Specialized training in the treatment of vestibular issues, such as vertigo and dizziness, combined with decades of experience in balance retraining can help anyone from the athletic to the elderly.
Benign Paroxysmal Positional Vertigo (BPPV) can be effectively treated in just 1-2 visits, with a thorough evaluation and treatment specific to your situation. A significant portion of the examination is dedicated to ruling out other potential sources of dizziness that have serious underlying conditions, then using movement and positional tests to precisely determine the area of your vestibular system that is causing the problem. In cases of canalysthiasis or cupulolisthiasis, calcium carbonate crystals that assist in determining your balance have become dislodged and trapped in one of the semicircular canals. Canalith repositioning is the process of returning these small crystals, called otoliths, to their correct position, by performance of a specific set of movements, based on the results of your examination.
There are many conditions which can cause dizziness and difficulties with balance. Many of them can be addressed directly by physical therapy, while others can use a few sessions with the therapist for control of symptoms or adaptation to positions and situations that produce problems. Sometimes the cause of a balance problem is related to blood pressure, but the time you are able to spend in your physician’s office is not enough to highlight the issue. I can address all of these situations and communicate your needs back to your referring physician, and even arrange for adaptive equipment when necessary.
Sciatica, Stenosis, and Pinched Nerves
From the neck and back, to the elbow, wrist and ankle, pinched nerves can cause pain, tingling, burning, and weakness. Sciatica is pain, numbness, or tingling that originates in the back and extends down the leg, past the knee. Any pain above the knee coming from the back is normally classified as simply “referred pain.” A specific type of sciatica results from stenosis, which is the narrowing of the area around the nerve root as it exits the spine.
Sometimes these conditions – together part of a larger classification called radiculopathy – are the result of a disk problem, facet joint arthritis, or an instability/assymmetry of movement of the spinal segment. Each situation is different. You may have been diagnosed with stenosis by x-ray, when in fact, the stenosis on the x-ray is not causing your problem.
A through examination and evaluation of your problem – using a proven and time-tested decision methodology – can get to the source of your problem, and allow your therapist to tailor your treatment program specifically to it. Let us evaluate your problem and recommend the right course of care, or even further nerve testing, as needed.
Back and Hip
Pain in the hip (groin pain, outside of the hip, and the buttock) can be difficult to track down, especially in the presence of low back pain. There are usually multiple contributing problems and factors associated with correct and effective treatment. Let us unravel the mystery for you, using our expertise in orthopedic rehabilitation. Whether you suffer from disk degeneration, hip arthritis, bursitis, a labral tear or lumbar radiculopathy, our expert examination and treatment program can make the best of your recovery, and provide you with guidance for further surgical consultation, if you end up needing it.
Common diagnoses related to the back include: Disk Bulging/Herniation/Extrusion, Spinal Arthritis, Sciatica, Degenerative Disk Disease (DDD), Lateral/Central Stenosis, Spondylosis/Spondylosthesis, Segmental Instability, Sacroiliac (SI) Joint Dysfunction, Postural Syndromes, Stress Fractures, Compression Fractures, “Simple Backache” (contributing factors such as limited flexibility, strength, and range of motion), Sprains/Strains, Failed Back Surgery Syndrome, Chronic Low Back Pain.
Common diagnoses related to the hip include: Osteoarthritis (OA), Degenerative Joint Disease (DJD), Labral Tears, Femoro-Acetabular Impingement (FAI), Snapping Hip Syndromes, Trochanteric Bursitis, Piriformis Syndrome, Hip Flexor Tendonitis/Tendonosis.
I provide complete back post-operative programs for: Spinal Fusion, Laminectomy, Microdiscectomy, Foraminotomy, Disk Replacement, Vertobroplasty.
I provide complete hip post-operative programs for: Total/Hemi Hip Replacement, Labral Repair, Labral/Femoral Debridement for FAI, Bursectomy, Hip Fracture Repair (ORIF).
