Tag Archives: Treatment

Tips for Safe and Healthy Spring Cleaning

Spring is always a welcome change after cold and lethargic winters. The blue skies and warm temperatures also bring open windows, fresh air, blossoming flowers and above all the spring cleaning.  Spring cleaning can be as hard and difficult as full-body workout as it involves good dusting, mowing of lawns; clearing gutters and many more. But the statistics show that great many numbers of people injure themselves during this annual cleaning. Active Physical Therapy suggests you to be cautious and observe the following measures to avoid any harm or injury to your body:

  • Do not perform similar motions repeatedly as this can result into sprains, strains or low back pain.
  • Keep your spine in line i.e. maintain a good posture and keep a wide base of support.
  • Avoid too much twisting or bending while lifting objects. Lift the objects properly by getting closer to them i.e. use your legs instead of your back.
  • Use long-handled tools, kneeling pad and stools while doing yard work and gardening as well.
  • Keep your properly hydrated throughout the cleaning session.
  • Wear skid resistant shoes to ensure proper footing on uneven surfaces.
  • Take regular breaks, in order to relax your tense muscles.
  • Use correct height ladder to minimize the risk of falls during cleaning your windows. Also make sure that ladder is placed on a levelled surface.
  • Move your feet and body while vacuuming, instead of reaching forward and sideways with your arms and trunk.
  • Use extension cords carefully. Do not drape them across the spans of crossing walkways to avoid tripping or falling.
  • Avoid twisting while bending, raking or thatching; instead use your legs to shift your weight from side to side.
  • To avoid slips and falls, always work in the yard wherever it is dry. Do not overfill bags or tarps as it can put pressure on your spine.
  • Do not over-exert yourself. Listen to your body and if you notice any symptoms like light-headedness, shortness of breath, sudden or severe headache, excess sweating, chest or stomach pain after or during cleaning, Contact Your Doctor immediately.

Prevention is always better than cure. Poor Physical posture, lack of exercise or warm-up, poor Physical condition can lead to injury or pain. So always do your best and follow good practices to save yourself form all such hazards.

Active Physical Therapy will be glad to help you with more spring cleaning tips or with any injuries or pain you experience during cleaning. Our diligent and expert physical therapists use state of art techniques to treat any of your musculoskeletal pains or injuries.

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Treatment of Hand Joint Pain:

Volar Barton (Palmar rim dislocation) is a palmar rim fracture of distal radius. The most common cause of this type of fracture is a drop on an outstretched hand.


It is due to palmar tensile stress and dorsal shear stress and is usually combined with Radial styloid fracture.

Clinical Features

  • Pain

  • Swelling

  • Tenderness

  • Loss of wrist movements

  • Palmar flexion is grossly restricted and painful


Palmar rim of distal radial articular surface is displaced dorsally. Proximally and posteriorly and may be associated with dorsal subluxation of the wrist.



Reduction is simple, but retention is difficult. Long arm cast is used.


If reduction does not remain satisfactorily with the wrist in neutral or slight palmar flexion, fixation with K-wire, external fixators and buttress plate, etc. may be done. Ellis T-’shaped buttress plate fixation is the preferred method of treatment.

Active Physical Therapy provides state of the art physical therapy throughout the state of Maryland.  Active’s friendly staff looks forward to assisting you in making your appointment in any of our clinics. Contact Us



Elbow Pain and Problems

The elbow is a hinge joint between the lower end of the humerus bone in the upper arm and the upper end of the radius and ulnar bones in the lower arm. The arm is bent and rotated at the elbow by the biceps muscles in the upper arm. Ligaments located at the front, back, and sides of the elbow help stabilize the joint.

Elbow pain can be caused by many problems. A common cause in adults is tendinitis. This is inflammation and injury to the tendons, which are soft tissues that attach muscle to bone.

Lateral Elbow Pain: Causes, Symptoms And Treatment

Use of the upper limb in sport demands a well functioning elbow. In addition, injuries in this region may interfere with the patient’s everyday activities. The clinical approach to elbow pain is considered under the following headings:

  • Lateral Elbow Pain, with a particular focus on
  • Extensor Tendinopathy
  • Medial Elbow Pain
  • Posterior Elbow Pain
  • Acute Elbow Injuries
  • Forearm Pain
  • Upper Arm Pain.

