With many people out of their typical routines participating in new virtual exercise programs without many cues, the risk of injury can go up. Our SHIFT physical therapists spotlight a few common injuries and some exercises you can do for pain relief. For a more individualized plan of care, please contact our SHIFT Physical Therapists, Eric Hughes (eric.hughes@shiftlife.com) or Avis Jason (avis.jason@shiftlife.com), for to schedule an in-person or telehealth visit to further assess symptoms.
1) Plantar Fasciitis
What is it? Plantar fasciitis is the inflammation of the thick fascia that spans the bottom of your foot and supports the arch from calcaneus (heel bone) to your toes. The repeated stress can cause small tears in the fascia and associated pain.
Common symptoms:
- Sharp pain into the arch of foot near heel, especially occurring during the few steps in the morning or after standing for prolonged periods of time
- Worsened pain after exercise
Risk factors:
- Common between ages 40 and 60
- Participation in jumping activities, long-distance running or dancing
- Flat feet
- Weight gain or obesity
- Occupations that require long periods of standing
Solutions:
- Gently roll arch of foot on tennis ball
- Complete calf and hamstring stretching (see pictures below)
- Strengthen the intrinsic muscles in arch with a seated arch correction (exercise below)
- Apply ice massage to tender spot on heel
Seated Arch Correct: Begin with your foot flat on the floor, toes relaxed. Rise up to the ball of your foot, over-exaggerating the arch. Lower your heel, keeping your arch up and toes flat.
2) Iliotibial Band Syndrome (ITBS)
What is it? An overuse injury caused from friction to the outside of your knee resulting in inflammation and pain. The IT band is responsible for stabilization of your knee while it bends and extends during walking, running, biking, etc. Misalignment of the IT band from tightness and weakness through the hip muscles (tensor fascia latae and gluteus medius) leads to irritation and eventually pain with each step.
Common symptoms:
- Lateral knee pain with heel strike, especially walking or running downhill
- Clicking or popping on the outside of the knee
- Aching, burning or a tender feeling to the outside of the knee
- Worsening pain with prolonged repetitive activity or exercise
Risk factors:
- Common in runners, cyclists and long-distance walkers
- Significant mileage increase in training regimen
- Improper warm up or cool down during aerobic activity
- Poor gluteus medius strength and endurance
- Tightness in hips including TFL, quads, hip flexors and hamstrings
Solutions:
- Discontinue aggravating activity and focus on pain-free cardiovascular exercise
- Complete daily specific stretching and strengthening shown below
- Consult with your doctor about use of anti-inflammatory medication to reduce pain
- Apply ice to symptomatic area for 15 minutes 2x/day
- Practice mindful posture with both feet flat on the floor (A correlation exists between the symptomatic side and the top leg when crossing your legs while sitting)
Try these three exercises daily (15 reps on each side, 2x through) to alleviate long-term pain.
3) Patellofemoral Syndrome
What is it? Pain at the front or around the patella (kneecap). Patellofemoral Syndrome is often referred to as “runners knee” or “jumpers knee,” but can also occur in sedentary adults who sit for prolonged periods of time during the day. The cause of this injury is often misalignment of the knee joint and kneecap from muscle imbalances or activity overuse.
Common symptoms:
- Pain to the front, around or behind the kneecap
- Pain with bending the knee to walk, squat, kneel, or run
- Worsened pain with walking downstairs or downhill
- Swelling around the knee or popping/grinding feeling with activity
Risk factors:
- Although it can affect any age, adolescents and young adults are at the highest risk
- Women are more likely than men to experience this injury, possibly due to muscle imbalances with the wider angle of the female pelvis
- Frequently engaging in high-impact activities such as running, jumping, or deep squatting
- Flat feet as this can lead to over-pronation (rolling in of feet), causing knee misalignment
Solutions:
- Ice and compression 15-20 minutes twice per day
- Switch to low-impact aerobic activities including swimming and biking until pain resolves
- Complete quadricep stretching and hip strengthening exercises as shown below
- Taping techniques provided by physical therapist to improve alignment
1) Mini squat to chair with band to engage outer glutes – 30 reps, 2) Bridges with band to engage outer glutes – 30 reps, 3) Prone quad stretch – 3 x 30 seconds
4) Rotator Cuff Tendonitis
What is it? Inflammation or irritation to the tendons of rotator cuff muscles that assist in moving and lifting the shoulder joint. It can also be referred to as ‘impingement syndrome.’
