The ankle joint is made up of 3 bones, the tibia (shin), the fibula (bone on outside of leg) and the talus (top of foot). The tibia and fibula meet at the bottom of the leg and form an upside down U shape, which sits on top of the talus bone. Functionally the ankle joint is considered to have one direction of movement, dorsiflexion (pulling ankle upward), and plantarflexion (pointing foot downward). Along with the bones of the foot, the ankle must be able to withstand large weight bearing forces and at different times provide a stable base for standing and moving, as well as mobility to allow the foot and ankle to adjust to unstable and uneven surfaces. It is the complexity of the ankle and forces it endures that makes it a joint that is frequently injured.
Read more: Physical Therapy: Ankle
The brain and its many parts control all of our movement, balance, body awareness, and ability to physically perform our daily tasks. There are a large variety of injuries and diseases that affect the central nervous system and a person’s ability to function. Physical therapy plays a large role in helping people to regain their ability to move and function, and maximizing their capabilities when the brain has been affected. Each individual person will present very differently, therefore treatment programs are individually tailored to a person’s impairments and personal goals. Treatment frequently involves identifying affected activities, breaking the movement necessary to complete an activity down to it’s basic components, and retraining the neuromuscular system or learning new ways to accomplish functional activities. A major goal in physical therapy treatment is preventing/reducing the risk of falls. Secondary complications that arise from a fall (fractures, concussion, fear) can significantly complicate the primary impairments from an injury to the brain. Listed below is a sample of some of the diseases and conditions a person might be referred to physical therapy for.
Read more: Physical Therapy: Brain
The elbow is one of the more stable joints in the body and consists of the intersection of three bones: the humerus (upper arm bone), and the radius and ulna (paired bones in the forearm). The elbow joint allows for bending/straightening (flexion/extension) of the arm, and for twisting (supination/pronation) of the forearm. Because of its location between the shoulder and the wrist, many elbow injuries occur as overuse injuries and may be related to concurrent shoulder/wrist problems.
Read more: Physical Therapy: Elbow
Much like the hand, the foot is comprised of a large number of bones. This large number of bones provides more directions of movement and allows for more complex function. The bones are supported by a wide array of ligaments arranged in many different orientations. The ligaments contribute to the formation of an arch in the foot. In addition there are many small muscles within the foot that contribute to its’ stability and movement. The foot encounters a wide variety of positions and stresses and is designed to adapt as needed. When the foot is flat, the bones are more mobile. This allows for absorption of shock and for the foot to adapt to uneven surfaces. When the foot is pointed downward and turned inward, the ligaments of the foot become taught and make the foot more rigid. This is important to assist with pushing off during walking and running. The complexity of the foot and the requirement of daily use for function can make treatment of foot injuries a more difficult process.
Read more: Physical Therapy: Foot
The hand consists of 27 bones and allows us to manipulate objects in our environment. The structure and muscles of the hand are responsible for its alternating flexibility and rigidity and involve the complex coordination of motor patterns that we learn in our infancy/childhood. The hand can be injured in many ways, and physical therapy for this area can restore the loss of function and bring back the quality of life many of us take for granted.
Read more: Physical Therapy: Hand
The heel bone (calcaneous) provides a major point of contact with the ground and provides an attachment point for the large calf muscles and Achilles tendon. It works in coordination with the other tarsal bones to allow mobility of the foot, and assist with the transfer of force during propulsion in the gait (walking) cycle.
Read more: Physical Therapy: Heel
The hip joint, medically referred to as the acetabulofemoral joint, is the joint between the femur (leg bone) and acetabulum (socket of the hip bone) of the pelvis. The primary function of the hip is to support the weight of the body in both static (standing) and dynamic (walking or running) postures. Because of its close proximity to the pelvis and back, often hip pain is related to lower back pain (see the lower back section of the website).
Injury to the hip can occur from trauma (fracture, labral tear), overuse (tendonitis, bursitis), decreased flexibility/muscle tightness, and prolonged stress (obesity, athletics, poor posture).
