Southwest Therapy Specialists, P.C.

What Hurts?

The list below is not inclusive, just a starting point for Southwest Therapy Specialists' team of Physical Therapists, Occupational Therapists/Certified Hand Therapists and Aquatic Therapists to help. With a physician's prescription insurance carriers typically cover all and many more reasons of "What hurts" listed.
Call Southwest Therapy Specialists at (602) 249-9129 for questions. Select a category below to learn more about injuries.

Shoulder Injuries

Rotator Cuff Tendonitis:
      This condition is often associated with repetitive, abnormal stress to the tendons of the rotator cuff (four small muscles that surround and steer shoulder movement) resulting in inflammation and pain. Resultant cuff tendonitis may cause sharp, acute pain in the shoulder or upper arm aggravated after periods of activity such as overhead throwing or lifting. Pain may also be experienced when dressing, grooming, sleeping on the affected shoulder, reaching high over head, or behind the back. Functional weakness is usually present with lifting during everyday activities (especially between waist and shoulder height). If the condition is left untreated, the tendonitis may progress to a partial thickness tear of the rotator cuff, often requiring surgery. Physical therapy at Southwest Therapy Specialists can be beneficial to regain lost shoulder motion and functional strength while decreasing pain and facilitating the healing process to the injured tissues.

Anterior Shoulder Dislocation:
      This injury typically occurs as a direct result of trauma to the ligaments and capsular tissues that surround the ball and socket (glenohumeral joint) of the shoulder. Some common mechanisms of injury include being hit behind the arm while the shoulder is positioned in an overhead throwing motion and falling onto an outstretched arm. This condition contributes to a sense of instability in the shoulder combined with an inability to perform certain daily activities and sports. Those who experience a shoulder dislocation are typically evaluated by a physician for reduction and to rule out fracture or cartilage (glenoid labrum) damage. Physical therapy is often ordered to help restore shoulder motion and strengthen the muscles that cross the shoulder to prevent recurrence of dislocation. Strengthening and training the person with shoulder dislocation the “right” way to work back to full function is Southwest Therapy Specialists’ expertise.

SLAP (Superior Labrum Anterior and Posterior) Lesion:
      This condition involves injury to the superior (top) portion of the labrum of the shoulder joint. The labrum is a cartilaginous ring that serves to deepen the socket of the joint providing both stability and a site for muscular attachment for the biceps brachii. Common causes of a SLAP lesion include falling onto an outstretched hand, overhead lifting, and overhead throwing. This injury can be difficult to identify clinically; however, common patient reports include instability within the shoulder causing a vague ache. In addition, some patients may report catching, popping, or clicking within the joint during functional activities. Southwest Therapy Specialists, located in Phoenix, AZ is here to help with keeping the SLAP lesion from interfering with life, work, play and leisure activities.

Rotator Cuff Impingement:
      This condition involves a progressive, mechanical impingement of the rotator cuff tendons beneath the bony architecture (coracoacromial arch) of the shoulder joint. The resultant impingement of the cuff tendons results in significant shoulder pain increased with the performance of overhead and functional activities. Common causes of cuff impingement include bony abnormalities and rotator cuff tendon thickening. Conservative treatment with the one of our specialists at Southwest Therapy Specialists manual orthopedic Physical Therapist is typically geared towards decreasing the initial pain and inflammation, restoring pain free range of motion within the shoulder, and rebuilding functional strength to the rotator cuff and scapular musculature.

Adhesive Capsulitis (Frozen Shoulder):
      This condition involves stiffening (freezing) and inflammation of the soft tissues (joint capsule and ligaments) that surround the shoulder joint. The stiffening of these structures creates severe loss of functional shoulder movement, pain surrounding the joint, and an inability to sleep on the affected side. The time for complete resolution of shoulder range of motion can vary between 12 to 36 months, thus the team at Southwest Therapy Specialists aims to teach and educate how the person with adhesive capsulitis can manage their individualized home program. The incidence for this condition is approximately 2% within the general population and from 10-35% within the Diabetic patient population. Other common factors related to an increase in the prevalence of this condition include cervical spine (neck) disorders, hypothyroidism, and prolonged post-surgical or post-traumatic immobilization of the shoulder. “This too shall pass” but only with help from a dedicated team of professional such the Physical Therapists at Southwest Therapy Specialists, Phoenix, AZ.

