Conditions Treated

The knee contains the anterior cruciate ligament (ACL), one of four ligaments (tough bands of tissue) that connect the femur (thigh) bone to the tibia (lower leg) bone. In combination with the posterior cruciate ligament (PCL), the ACL makes a diagonal "X" through the center of the knee joint and provides stability to the knee and allows it to twist/rotate and move side-to-side. The ACL is injured or torn when it is stretched beyond its normal range of movement. Research shows approximately 50 percent of ACL injuries also involve other structures in the knee (meniscus, the pad/disc between knee bones, cartilage or other ligaments).

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The adductor/groin muscles are located on the inside of the thigh. Adductor/groin strains can happen during vigorous directional changes, while running, sprinting and jumping. A strain typically occurs when a muscle is placed in a stretched position and then contracted forcefully in the opposite direction, resulting in a possible pull or tear in the muscle.

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An ankle sprain is the overstretching of the ligaments (structures that connect bone to bone) during a traumatic fall or twisting of the ankle. There are varying types of ankle sprains dependent on location and severity. Lateral (outside of the ankle) sprains are most common.

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Anterior knee pain is pain around the front part of the knee and/or under the kneecap (patella). Anterior knee pain can have several causes such as patellofemoral pain syndrome, chondromalacia patella, patellofemoral instability/patella subluxation, fat pad irritation or iliotibial band friction syndrome (I-T Band).

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Back muscle strains can happen during any physical activity that requires the back to bend or rotate, including lifting, throwing, kicking, swinging and performing stunts. A strain typically occurs when a muscle is placed in a stretched position and then contracted forcefully in the opposite direction, resulting in a possible pull or tear in the muscle.

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Chondromalacia patella is the softening of the cartilage on the underneath surface of the patella (kneecap). When this cartilage lining becomes softened it begins to breakdown producing irregularities to the underneath surface of the patella. Chondromalacia patella is caused by excessive and uneven pressure on the cartilage from structural alignment of legs and muscle imbalances that can be caused from rapid growth or poor technique of training skills. Pain is around the patella and can sometimes be behind the knee.

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Fat pad impingement occurs when the fat pad becomes irritated and swollen from repetitive tissue pinching by the structures within the knee joint. The fat pad is situated deep within the patellar tendon and assists with providing a cushion to the front part of the knee as well as supplying blood and nutrients to the patellar tendon. If the fat pad is irritated/swollen it can become impinged into the knee joint causing extreme, exact pain.

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The gastrocnemius/soleus are located on the back of the calf. Gastrocnemius/soleus strains can happen during vigorous running, sprinting, jumping activities or repetitive heel raises (i.e. relevé in dance and gymnastics). A strain typically occurs when a muscle is placed in a stretched position and then contracted forcefully in the opposite direction, resulting in a pull or tear in the muscle.

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The hamstring muscles are located on the back of the thigh. Hamstring strains can happen during vigorous running, sprinting and jumping activities. A strain typically occurs when a muscle is placed in a stretched position and then contracted forcefully in the opposite direction, resulting in a possible pull or tear in the muscle.

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The hip flexor muscles are located on the front of the hip. Hip flexor strains can happen during vigorous sprinting and kicking activities. A strain typically occurs when a muscle is placed in a stretched position and then contracted forcefully in the opposite direction, resulting in a possible pull or tear in the muscle.

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Scoliosis is a curve of the spine measuring more than 10 degrees. Idiopathic means the cause is unknown. While there are different types of scoliosis, idiopathic scoliosis is the most common form affecting children and adolescents. Scoliosis is not caused by bad posture, diet or backpacks.

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Iliotibial band friction syndrome is an overuse injury that occurs as a result of the rubbing between the iliotibial band (a non-elastic collagen cord stretching from the outside of the hip to below the outside of the knee) and the lateral epicondyle on the femur (the outside of the knee). It is often the result of iliotibial band and tensor fascia lata muscle (outside of thigh) tightness.

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The knee contains the lateral collateral ligament (LCL), one of four ligaments (tough band of tissue) connecting the femur (thigh) bone to the tibia (lower leg) bone. In combination with the medial collateral ligament (MCL), the ligament on the inside of the knee, the LCL lies on the lateral (outside) of the knee joint and provides stability to the knee for side-to-side movement. When the ligament is stretched beyond its normal range of movement, it can become sprained or torn. LCL injuries may involve other knee structures, such as the medial or lateral meniscus, which can present as pain on the opposite side (inside) of the knee. Other ligament tears can also occur, such as the posterior cruciate ligament (PCL), when the LCL is injured.

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Lateral epicondylitis is caused by repetitive stresses on the outside of the elbow that causes inflammation (swelling) and microfractures (small breaks) in the apophyseal cartilage (growth plate on the bone) and the surrounding structures.

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The knee contains the medial collateral ligament (MCL), one of four ligaments (tough band of tissue) connecting the femur (thigh) bone to the tibia (lower leg) bone. In combination with the lateral collateral ligament (LCL), the ligament on the outside of knee, the MCL lies on the medial (inside) of the knee joint and provides stability to the knee for side-to-side movement. The ligament becomes injured or torn when it is stretched beyond its normal range of movement.

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Medial epicondylitis is caused by repetitive stresses on the inside of the elbow. It can cause inflammation (swelling) and microfractures (small breaks) in the apophyseal cartilage (growth plate on the bone) and the surrounding structures.

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The menisci are two C-shaped fibrocartilage structures that serve as padding and separate the two bones of the knee joint, the femur (thigh bone) and tibia (lower leg/shin bone). The menisci disperse 30-55 percent of the forces that impact the knee joint. The menisci also provide stability, cushioning and aid in joint lubrication. The medial (inside) meniscus is injured four times as often as the lateral (outside) meniscus.