Common symptoms:
- Pain and swelling in the front of your shoulder and side of your arm
- A clicking sound when raising your arm
- Stiffness within the shoulder
- Pain that wakes you up from sleep
- Pain when reaching behind your back
- A loss of mobility and strength in the arm
Risk factors:
- Common in both young athletes and middle-aged individuals
- Participation in sports requiring overhead movements such as swimming, baseball, and tennis
- Repetitive lifting or overhead activities including construction, painting, and weightlifting
Solutions:
- Avoid activities that cause pain in the shoulder, including repetitive overhead lifting
- Use ice to calm inflammation 2-3 times a day for 15 minutes at a time
- Connect with your doctor about use of over-the-counter medications
- Squeeze shoulder blades together to maintain good posture when seated at your desk
- Avoid sleeping, or carrying a heavy bag, on the affected shoulder
- Complete PT exercises as shown below
1) Doorway pec stretch – 3 x 30 seconds, 2) Shoulder blade squeezes – 10 x 5 second holds, 3) Extensions – 3 x 10, 5 second holds, 4) Rows – 3 x 10, 5 second holds
5) Cervical Radiculopathy
What is it? Often referred to as “pinched nerve” where a nerve in the neck is irritated or compressed as it comes off the spinal cord, causing pain, weakness and/or numbness from the neck down the arm.
Common symptoms:
- Sharp or burning pain originating at neck and traveling down one arm
- Loss of sensation somewhere between shoulder and hand
- Tingling or “pins and needles” feeling into the fingers or hand
- New onset of weakness in shoulder, forearm or hand
- Pain with rotation or extension of the neck
Risk factors:
- Strenuous activities that include repetitive load to spine, such as wrestling and heavy weightlifting
- Neck trauma from sports or motor vehicle accident
- Smoking
- Driving or operating vibrating equipment
Solutions:
- Cervical spine mobility and strengthening exercises
- Activity modification, including posture adjustment with workstation
- Manual or mechanical traction
- Pain medication or steroids prescribed by physician
- Complete specific exercises shown below
1) Chin retractions/tuck (5 seconds, 10x): Pull your head away from your finger until you feel some tightness build in the back of your neck, hold for 5 seconds and return to starting position. Avoid tilting head up or down, 2) Towel cervical rotation SNAG (20x per side): Hold one end of the towel steady, use opposite arm to pull towel up and across to increase rotation of neck, 3) Towel manual traction/suboccipital release (10 seconds, 10x): With towel positioned at base of skull, use both hands to lift up as traction and release the muscles in back of neck, 4) Median Nerve Glides (20 reps): Start with neck in neutral and hand positioned as pictured below, tilt head to opposite ear and extend arm out to the side until feel gentle pull through arm and forearm, pause and return to starting position, 5) Ulnar Nerve Glides (20 reps): Start with neck in neutral and hand positioned as pictured below, tilt head to opposite shoulder and bring hand up towards ear as shown in picture until gentle stretch is felt, pause and return to starting position.
6) Lateral epicondylitis
What is it? Lateral epicondylitis is often referred to as “tennis elbow” and is characterized by inflammation, pain, and microtears of the wrist extensor tendons that join to the outside of the elbow. It is categorized as an overuse injury resulting from repetitive movements.
Common symptoms:
- Pain or burning to the outside of the elbow
- Pain or weakness with grip strength
- Sometimes pain in the elbow at night
- Worsened pain with forearm activity, such as turning a wrench or shaking hands
Risk factors:
- Athletes who participate in repetitive sports such as tennis, pickleball, or paddle tennis
- Other recreational activities that require repetitive or vigorous use of forearm muscles with extension of the wrist and hand
- Painters, plumbers, and carpenters due to repetitiveness of work-related tasks
- Ages 30 to 50
- Improper stroke technique or equipment
- Can be “idiopathic” and sometimes develop due to an unknown cause
Solutions:
- Rest and avoid aggravating activities and movement patterns
- Stretch wrist flexors and extensors
- Eccentric loading of wrist flexors and extensors
- Incorporate shoulder strengthening to reduce the overuse of wrists
- Bracing for symptom relief
- Pain medication or steroids prescribed by a physician
1 and 2) Wrist Extensor Stretch, start and end position (3×30 seconds): Turn palm down and apply pressure at wrist to achieve stretch to top of forearm, 3 and 4) Wrist Flexor Stretch, start and end position (3×30 seconds): Turn palm up and apply pressure to wrist to achieve stretch to backside of forearm, 5) Eccentric wrist flexor (30 reps): Use opposite arm to lift weight up to top of motion and slowly lower weight past neutral, 6) Eccentric wrist Extensor (30 reps): Use opposite arm to lift weight up and slowly lower weight past neutral, 7) Eccentric pronation/supination (30 reps): Hold dumbbell at one end and control motion of turning palm up to palm down, 8) Scapular Retraction (10×5 second hold): Bring shoulders down away from ears and squeeze shoulder blades together in the middle of your back. Hold for 5 seconds and release.