Rotator Cuff Tear (Partial Thickness and Full Thickness):
      This condition involves complete (full thickness) or incomplete (partial thickness) disruption of the tendons of the rotator cuff muscle group. Common causes of injury include direct trauma to the shoulder, repetitive overhead lifting, and participation in sports that require overhead throwing. In addition to these causes, some patients experience a cuff tear simply as a direct result of a degenerative process with no specific trauma or activity associated with the injury. A common presentation for a patient with a rotator cuff tear includes an individual 40 years of age or older with reports of constant, lateral shoulder pain affecting the ability to sleep accompanied with functional weakness limiting his or her ability to lift the arm against gravity. Southwest Therapy Specialists, PC is here to help identify the issue if not fully diagnosed as presented with just a partial thickness tear, and often physicians refer to our specialized Physical Therapists to assist with their firming up their definitive diagnosis.

Acromioclavicular Joint Injuries:
      The acromioclavicular (AC) joint (the connection between the collar bone and the shoulder blade) is commonly injured as a result of either a direct force to the tip of the shoulder or through an indirect force sustained during a fall on an outstretched hand. This resultant force results in disruption to the capsule and ligaments that supports the bony architecture of the AC joint. The patient with an acute AC joint injury will typically cradle the involved arm against the body with the uninvolved hand for support. This posture helps to decrease the pull of the weight of the arm against the ligamentous and capsular tissues that have been disrupted. The dedicated manual orthopedic Physical Therapists will help gently guide the person with an acromioclavicular (AC) joint injury to achieve the best functional outcome.

Low Back Pain
      The spine is the most dynamic structure in our body as it allows for optimal stability and movement and maintains our posture. This highly integrated and dynamic structure is involved in all movement and is undergoing constant stress 24/7, so it should not be surprising to us when it starts to show wear and tear. Contributing factors to low back pain include poor body mechanics and work ergonomics, decreased strength, and muscular/structural imbalances. As the low back is subject to repetitive stresses of daily life and occasional injury, it may respond by showing signs and symptoms of wear and tear. These symptoms may manifest themselves as pain located around the waistline and/or lower extremities, and possibly, numbness and tingling to the lower extremities. If any of these symptoms persist or worsen, seek immediate medical attention. The team at Southwest Therapy Specialists is here to help with all issues of the spine and are dedicated to ensuring the best outcome.

      Spondylolisthesis is a forward slipping of a vertebrae over another. The individual may or may not present with pain and is usually the result of repetitive stress to the spine. A program emphasizing proper body mechanics, aerobic conditioning, lumbar stabilization, core strengthening, and patient education is key to eliminating and preventing low back pain. Individuals with low back pain are encouraged to take a proactive role in their recovery in conjunction with the guidance and supervision of your physician and physical therapist at Southwest Therapy Specialists.

Low Back Strain:
      Muscle strains may occur as a result of poor body mechanics with daily activities/work tasks or unexpected movement (i.e. lifting heavy objects, slipping on ice, or motor vehicle/sports accident). All of these can cause the muscles to contract beyond their normal limits placing stress on the spine. Ice and anti-inflammatories will help reduce pain and swelling. Consult a physician or Southwest Therapy Specialists’ manual orthopedic Physical Therapist to determine severity of injury and if exercise may be beneficial.

Herniated Disc:
      Discs are located between the vertebrae of the spine to help minimize shock and help optimize movement. As we age, the discs lose their elasticity and may tear or bulge onto the spinal nerves. This can produce extreme muscle spasms and pain to low back and legs and/or numbness and tingling to legs and toes. Our team of Physical Therapists have helped person’s with herniated disc issues achieve the best possible level of function and fitness without increasing the symptoms from all areas of Phoenix, AZ.

Hip Injuries

Hip Pointer:
      A bruise caused by direct contact to the front hip bone aka hip pointer. This injury can produce extreme pain and limit normal motion at the hip and trunk. Because of close proximity of internal organs, follow-up with a family physician is advised to rule out potential fracture or internal injury. Range of motion exercises may begin to help minimize pain and swelling if all other injuries are ruled out. Ice and anti-inflammatories will also help reduce the effects of the injury. Referral to Southwest Therapy Specialists, PC in Phoenix, AZ is just a prescription away from help.

Piriformis Syndrome:
      This condition refers to irritation of the piriformis muscle which lies underneath the gluteus muscle, or buttock. Because the sciatic nerve passes underneath or through the piriformis muscle, burning or numbness/tingling may occur due to nerve irritation. Pain may start in the buttock and radiate down the affected leg. It is important to seek proper medical attention to rule out referred pain from the spine. In most cases, piriformis syndrome may be alleviated through anti-inflammatories, and lower extremity flexibility program, if spine problems are ruled out. Many fitness trainers miss this area during their strength training and fitness club work-outs, often aggravating the symptoms. Southwest Therapy Specialists manual orthopedic Physical Therapists are experts in identifying the cause and specific treatment as part of their fitness training, flexibility, stretching, and overall conditioning programs.