Neck and Shoulder
Pain along the neck and shoulder can be difficult to pin down and confusing to treat. Is your problem from a pinched nerve in the neck or tendonitis in the shoulder, or a little bit of both? Let us help you find your fix. Expert examination will pin down the contributing factors more precisely than any MRI or X-ray can, because I not only test each part of your shoulder, I also assess how those parts function.
Do you have pain running down your arm, numbness in your hand, or weakness? Did it just start with a “crick” in the neck one morning, but has continued to limit your motion? All of these problems can be treated by physical therapy, effectively, and relatively inexpensively. Waiting for an MRI doesn’t change the treatment plan. Start now, and get the recover you deserve.
Common diagnoses related to the neck include: Bulging/Herniated Disk, Degererative Disk Disease, Facet Joint Arthritis, Radiculopathy, Thoracic Outlet Syndrome, Lateral/Central Stenosis, Postural Syndromes related to strength and flexibility.
I provide complete post-operative rehabilitation programs for: Neck Fusion, Disk Replacement, Foraminotomy.
Anything from a torn labrum, to impingement, to bursitis or a rotator cuff tear can be treated effectively by physical therapy, and in the vast majority of cases, our patients realize a full recovery. Sudden onset of relatively severe pain with a trivial movement or activity can sometimes be a warning sign of a frozen shoulder. Don’t wait around – starting treatment earlier fixes the problem faster, before a frozen shoulder can set in and mean big problems down the road.
Common diagnoses related to the shoulder include: Subacromial Bursitis/Impingement (SAI), Rotator Cuff Tendonitis/Tendonosis, Rotator Cuff Tears, Adhesive Capsulitis (Frozen Shoulder), Biceps Tendonitis/Tendonosis, Biceps Rupture, Labral Tear, Shoulder Instability/Dislocation, Scapular Muscle Weakness/Dysfunction (SICK scapula), Shoulder (Humeral) Fracture, Glenohumeral Internal Rotation Deficit (GIRD), Acromioclavicular Sprains (Shoulder Separation).
I provide complete postoperative programs for the shoulder including: Rotator Cuff Debridement/Repair, Labral Debridement/Repair, Mumford (Distal Clavical Resection), Subacromial Decompression (SAD), Biceps Tendodesis, Biceps Tendolysis, Shoulder Replacement, Reverse Shoulder Replacement, Open Reduction Internal Fixation (ORIF) of the humerus.
I treat everything from sports injuries to arthritis, and everything in between.
Have you recently experienced a knee sprain, swelling, or instability? Do you have pain associated with stair climbing, prolonged sitting, squatting or kneeling? Have you noticed swelling, limited movement, or has your knee been giving way?
A thorough examination can pinpoint the cause of your problems better than an MRI. Stop wasting your time waiting for your knee pain to go away. Get started on a personalized treatment program today. Our average patient completes therapy in just 6-8 visits.
Common diagnoses related to the knee include: Patellofemoral Syndrome or Anterior Knee Pain Syndrome, Ligament Sprains/Tears, Arthritis/Articular Cartilage Damage, Meniscal Tears or Degeneration, Iliotibial Band Friction Syndrome, Tibial or Patellar Fractures
I also provide complete knee post-operative programs for: Total/Partial Knee Replacement, ACL/PCL Reconstruction, Meniscal Debridement, Meniscal Repair, Articular Cartilage Debridement, Articular Cartilage Repair/Resurfacing, Knee Pain/Stiffness after Intramedullary Nail Placement (for Femur/Tibia Fractures), Posterolateral Corner Reconstruction, Patellar Fracture Repair.
Do you suffer from chronic ankle weakness and pain from multiple past sprains? Surgery may not be what you need. Research demonstrates that while early and thorough ankle rehabilitation can prevent future problems, treatment at any time can improve your abilities to function and even participate in sports.
Do your feet hurt? Have you been told that you have a problem like plantar fasciitis, or flat feet, and referred to a podiatrist to be told your only alternatives were surgery, injections, or expensive custom orthotics that you’ll need to have refit every few years?