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Osgood-Schlatter is an overuse condition found in child/adolescent athletes. It is characterized by inflammation and pain around a growth plate where the patellar tendon (this tendon straightens your knee) attaches to the front of the shinbone (tibia). This is just below the kneecap at an area called the tibial tubercle. The pull of the tendon creates tension on the area of the growth plate. In some child/adolescent athletes, this may lead to inflammation, local swelling and then pain with activities. Some patients may also develop a limp. This discomfort may last over a period of months.

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Panner's disease is abnormal ossification (formation of bone) of the capitellum (base of the upper arm bone, the humerus, forms the top part of the elbow joint). This abnormal ossification is believed to be caused by an interference in blood supply to the growth plate of the bone blockage.

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Patellofemoral instability is when there is excessive movement of the patella (kneecap) and/or weakness in the surrounding structures. The patella connects the muscles of the thigh to the tibia (shinbone). The patella moves through a groove on the femur (thigh bone) when the leg is flexed (bent) and extended (straightened). If this groove is too shallow or uneven in addition with muscle weakness, it could result in a subluxation (comes out of the groove, but comes back into position) or a complete dislocation (remains outside of the groove). Patellofemoral subluxations/dislocation can also be a result of muscle imbalances or a direct traumatic fall on the knee.

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Patellofemoral pain syndrome is a dull, achy pain with minimal swelling around the patella (kneecap) due to malalignment of the femur (thigh bone), tibia (shinbone), patella and/or feet. Individuals with genu varum (bowed legs), genu valgus (knocked knees), femoral anteversion (thigh bone turning in), tibial torsion (shinbone turning in or out), patella alta (high-riding knee cap), patella baja (low-riding knee cap), leg length discrepancies, muscle imbalances and/or soft tissue tightness are more prone to have patellofemoral pain syndrome.

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The knee contains the posterior cruciate ligament (PCL), which is one of four ligaments (tough bands of tissue) that connect the femur (thigh) bone to the tibia (shin) bone. In combination with the anterior cruciate (ACL), the PCL makes a diagonal "X" through the center of the knee joint and allows the knee to twist/rotate and move side-to-side. The PCL becomes injured or torn when it is stretched beyond its normal range of movement. Research shows that up to 60 percent of PCL injuries may also involve other structures in the knee (meniscus, the pad/disc between the knee bones, cartilage or other ligaments) creating increased instability.

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Quadriceps muscle is located on the front of the thigh. Quadricep strains can happen during vigorous running, sprinting, jumping and kicking activities. A strain typically occurs when a muscle is placed in a stretched position and then contracted forcefully in the opposite direction, resulting in a pull or tear in the muscle.

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The shoulder joint is a ball and socket-type joint formed by the scapula bone (shoulder blade), which acts as the socket, and the head of the humerus (upper arm bone), which acts as the ball. The rotator cuff includes four muscles (supraspinatus, infraspinatus, teres minor and subscapularis) located on the upper back portion of the shoulder. The rotator cuff muscles provide stability to the shoulder joint and perform specific movements at the joint. Injuries can occur as a result of traumatic injury, overuse, incorrect movement patterns involving the arm. A rotator cuff injury can be a muscle strain, a partial tear or a complete rupture of the muscle.

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Sever's disease is an overuse syndrome found in child/adolescent athletes and is characterized by inflammation and pain around a growth plate on the back of the heel bone (calcaneus). This area is where the heel cord (Achilles tendon) attaches to the heel bone. The pull of the tendon on the bone and growth plate creates inflammation in some children and adolescents. This may lead to pain with activities and occasionally a limp. The discomfort may last over a period of months.

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Shin splints can be defined as a pain response between the knee and ankle on the inside of the tibia (shinbone). The pain is a result of a stress overload on the tibia and the connective tissue that attach your muscles to the bone during repetitive activities.

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The shoulder joint is a ball and socket-type joint formed by the scapula bone (shoulder blade), which acts as the socket, and the head of the humerus (upper arm bone), which acts as the ball. A dislocation injury occurs when the ball (the head of the humerus) is forced out of the socket, usually resulting from a traumatic event such as falling on an outstretched arm, a direct blow to the shoulder or an overstretch injury associated with overhead hanging (i.e., on monkey bars, basketball rim, etc.). The head of the humerus (the ball) typically dislocates in a forward or downward direction.

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The shoulder joint is a ball and socket-type joint formed by the scapula bone (shoulder blade), which acts as the socket, and the head of the humerus (upper arm bone), which acts as the ball. Shoulder instability/subluxation occurs when the head of the humerus (the ball) does not move properly against the surface of the scapula called the glenoid fossa (socket). Shoulder instability/subluxation can have several causes, including genetic factors, falling on an outstretched arm, poor throwing technique, excessive overhead activities (throwing, tennis, swimming) and previous shoulder injuries.

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Sinding-Larsen-Johanson is an overuse condition found in child/adolescent athletes. It is characterized by inflammation and pain at the bottom of the patella (kneecap) and the attachment of the patellar tendon. The pull of the tendon creates tension on the area of the growth plate. This may lead to inflammation, local swelling which leads to pain with activities. Some patients may also develop a limp. This discomfort may last for months.

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Spondylolysis in athletes is typically an overuse stress reaction on the bone. This leads to a crack in the back (posterior elements) of the spine called the pars interarticularis. It can be on one side of the spine or both sides and is usually in the lower back (lumbar spine). If both sides have complete breaks, it can cause a condition known as spondylolisthesis. Spondylolisthesis occurs when the pars defect has allowed a forward slippage of one of the vertebral body on another vertebral body. Spondylolysis and spondylolisthesis are often seen in athletes who participate in sports that require forceful hyperextension (excessive bending backwards) of the lower back.

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