Iliotibial Band Syndrome:
      Inflammation of the thick, fibrous tissue that runs from the top of the hip to just below the knee. This injury commonly occurs in runners and can be very debilitating. Formal rehabilitation at Southwest Therapy Specialists may be required to reduce pain and inflammation and restore proper muscle balances throughout the pelvic region. Once the pain diminishes, a thorough running analysis may be completed to prevent recurrence of the injury.

      An injury to the inner thigh or groin area can be caused by running, jumping, twisting, kicking. Signs and symptoms may range from mild tenderness over the muscle involved to the inability to contract the muscle and walk. There will be localized pain and swelling and in severe cases, the person may have bruising to the inner thigh, indicating bleeding to the injured muscle. Depending upon the severity, treatment may include ice, compression wrap, crutches (if unable to walk). Rehabilitation is usually slow and controlled to minimize re-injury and our team of Physical Therapists know how to minimize the pain and help transition the person with a groin injury back to activity.

      Injury to the front of the thigh caused by a forceful contraction of the quad muscle when the hip is bent and the leg is straight (as in a kicking movement). Signs and symptoms may range from mild tenderness to the touch to the inability to walk without pain. Bruising may be present with associated swelling. Treatment includes ice, anti-inflammatories, crutches (if unable to walk). Manual orthopedic Physical Therapy at Southwest Therapy Specialists, PC in Phoenix, AZ may be warranted to regain proper mobility.

      Injuries to the muscles and their tendons due to a forceful contraction of the muscle involved.

Knee Injuries

Osteoarthritis (OA):
      General degeneration of the knee joint that stems from wear and tear is often diagnosed as osteoarthritis, and can be helped by Southwest Therapy Specialists’ team. The degeneration is accompanied by a gradual increase in pain with activities (walking, stairs, prolonged sitting or standing). Physical therapy will help alleviate the pain by focusing on proper strength training, fitness training, and overall teaching how to properly protect the knee joints.

ACL Injury:
      The ACL injury is the most common injury to the knee. This ligament prevents the lower leg from moving forward on the upper leg. The mechanism of injury is from a twisting motion when the foot is firmly planted. The degree of severity ranges from a mild stretch of the fibers (Grade I) to complete rupture of the ligament (Grade III). The individual may feel or hear a “pop” with associated swelling. The individual may also report a feeling of “giving out” to the knee, limiting the function of the knee. An orthopedic specialist will be able to help diagnose and recommend treatment options for the individual. A referral to Southwest Therapy Specialists is an important part of achieving recovery and having the best possible outcome.

MCL Injury:
      This ligament lies along the inside of the knee and can be damaged by direct trauma from the outside of the knee towards the inside while the foot is planted. The individual may experience pain while walking, climbing stairs, and prolonged sitting. Treatment may include ice, anti-inflammatories, and short-term immobilization to allow the fibers to heal. Rehabilitation may be required to establish range of motion and strength following this injury.

Meniscus Injuries:
      Commonly called torn cartilage, this is an injury to one of the two circular pads between the upper and lower legs. They function to decrease shock to the knees and distribute weight bearing forces through the legs. The mechanism of injury is a compression force associated with a twisting motion. A “pop” may be heard, but there is usually increased pain along the joint line of the knee. Signs and symptoms include pain, swelling, knee “locking up” or the feeling that the knee is stuck, and difficulty with walking and stairs. An orthopedic consultation is suggested to rule out trauma to other structures. If the tear is small enough, the meniscus may heal on its own; however, if pain and decreased function persist, arthroscopic surgery may be required to repair the meniscus.

      Injuries to the ligaments in a joint. The knee has four main stabilizing ligaments, any of which can cause problems if torn.

Patellofemoral Pain Syndrome:
      Categorized as general knee pain that manifests itself near or around the kneecap (patella). This can be caused by an acute injury, muscle imbalances, walking abnormalities, or misalignment of the kneecaps. One or a combination of all of the above can lead to PFPS, causing pain with walking, stairs, squatting, prolonged sitting. Manual orthopedic Physical Therapy can address muscle imbalances and acute symptoms, as well as recommend proper footwear to maximize proper walking mechanics.

