the acute cramping from creeping in. Also be sure to keep hydrated whether exercising or not. If you’ve tried reducing muscle cramps on your own, but haven’t found the right solution, head on it to Encore Physical Therapy to see how we can help. 

You can find further reading on the research here.

None of us want to admit it, but stress is part of our everyday lives. From the overpacked schedule to unrealistic expectations, stress contributes to sleep problems, relationship issues, and even your health. In addition to elevated blood pressure that can bring a host of other problems, stress weighs us down with physical pain too. With some information and a game plan though, stress doesn’t have to bring you to your knees. When daily stress leads to aches and acute or chronic muscle pain, it’s time to employ ways to reduce stress in your life, and Encore Physical Therapy can help. 

Step 1 – Acknowledge the Problem

You may not even realize what is causing your pain. Perhaps you have neck issues you feel are related to too much computer work or back pain you attribute to your office chair. Stomach problems are an often overlooked symptom of acute stress too. In reality, stress should be looked at as a possible cause when evaluating nearly every bodily ailment, and for good reason. While you may recognize common stress-related symptoms like moodiness, irrational thinking, fatigue, frequent illness, stomach issues, and anxiety, remember that the body responds to stress in a variety of other ways too. According to The American Institute of Stress, some common physical manifestations of stress include headaches, muscle tension, neck pain, back pain, muscle spasms, and an increased reliance on over-the-counter medications to counterbalance these issues. 

Step 2 – Incorporate Stress Reduction Techniques

Once you’ve acknowledged that stress may be having a bigger impact on your life than you initially recognized, it’s best to reduce stress at the source rather than focus on treating the effects of the damage now or down the road. Dealing with stress requires an assortment of tools. Common and effective tools include:

1. Breathing. Some people lump this practice in with meditation, but it can be implemented separate from meditation too. Start with a long, slow, deep breath. Allow your stomach to expand as you inhale. Hold the breath for a few seconds and then slowly let it out in a controlled manner. Exhale a few seconds longer than your inhale. Practice this method for three to five minutes a few times each day. 
2. Exercise. Get your body moving to reduce stress and increase the feel-good endorphins. Patients suffering from injury or post-surgery healing often fall into a depression stemming from the frustration of being unable to exercise because they are missing the pick-me-up it brings. Of course, when the body is healthy you should keep it that way with frequent exercise. Choose a sport or activity you love to help stay motivated. Create a schedule and give yourself a reward for sticking to it. You’ll feel better and have the ability to cope with stress more effectively. 
3. Communication. This is often the most difficult tool for people to employ, but dealing with stress in a relationship or at work means effectively communicating your ideas, needs, and concerns. There’s no one-plan-fits-all for communication, but make sure you find a way to express yourself via text, phone, chat, email, or fax so you’re not losing sleep rehashing the same conversation in your head again and again.
4. Let it Go. Stress management often means simply deciding to let things go. That doesn’t mean not dealing with it by pushing it aside, but actually letting go. Forgive the debt, decide to cut out unhealthy relationships, create a plan for your money and work it rather than spending every waking moment consumed with what you can’t control, recognize you may not be in a position to make the changes you would like to see at work and either accept it or find a new job. When you feel stress building ask yourself two questions. 1. On a scale of 1-10 how stressful is this event? Perhaps you’re facing a potential job layoff or it’s one of those trips to the grocery store when your toddler is throwing a fit in the checkout line, drawing attention from every side. You’re feeling stress at an eight or maybe even a 10. The second question is this: Twenty years from now, how stressful will you rate this same event on a scale of one to 10? Likely the answer is one. The point is that what seems overwhelming in the moment will likely pass, and soon. So don’t let it become part of your daily struggle, causing you health issues, sleepless nights, and pain.

Step 3 – Seek out Medical Help

Once you’ve identified the problem and taken steps to reduce your stress, think about incorporating the help of medical professionals. Seek out effective communication advice from a therapist. Consider whether antidepressants are a good option for you. And create a useful plan to treat physical ailments like neck and back pain that keep you from participating in the activities that bring you joy. 

As part of your health team, the physical therapists at Encore Physical Therapy are here to support you in your efforts to reduce stress and feel your very best.