Read more: Physical Therapy: Hip
TMD (aka TMJ): Temporomandibular Disorder causes pain and other symptoms of the temporomandibular joint or joints (TMJ). The TMJs are the jaw joints. There is one on each side of your head just in front of your ear canals. Each joint contains the same types of structures that are present in other synovial joints of the body. There are a variety of temporomandibular disorders. The muscles, joint(s), or a combination of the two may cause pain. Since physical therapists treat muscle and joint problems, they are ideally suited to address TMD. Also, a majority of patients diagnosed with TMD, also have associated neck pain. Both respond well to treatment provided by a physical therapist. Symptoms include: pain in the jaw with chewing/opening, grinding in the jaw, a locking sensation/inability to fully open the jaw, or an “achy” pain running along the jaw line at rest.
The knee joins the thigh with the lower leg and consists of two joints: the patellofemoral joint (the joint between the patella and the anterior groove of the knee) and the tibiofemoral (the joint between the thigh and shin bone). Between the femur (thigh bone) and the tibia (shin bone), the knee contains two menisci (pieces of cartilage that make the convex femur and concave tibia more congruent). Each meniscus allows for stable motion and cushions the knee during weight bearing. The knee also contains four cruciate/collateral ligaments (ACL, PCL, LCL, and MCL) that give it stability and prevent excess motion at the joint. Finally, like most of the other joints in the body, the knee is bathed in synovial fluid and each bone is covered in a protective layer of cartilage, both of which are contained inside joint capsule.
Read more: Physical Therapy: Knee
The low back, or lumbar spine, is composed of bones, discs, joints, tendons, muscles, ligaments and nerves. It consists of five stacked vertebrae with a fluid-filled disc between each. The lumbar spine curves in a C-shape (called the lumbar lordosis), which allows it to support tremendous forces. In front of each vertebral body, is a foramen (hole/opening) that allows the spinal cord to pass through. The spinal cord is made up of nerves that pass signals to the brain, which controls muscle movement, sensation, regulates body functions, and maintains our balance and upright posture. At each vertebral level, nerves (called nerve roots) break off the spinal cord and exit out of holes called intervertebral (meaning between the vertebrae) foramen.
Read more: Physical Therapy: Lower Back
The lower leg, or shin, is composed of two bones. The tibia (the main weight bearing, or “shin” bone) and the fibula (the thinner outer leg bone). The lower leg connects the knee to the ankle and is an important attachment point for muscles that cross the knee and the ankle. Many of the muscles that control the foot and ankle originate in the lower leg, so it is highly correlated with foot and ankle pain.
Read more: Physical Therapy: Lower Leg
The “midback” or thoracic spine consists of twelve vertebrae and composes the posterior aspect of the thoracic cavity. Each of these vertebrae attach to a left and right rib that surround the organs and form the thoracic cage. Because of its attachment to the ribs, the thoracic spine is much less mobile than the cervical or lumbar spine. Pain can be disc, muscle, bone (rib or vertebra), or even organ related so it is important to let your primary care physician know about your pain.
Read more: Physical Therapy: Mid Back
Many conditions can cause neck pain. Often with neck pain there is a loss of motion, feelings of stiffness, weakness in the neck and arms, or headaches/jaw pain. All of these can lead to activity limitations and interfere with your life.
Read more: Physical Therapy: Neck
The shoulder is the most mobile joint in the body. It consists of three structural joints: the glenohumeral (the ball and socket), the acromioclavicular (where the collarbone meets the shoulder), and the sternoclavicular (where the sternum and the collarbone meet). These three joints work together to allow for motion in all planes. However this mobility also makes the shoulder one of the most unstable joints, leaving it susceptible to injury. To compensate and maintain stability, the cartilage, ligaments, and muscles act as the primary supports. Some shoulder problems arise from disruption of these soft tissues as a result of injury (rotator cuff tear, SLAP tear) or from overuse of the shoulder (tendonitis, bursitis). Other problems arise from a degenerative process in which tissues break down and no longer function normally (arthritis).
Read more: Physical Therapy: Shoulder
The wrist includes several joints and consists of the intersection of the radius and ulna (forearm bones), the eight carpal bones (two rows of four), and the five proximal metacarpals (the bones of the hand). The wrist joint moves in four directions and allows for a good deal of the dexterity that we rely on everyday. Many of the muscles, nerves, and arteries that coordinate hand movement originate in the forearm and travel through the wrist to the hand. This makes the wrist a key area in both forearm and hand pain.
Read more: Physical Therapy: Wrist