Foot Injuries

Plantar Fasciitis:
      Catchall phrase used to describe pain along the inside arch and heel. Increased pain occurs upon the first few steps in the morning or after prolonged sitting. Plantar fasciitis can occur in individuals with poor foot biomechanics (excessive foot pronation), decreased flexibility and strength in the surrounding musculature. Ice massage and rolling the foot over a rolling pin may help reduce pain and irritation. Proper shoe wear and walking analysis should be addressed as well.

Turf Toe:
      Repetitive overuse or trauma to the Big Toe, causing the toe to hyperextend. This condition can be very painful, especially with walking or recreational activities involving stop and go movements. Orthotics may help decrease the pain limiting the toe’s movement. Ice and anti-inflammatories will also help reduce pain and swelling to the joint.

Morton’s Neuroma:
      A mass of tissue that surrounds the nerve sheath of the nerves that innervate the toes is Morton’s Neuroma. It commonly occurs between the third and fourth toes and can cause burning, numbness, and tingling to the toes. Proper shoe wear is a must to avoid compressing the toes. Ice and anti-inflammatories will also help decrease the inflammation surrounding the nerve.

Lower Leg Injuries

Shin Splints:
      Overuse musculotendinous injury that can be caused by abnormal biomechanics, poor conditioning, and improper training. Pain can manifest in two locations: anterior or posterior. Proper Fitness Training and aerobics can be taught by the Physical Therapists at Southwest Therapy Specialists to help mitigate the pain.

Anterior shin splints:
      Pain is on the outside of the lower leg and is associated with those runners who have a loud heel strike when running.

Posterior shin splints:
      Pain is on the inside of the lower leg toward the ankle. In both instances, weak muscles in the lower leg accompanied by improper footwear and running mechanics may exacerbate the symptoms and possibly lead to stress fractures. Physical therapy is needed to focus on pain reduction, lower extremity flexibility and strengthening, proper running mechanics, and proper footwear.

      If the above factors go unchecked, stress fractures may occur. They are usually caused by fatigue and breakdown of the surrounding musculature, subsequently placing greater stress on the bones. Immobilization is required to allow the bone to heal. Surprisingly, stress fractures do not appear on X-rays until after the fracture site starts to heal. Southwest Therapy Specialists’ team of manually based orthopedic specialists can assist in helping the physician in diagnosing this condition.

Achilles’ Tendonitis:
      The Achilles tendon is the large tendon found at the back side of the foot and ankle. This tendon attaches the calf muscles to the ankle and allows the ankle to be pointed in a downward position and propel us when we walk. Inflammation of the Achilles’ tendon is caused by overuse injuries (running, jumping), as well as decreased calf strength and flexibility. Tenderness and swelling are present over the tendon along with pain with walking, stairs, and running. Treatment includes ice, anti-inflammatories, flexibility training, and lower extremity strengthening. Foot biomechanics and proper footwear should be addressed as well.

Ankle Injuries

Lateral Ankle Inversion Sprain:
      This injury is typically found in athletics when an individual “rolls” their ankle. Often times, this injury is characterized by swelling at the outside ankle bone (lateral malleolus) with possible bruising if the injury is severe enough. An ankle sprain results in damage to the ligaments of the outer ankle, although a small fracture can occur at the outer ankle bone. Initial management of this injury should include rest, ice with compression, and elevation of the leg to decrease swelling. Southwest Therapy Specialists’ team is here to help with all soft tissue injuries.

Peroneal Tendonitis:
      The peroneal tendons are the tendons at the outside of the ankle. In some instances, these tendons can become injured resulting in swelling and pain at the outside of the ankle, slightly underneath the outer ankle bone. These tendons can also be injured following a lateral ankle sprain when the peroneal muscle is forced to contract quickly to prevent the ankle from rolling inward too far. Ice and compression is helpful in managing this injury acutely but if pain persists, seeking medical attention may be helpful in resolving the injury completely.

Posterior Tibialis Tendonitis:
      The posterior tibialis muscle is found at the inner aspect of the lower leg with the tendon extending down the leg and along the inner aspect of the foot. The function of this muscle and tendon is to support the arch of the foot. This tendon can become injured with running and also if the foot pronates or collapses too much. In this instance, the muscle and tendon become overworked resulting in swelling and irritation of the tendon. Often, this injury requires a biomechanical assessment by a medical professional to resolve aggravating factors and resolve the injury. Initial management can include ice and rest.

Plantar Fasciitis:
      The plantar fascia is a thick band of tissue along the arch and the bottom of the foot that is needed to support the arch. This band of fascia attaches the underside of the heel. This diagnosis is usually used to describe pain that occurs at the inside arch and the heel. Typically, this is characterized by pain occurring at the heel with the first step in the morning and made worse with prolonged walking and running. Ice massage at the area of the pain can be helpful and analysis of biomechanical factors contributing to the injury is usually needed to completely resolve this condition.

