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Leg and Foot Pain

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Achilles Tendonitis/Ruptures
The Achilles is the large tendon in the posterior ankle which connects the gastroc and soleus muscles to the heel bone. The tendon can become inflamed and irritated with overuse, falls, improper shoe wear, poor foot mechanics, or trauma. At CPTI, we focus on correcting the cause of the irritation as well as treating the symptoms.

Bunion
It’s important to allow the first toe (great toe) to move through enough range of motion to maintain a normalize gait cycle. This will allow a patient to return to pain free walking and regular athletic activities. Great toe stiffness can change the way you walk and cause a lot of pain. This can change how the foot, ankle, knee, hip and back work. Bunions are often the result of a mechanical fault in the foot and it’s important to get a proper physical therapy evaluation of the foot and gait mechanics. Arch supports and orthotics can be helpful in preventing bunions and halting the progression of an existing bunion. Surgery may be needed to restore function and alleviate pain. Many times surgery on the top of the foot will cause adhesions and scarring which can limit range of motion and can cause pain. Many patients are referred to therapy post surgery for strengthening and to address range of motion limitations.

foot

Fracture of the foot or ankle
Therapy is essential in retuning a patient quickly to their daily living as well as athletic activities. Restoring proper mobility of the various ankle bones as well as strengthening and balance control of the ankle is essential in preventing future injuries to the foot, knees, hip and back.

Hamstring Strain/Quadricep Strain/Groin Strain
The above muscle strains are a common occurrence among athletes and people who may be beginning an exercise program.  Overuse is a common cause of muscle strain, but biomechanical faults with gait and running may be the underlying precipitating factor.  Achieving proper muscle balance and flexibility within the pelvis and lower extremities is paramount.  Manual therapy techniques to the muscles and joints may be necessary to allow a full return to activity.

knee

Knee
At CPTI we treat a wide variety of knee injuries related to falls, sports injuries, motor vehicle accidents, post –operative procedures and work related injuries. Patella-Femoral Syndrome/ Poor Patellar Tracking. These conditions are very common and can be treated successfully with physical therapy. Symptoms often appear as pain around or under the knee cap, popping and or grinding under the knee cap, pain with prolonged sitting and going down stairs or declines.

"I highly recommend CPTI they helped solve the problems with my knee.  They also found some scar tissue around my knee and broke it up. Their deep tissue massage and the therapy have now made it possible to walk further with little or no pain." 
Judy S.

The goal of therapy is to regain proper mechanics through medial quad and hip strengthening. It is also important to stretch the IT Band and any other lateral knee tissues. A gait analysis is often necessary to determine if any underlying foot mechanics are adding to or causing the knee pain. Shoe inserts or orthotics can often be helpful. A variety of taping techniques in conjunction with exercise can be very beneficial.

Ligamentous Injuries Pre and Post Operative (ACL, MCL, LCL, PCL SPRAINS/ TEARS)
Patients with the above injuries who are requiring surgery may be sent to physical therapy for pre-operative therapy to regain full range of motion, maintain strength, control pain and swelling to optimize surgical results. Postoperatively, patients will be guided through a program of exercises which will follow the surgeons protocol for range of motion and strength gains. Strict protocols are followed to ensure protection of the reconstructed ligaments. In the later stages of rehab patients are educated in advanced balance proprioceptive activities and sport specific exercises are given. Four to six months is the average return to sport time frame within most protocols.

Total Knee Replacements
The main goal of therapy is to decrease pain and swelling in order to regain range of motion and functional strength. Range of motion is achieved through manual techniques for the knee cap and scar mobility. A range of 120 degrees plus of flexion and 0 degree extension is key to restoring a normal gait pattern. Our patients are progressed through a home exercise program per the doctor’s protocol. Our goal is to minimize pain and optimize function.

Runner’s Knee
This is often referred to as Illio-Tibial Band Syndrome or IT Band Friction Syndrome. A thorough diagnosis is important, to determine the cause of this as it can be related to foot/ankle dysfunction, knee dysfunction, or weak muscles in the hip or back. Meniscus tears, repairs, and meniscectomies. A proper physical therapy evaluation is necessary to determine if a possible biomechanical fault is the reason for the meniscus failure. The rehabilitation for meniscal repairs is very different than that of a meniscectomy. Therefore, it is imperative that you get proper guidance to have the best outcome after one of these surgeries. Meniscal repair procedures usually entail a period of nonweight bearing status to allow healing of the repair.

Restless Leg Syndrome
This is a sleep disorder characterized by leg discomfort during sleep and it’s only relieved by frequent movements of the legs.  The uncomfortable sensations usually occur shortly after going to bed, but can occur in the daytime.  Symptoms can be worse during stress or emotional upset.  There is no known cure for RLS.  At CPTI we have had good results treating patients with RLS.  We use a combination of gentle exercises, stretching, and massage.  Stretching on the Power Plate machine in combination with Anodyne, an infrared light therapy, has provided excellent results.  It is also recommended that persons with RLS decrease alcohol, caffeine, and tobacco use. 

hip

Hip Impingement Syndrome
CPTI has been working with athletes with this syndrome, particularly soccer players, for the last 20 years. For the last thirteen years, we have worked with many hockey and soccer players who have chronic groin strains and hip impingement syndromes. Many times there are easy mobilization techniques that can be done at the clinic to minimize the symptoms and pain associated with this condition.   The patient can then be taught how to control or manage symptoms, in order to return to normal activities of daily living as well as athletic activities.

Trochanteric Hip Bursitis
This is often referred to as Illio-Tibial Band Syndrome or “snapping hip.” A thorough evaluation, looking at the biomechanics of the entire lower leg, foot, ankle, knee, hip, and back is very important in order to find a possible mechanical cause of the pain. Often, these types of symptoms are also related to the lower back. At CPTI, you will learn the proper stretching, strengthening, stabilization, and balance techniques to minimize your symptoms and return to your active lifestyle.

Total Hip Replacement
Total hip replacements are becoming very common within our aging populace.  Most patients, depending on age and functional status, will receive postoperative care for a brief period in a skilled nursing facility or at home with a home health physical therapist.  The surgeon will usually send patients to outpatient therapy in order to regain full range of motion and for progressive strengthening.  The primary focus is to improve hip abductor muscle strength in order to eliminate any limp with gait.  Scar massage may be necessary and initially modalities may be used to help control pain levels.  Most patients progress well and can make a full return to normal activities.

Oversupinators
Oversupinators tend to have rigid, high-arched feet. They may need orthotic devices to support the feet and provide shock absorption during walking, running and jumping activities.

Overpronators
This foot structure is commonly referred to as soft foot. Soft foot may lead to foot, knee, hip and back pain. When the foot pronates too far it allows the entire leg to roll in causing abnormal stresses to the knee, hip and back. Various exercises along with orthotic devices or shoe inserts may be beneficial in helping control the foot and alleviate associated pain. It’s imperative to get a comprehensive physical therapy biomechanical evaluation to determine if this is related to your symptoms so an appropriate individualized plan can be used to provide the quickest recovery possible.

Tarsal Tunnel
Tarsal Tunnel symptoms are similar to Carpal Tunnel Syndrome symptoms in the wrist and hand. Pressure on the tibial nerve results in pain and symptoms that can mimic plantar fasciitis and heel pain. It’s important to get a comprehensive physical therapy biomechanical evaluation to determine the cause of your foot pain so an appropriate individualized plan can be used to provide the quickest recovery possible.