Let us help you with an expert evaluation and treatment plan that many times incorporates an inexpensive, customized shoe insert that is specific to the treatment of your problem. Most of your treatment can be fit into activities that are easy for you to perform, and address your problems directly. If you are found to have a need for them, I can also assess, measure and fit you for custom orthotics, at a price that beats what you were quoted at the podiatrist, or in some cases, I may be able to arrange for your insurance to cover the cost.
I provide treatment for common diagnoses related to the foot and ankle including: Ankle Sprains (inversion, eversion, “high” ankle sprains), Achilles Tendonitis/Tendinsosis, Chronic (long term) Ankle Instability, Plantar Fasciitis and other Heel Pain Syndroms, TIbial Tendonitis/Tendinosis, Foot Sprains, Ankle Fractures, Foot Fractures, Ankle Impingement Syndromes, Sinus Tarsi Syndrome, Other Foot/Ankle Pain due to poor biomechanics.
I provide postoperative rehabilitation programs for surgeries of the foot and ankle, including: Lateral Ankle Reconstruction, Open Reduction Internal Fixation (ORIF) of ankle fractures, Pinning of foot fractures, Tarsal Fusion.
Golfer’s Elbow and Tennis Elbow are two common types of elbow pain. Each can have multiple contributing factors, and based on the amount of limitation you are experiencing and how long you have had the problem, the treatment can be remarkable different. These issues don’t solve themselves, but you don’t have to break the bank getting therapy for them either. Especially in cases that have dragged out for some time, therapy is focused around simple activities you can do to slowly, surely, and safely return to full activities without pain.
Wrist and Hand
Have you recently fallen and sprained your wrist? Do you have a nagging pain that you were told was “just tendonitis” but is now stopping you from some of your favorite activities, or worse yet, limiting how you go about your daily routine? Have you been told that the numbness and tingling in your hand was just carpal tunnel or tendonitis? Do you have a brace? Are you sure it’s the correct one for your problem? Are you wearing it at the right times? What do you do if you start to have tingling or weakness? Call us, and I’ll be happy to take you through the steps to get over this potentially debilitating problem, and provide you with guidance and education on what you need to do if things get worse.
Common diagnoses related to the elbow/wrist/hand include: Tennis Elbow (Lateral Epicondylitis/Epicondylosis), Golfer’s Elbow (Medical Epicondylitis/Epicondylosis), Carpal Tunnel Syndrome (median nerve entrapment at the wrist), DeQuervain’s Tenosynovitis, Wrist Sprains/Fractures, Supinator Syndrome (anterior interosseus nerve entrapment), Superficial Radial Nerve Impingement, Cubital Tunnel Syndrome (ulnar nerve entrapment at the elbow), Carpo-Metacarpal (CMC or Basilar Joint) arthritis.
I also provide complete post-operative rehabilitation programs for the elbow/wrist/forearm/hand, but do not provide customized splinting at this time.
Arthritis/Degenerative Joint Disease
“Arth” is the latin term for joint, and “itis” is anything that is inflamed or painful…if you’ve been told you have arthritis, many times that’s all it really means technically. However, joints that are inflamed and painful over time become stiff and weak, making them more stiff and weak, making them more painful….you get the picture.
Sometimes the solution is as simple as a few stretches and targeted strength training, while other issues call for bracing, taping, or intermittent support for specific activities.
Break the cycle today, by letting us unravel your joint, step-by-step, restoring normal motion, flexibility, and strength, so that you can get back to your normal activities.
Muscle and Nerve
Have you noticed muscle weakness that is causing you difficulty? Have you also noticed numbness and tingling along an arm, leg, hand or foot?
Subtle muscle weakness can lead to bigger problems due to muscular substitution and mechanical changes over time, and sometimes muscle weakness can be an indicator of a bigger underlying problem, like a pinched nerve, sciatica, peripheral neuropathy, or other condition.
Let us take a look at your situation, arrange a treatment plan that addresses your needs, and together, I can make sure you have a solution.