Stress fractures:
      A stress fracture can occur in any bone; however, one area common for injury is at the 5th metatarsal or the lateral bone of the foot. Usually the area of the fracture is point tender and feels worse with running and sometimes with walking. A stress fracture is typically diagnosed with the use of a bone scan or an MRI and the team at Southwest Therapy Specialists have helped the person with a stress fracture deal with the pain associated with this point tender area.

Generalized Weakness

Chronic Fatigue Syndrome:
      Southwest Therapy Specialists is here to help with care and compassion for this extremely debilitating syndrome in which the person may be misdiagnosed or the problems overlooked by the physician as its symptoms are similar to so many other ailments. Fatigue can be a symptom for other illnesses, but the primary symptoms for Chronic Fatigue Syndrome are noted that the fatigue is not the kind normally felt after a particularly busy day or week or stressful event but instead is a severe, incapacitating fatigue that is not improved by bed rest and often worsens with physical activity or mental exertion. As a result, the all-encompassing fatigue lasting at least six (6) months can dramatically put a halt to the person’s stamina and activities. Symptoms include:
      • increased malaise (extreme exhaustion and sickness) following physical activity or mental exertion
      • problems with sleep
      • difficulties with memory and concentration
      • persistent muscle pain
      • joint pain (without redness or swelling)
      • headache
      • tender lymph nodes in the neck or armpit
      • sore throat
      In addition, persons with Chronic Fatigue Syndrome may report:
      • brain fog (feeling like you're in a mental fog)
      • difficulty maintaining an upright position, dizziness, balance problems or fainting
      • allergies or sensitivities to foods, odors, chemicals, medications, or noise
      • irritable bowel
      • chills and night sweats
      • visual disturbances (sensitivity to light, blurring, eye pain)
      • depression or mood problems (irritability, mood swings, anxiety, panic attacks)
      CFS often affects patients in cycles: Patients will have periods of illness followed by periods of relative well-being. For some patients, symptoms may diminish or even go into complete remission; however, they often recur at a later point in time. This pattern of remission and relapse makes CFS especially hard for patients to manage. Patients who are in remission may be tempted to overdo activities when they're feeling better, but this overexertion may actually contribute to a relapse. Southwest Therapy Specialists, PC in Phoenix, AZ helps the person with Chronic Fatigue Syndrome to regain control of their symptoms with gentle, conditioning using Aquatic Therapy, or a combination of traditional land-based manual Physical Therapy to regain muscle strength and overall fitness while teaching the person how to manage their symptoms.

Weight Loss/Bariatric Issues

Weight Gain:
      Despite all the marketing schemes and advertisements, physical activity and exercises with positive motivation all make a marked difference for the success in weight control, weight loss, or the yoyo effect of fad diets without exercise. Southwest Therapy Specialists is uniquely able to help the person with weight loss concerns to achieve the steady, consistent level of varied exercise in an intimate, private practice away from the Fitness Clubs and gyms. Our dedicated Aquatic Therapy pool is designed to help the person with the ability to safely enter down five (5) steps with side grab rails on either side of the steps, to work out in an unloaded program that is safe for the spine, hips, knees, ankles and feet of the person with bariatric concerns. Our clinic can accommodate persons with 350 lbs. or less current weight, and if the weight issue is close but over this written limit a simple phone call to us at (602) 249-9129 may further clarify if we can assist. Our team of Physical Therapists are passionate in helping those who seek help with managing weight. Whether it is a “Roux-en-Y” gastric bypass surgery, adjustable gastric banding (lap banding), or other surgery to reduce obesity, physical activity is an essential part of any weight-loss program, to maximize the person’s fat loss while keeping valuable muscle mass.

Elbow/Forearm Injuries

Tennis Elbow:
      Also known as lateral epicondylitis. Tennis elbow stems from overuse, improper muscle strength, and repetitive movement of the wrist or elbow where the tendons at the elbow become stressed due to poor mechanics (i.e. typing, racquetball, tennis, golf). Localized pain at the lateral (outside) elbow is present with wrist and elbow movement. Pain can become so intense that lifting a glass of water may be a chore! Tennis elbow can be difficult to relieve if mechanics and flexibility/strength issues are not addressed. Ice massage and anti-inflammatories may help with the acute pain, but therapy may be required to address proper work and leisure ergonomics as well as muscle imbalances. Thermal or electrical modalities may be used to decrease inflammation and promote tissue healing. Splinting of the wrist may also be utilized to rest the muscles around the elbow during this time of healing. Many sporting goods stores carry straps that are placed below the elbow to help reduce pain. While these straps may be beneficial for some, they should not be considered as a cure-all, and improper use may even worsen symptoms. Our professional staff will also be able to analyze your golf swing or racquet stroke to prevent further injury.

Golfer’s Elbow:
      Also known as medial epicondylitis. Similar to tennis elbow with associated pain and decreased movement, but golfer’s elbow occurs on the inside of the elbow. Golfer’s elbow presents similar signs and symptoms as tennis elbow and is also difficult to heal if not handled properly. Therapeutic management of golfer’s elbow is very similar to that of tennis elbow. Splinting may be used to decrease strain on the muscles, and the use of anti-inflammatories will help with tissue swelling and pain. Therapy focuses on restoration of muscle balances (flexibility and strengthening), education on causative factors and prevention, and thermal and electrical modalities to decrease inflammation and facilitate healing. Our professional staff will also be able to analyze your golf swing or racquet stroke to prevent further injury.

Pronator Syndrome:
      This condition involves the compression of the median nerve in the forearm. The median nerve passes into the forearm down the front of the elbow and passes under ligaments and into muscles. Compression of this nerve in the forearm generally occurs as it enters between two heads of a muscle—the pronator teres (thus the name “pronator” syndrome). The pronator teres muscle turns the palm of the hand down. Patients with this condition usually complain of an aching pain in the forearm, increased pain with gripping while the forearm is pronated (palm down), decreased strength, and forearm fatigue. Conservative management is generally the first course of treatment. Occupational therapy may be prescribed for splint fabrication to limit forearm rotation, nerve gliding exercises, stretches to maintain flexibility, and activity and job modification to restrict repetitive forearm rotation. If the condition is unresponsive to conservative treatment, surgical decompression of the nerve may be considered.

Cubital Tunnel Syndrome:
      This condition involves the ulnar nerve as it travels down the inside of the arm behind the elbow. This nerve lies in a groove on the inside of the elbow. If you’ve ever hit your “funny bone” then you’ve experienced the symptoms of Cubital Tunnel Syndrome—elbow pain and numbness/tingling in the ring and small fingers. If left untreated, it can progress to significant hand weakness and a “claw” deformity of the ring and small fingers. It is exacerbated by repetitive or static bending of the elbow, arthritis, or trauma to the elbow. Treatment for Cubital Tunnel Syndrome includes use of anti-inflammatories to reduce swelling, splinting of the elbow at night to prevent bending of the elbow and stretching of the nerve, and use of an elbow pad during the day to protect the nerve. You may be referred to an occupational therapist for splint fabrication, education on proper body mechanics and workstation set-up, nerve gliding exercises, and exercises to maintain range of motion and strength.

      Fractures may be caused by falling on an outstretched arm or by direct trauma to the elbow. The elbow has three joints that are surrounded by ligaments. Because of its complex structure, improper alignment of the bones and any associated ligament damage can significantly reduce elbow motion, stability, and function. It is very important to seek medical attention if an elbow fracture is suspected.

Wrist/Hand Injuries

De Quervain’s Syndrome:
      This condition involves inflammation of the tendons of the thumb. Pain is very noticeable in the wrist and thumb during general thumb use and during gripping and pinching activities. Conservative management usually consists of splinting the wrist and thumb, along with the use of anti-inflammatories (oral and/or injection). Occupational therapy may also be introduced to restore flexibility to the wrist and thumb, evaluate causative factors, educate on the prevention of symptoms, and strengthen the wrist and thumb to regain function. Therapy may also be prescribed to use thermal or electrical modalities to control inflammation and pain.

Fractures to Hand or Wrist:
      Bones can be fractured and dislocated. Southwest Therapy Specialists helps with all fractures (of all bones, not just the hand or wrist bones). All treatment is aimed to increase movement and decrease pain when medically appropriate to move post-fracture or dislocation. A fracture is a break in the bone (a.k.a. broken bone), and a dislocation is when a bone is pushed out of place so the two bones are no longer lined up correctly at the joint where they previously articulated. An example is a “FOOSH” as one of many common mechanisms of injury, i.e. Fall On Out Stretched Hand with the wrist hyper-extended backwards. Fractures of the metacarpals (the longest bones in the hand just before the bid knuckles) are also common sports injuries with the most common fracture known as boxer’s fracture, that typically occurs when the hand strikes an object with a closed fist. Other common fractures include scaphoid fractures that are not readily obvious upon first examination. Many people believe the fractured scaphoid is simply a sprained wrist because initially there is no obvious deformity and very little swelling, but the pain persists and progressively can become excruciating if the fractured bones begin to move apart. Complications occur in the wrist area with this Navicular bone fracture as the decreased blood circulation becomes compromised and the fractured bone may begin to die. Proper alignment of the bone(s) is essential for normal healing and restoration of motion. In addition, because of important vessels and nerves surrounding these structures, it is very important to follow-up with an orthopedic surgeon or a hand surgeon. Treatment in Hand Therapy generally begins immediately after the casting or surgery stabilized the fracture, followed by swelling management, pain management, desensitization and specialized exercises to regain range of motion of the joints. Strengthening and functional use with dexterity, coordination and Visual Feedback Therapy initially help to regain the person’s use in life.

      Tendonitis, simply put, is inflammation of the tendon. A tendon is what connects muscles to bone, and it typically crosses a joint. Overuse of the joint or muscle causes inflammation of the tendon. Tendonitis is very common in the wrist and hand. Tendonitis of specific tendon(s) can have different names (i.e. DeQuervain’s syndrome or tenosynovitis is a common injury in racquet sports and in anyone who uses a lot of wrist motion, especially repetitive rotating and gripping with the thumb and wrist. This overuse may eventually lead to irritation and swelling of the thumb tendons in the anatomical snuff box area just at the base of the thumb in the first dorsal compartment.) (Other closed tendon injuries treated at Southwest Therapy Specialists include, but are not limited to: Intersection syndrome, finger tendonitis, trigger finger, Extensor Carpi Ulnaris (ECU) Tendonitis). Southwest Therapy Specialists therapists focus on the specific cause and educates the person with tendonitis how to manage and improve the symptoms, and to help prevent re-occurance.

      Tendonitis is generally treated with anti-inflammatories to reduce pain and swelling as well as by immobilizing the joints the tendon crosses. Certified Hand Therapy (CHT)/Occupational Therapy may be prescribed as the professional to use thermal or electrical modalities to decrease pain and inflammation, for custom orthotic fabrication, to teach the person with tendonitis exercises and stretches to restore muscle and tendon flexibility, and to guide the person to strengthen the wrist and hand to resume normal use. Workstation and how the upper extremity is used in daily activities may need to be modified to prevent further injury and overuse.

Carpal Tunnel Syndrome:
      The carpal tunnel is a narrow passageway in your wrist that allows nine tendons in the fingers and thumb, as well as the median nerve, to travel into the hand. Pressure inside the carpal tunnel may be increased by repetitive wrist motions, gripping, or sustained wrist and finger positions. This increased pressure on the nerve may cause wrist pain, numbness and tingling in the thumb and first two fingers, and eventual hand weakness.

      Carpal Tunnel Syndrome may be managed at Southwest Therapy Specialists with anti-inflammatories and with custom orthotics or prefabricated bracing to immobilize the wrist and decrease pressure in the carpal canal located on the volar (palm side) aspect of the hand near the wrist flexion crease. A patient may be referred to our occupational therapist/Certified Hand Therapist (CHT) for custom fabrication of low temperature orthotics, instruction in a home program of nerve and tendon exercises, thermal or electrical modalities to decrease inflammation, and education on prevention of symptoms and activity modification. Tendon glides and neural tension glides along the entire Median Nerve path optimize the function and help prevent numbness, tingling, pins and needles nerve pain. Our professional staff may also visit your worksite to adjust your workstation and fully optimize good technique to avoid future injury or recurrence. The field of Health Ergonomics has heightened the public awareness of Carpal Tunnel Syndrome and many ergonomic adapted keyboards and manufacturing changes have occurred to help control this syndrome. If conservative management is unsuccessful, surgery may be required to decompress the nerve. Post-operative Hand Therapy for Carpal Tunnel Release ensures scar adhesions and pillar pain problems are minimized, swelling or edema is controlled or mitigated, and full functional strengthening of the grip and pinch strength is achieved in as cost-effective time frame as possible.

      Although there are hundreds of types of arthritis, the general population is most familiar with Osteoarthritis or Rheumatoid Arthritis. Southwest Therapy Specialists Certified Hand Therapists and manual orthopedic Physical Therapists are able to treat all types of arthritis. Most familiar, the patient with osteoarthritis generally has to cope with the “wear and tear” on the joints, somewhat likened to the tread on the car tire wearing out (as the cartilage lining the bone’s surface at a given joint thins causing potential of raw bone rubbing on raw bone); while the person with Rheumatoid Arthritis is actually coping with an autoimmune disorder that attacks the lining of the joints. Both of these two forms of arthritis frequently occur in the wrist and hand. In addition to medical management, occupational therapy may be prescribed and the specialization of a Certified Hand Therapist (CHT) is highly needed. Therapy goals are to decrease joint inflammation, improve joint range of motion, and provide education on joint protection techniques as well as to provide equipment to relieve strain on the affected joints during daily activities. Certified Hand Therapists may also fabricate a rigid orthotic out of low temperature thermoplastic material to rest and immobilize joints during a “flare-up” and recommend a variety of prefabricated soft braces that support joints during hand use. Modalities for pain management and to decrease inflammation are taught as part of the home program and utilized in the clinic, desensitization is instructed, adaptive equipment and modifications to the functional approach to activities is instructed. Instruction is carried out including pacing of activities and health ergonomic ways to perform work, leisure and recreational activities.

Trigger Finger:
      Trigger finger, also known as stenosing tenosynovitis, can occur in any of the fingers or thumb. It is caused by the swelling of one of the tendons that bend the finger or thumb. This tendon inflammation causes the finger to catch in a bent position. Straightening of the finger will then cause it to snap. Trigger finger can be associated with chronic inflammation (i.e. rheumatoid arthritis), overuse of the hand, or from using tools with hard or sharp edges. Conservative management may consist of anti-inflammatories or cortisone injections. Occupational therapy may be prescribed for splinting of the hand in order to rest the tendon and prevent triggering, for use of modalities to decrease inflammation, to provide exercises to maintain joint motion, and to provide ergonomic assessment and education.

Mallet Finger:
      Mallet finger is an injury to the fingertip. It commonly occurs when the tip of the finger is hit—usually while playing sports such as baseball and basketball. With this injury, the tendon that straightens the tip of the finger is disrupted, and the finger ends up in a bent position. Mallet finger can also be associated with a fracture of the fingertip. Your finger will be splinted or pinned in a straight position until the tendon heals (usually around 6 weeks). The tip of the finger is NOT allowed to bend during this time. You may need to see a specialist if there is a fracture or if the finger does not heal properly.

Jersey Finger:
      Jersey finger is the opposite of mallet finger and occurs when the fingertips, usually the ring finger, is forcibly extended, such as when a person’s finger gets caught in the opponent’s jersey. The flexor tendon is forcibly bent at the fingertip, to be pulled away from the bone and the inability to flex the finger forward without assisting the tip is a tell-tale sign that immediate intervention with a Hand Surgeon is needed. Just as with the mallet finger, custom orthotics and Hand Therapy will help ensure recovery once the surgeon has deemed therapy is appropriate. Edema management, pain management, range of motion, and isolated functional activities are specifically taught to isolate the most important treatment to regain function as quick as is feasible. Soft tissue injuries take time to heal, and patience is a virtue!

Tendon/Ligament Injuries to Fingers:
      These types of injuries usually occur with direct contact to the fingers (“jammed finger”) or forceful gripping of an object that is moving. Pain may occur with movement, or in some cases, finger movement may not occur at all if a tendon is ruptured. Proper medical attention is necessary to avoid permanent deformity to the finger involved. Immobilization is usually done as required by the physician to allow proper healing of the damaged tissues. Once the splint is removed, occupational therapy will help restore proper motion to the fingers and facilitate the return to full function.

Guyon Canal Syndrome:
      This condition involves the ulnar nerve and artery as they pass into the hand at the wrist (on the small-finger side of the hand). It is also known as “handlebar palsy”—named for pressure on the ulnar nerve in the hand from the handlebars of a bicycle during long-distance cycling. Pressure on this nerve causes numbness and tingling in the ring and small finger, pain on the small-finger side of the hand, and eventual hand weakness. Treatment generally consists of conservative management with the use of anti-inflammatories and/or therapy. Therapy may include splinting of the wrist until the irritation of the nerve subsides, use of modalities to decrease inflammation, activity and tool modification to reduce pressure on the nerve, and strengthening of weak muscles.

      Southwest Therapy Specialists expertise in wound management, dressing changes, skin care, edema control, soft tissue manual mobilization, lymphatic drainage, pain management and overall treatment of the arm following infections is highly regarded. Our Certified Hand Therapists (CHT) have over 30 years of managing wounds from cat bites, dog bites, human bites, spider bites, Diabetic wounds, gangrene, and flesh-eating diseases, to name a few. With the proper surgeon management and immediate referral to our Certified Hand Therapist/Occupational Therapists the scar and tissue transfer/split thickness skin grafts or other coverage is ensured of the best possible outcome.