Lateral Elbow Pain

Lateral elbow pain is an extremely common presentation among sportspeople and manual workers. The most common cause is an overuse syndrome related to excessive wrist extension. This condition has traditionally been known as ‘tennis elbow’. This is an unsatisfactory term as it gives little indication of the pathological processes involved. In fact, the condition is more common in non-tennis players than in tennis players. It has also been referred to as ‘lateral epicondylitis’. This is also inappropriate as the site of the abnormality is usually just below the lateral epicondyle and the primary pathology is due to collagen disarray rather than inflammation.

The primary pathological process involved in this condition is tendinosis of the extensor carpiradials brevis (ECRB) tendon, usually within 1-2 cm of its attachment to the common extensor origin at the lateral epicondyle. This condition will be referred to as extensor tendinopathy.

Other conditions that may cause lateral elbow pain include synovitis of the radio humeral joint, radiohumeral bursitis and entrapment of the posterior interosseous branch of the radial nerve (radial tunnel syndrome). These conditions may exist by themselves or in conjunction with extensor tendinopathy.

There is often a contribution to lateral elbow pain from the cervical and upper thoracic spines and neural structures. This may be a relatively minor contribution or, in some cases, the main cause of the patients elbow pain. A full assessment of the cervical spine and neural structures is essential in examination of the patient with lateral elbow pain.


The characteristics of the patients lateral elbow pain should be elicited. The diffuse pain of extensor tendinopathy typically radiates from the lateral epicondyle into the proximal forearm extensor muscle mass. Occasionally the pain may be more localized. The onset of pain may be either acute or insidious. There may have been recent changes in training or technique, note-taking or equipment used in sport or work.

The severity of pain ranges from relatively trivial pain to an almost incapacitating pain that may keep the patient awake at night. It is important to note whether the pain is aggravated by relatively minor everyday activities, such as picking up a cup, or whether it requires repeated activity, such as playing tennis or bricklaying, to become painful.

Pain may radiate into the lateral aspect of the forearm. This may be consistent with posterior interosseous nerve entrapment or irritation of other neural structures. If pain is closely related to the activity level, it is more likely to be of a mechanical origin. If pain is persistent, unpredictable or related to posture, referred pain should be considered.

Certain movements, usually those involving wrist extension or gripping, will aggravate mechanical pain. Referred pain is affected by prolonged posture, such as lengthy periods seated at a desk or in a car. Associated sensory symptoms, such as pins and needles, may indicate a neural component. Presence of neck, upper thoracic or shoulder pain should also be noted.

Often by the time the patient presents to the sports medicine clinician, he or she will already have undergone a variety of treatments. It is important to note the response to each of these treatments.

An activity history should also be taken, noting any recent change in the level of activity. In tennis players, note any change in racquet size, grip size or string tension and whether or not any comment has been made regarding his or her technique.

Extensor tendinopathy

For this major sports medicine condition, we review the pathology, outline the clinical presentation, and then discuss evidence based and clinically founded treatment.

Clinical Features

Extensor tendinopathy occurs in association with any activity involving repeated wrist extension against resistance. This includes sporting activities, such as tennis ,squash and badminton, as well as occupational and leisure activities, such as carpentry, bricklaying, sewing and knitting. Computer use has been shown to be associated with the development of this condition. The peak incidence is between the ages of 40 and 50 years but this condition may affect any age group.

There are two distinct clinical presentations of this condition. The most common is an insidious onset of pain, which occurs 24-72 hours after unaccustomed activity involving repeated wrist extension. This occurs typically after a person spends the weekend laying bricks or using a screwdriver. It is also seen after prolonged sewing or knitting .In the tennis player, it may occur after the use of a new racquet, playing with wet, heavy balls or over hitting, especially hitting into the wind. It also occurs when the player is hitting ‘late’(getting the position slowly), so that body weight is not transferred correctly and the player relies on the forearm muscles exclusively for power.


No single treatment has proven to be totally effective in the treatment of this condition. A combination of the different treatments mentioned below will result in resolution of the symptoms in nearly all cases.

The basic principles of treatment of soft tissues injuries apply. There must be control of pain, encouragement of the healing process, restoration of flexibility and strength, treatment of associated factors (e.g. increased neural tension, referred pain),gradual return to activity with added support and correction of the predisposing factors.

Control of Pain

It remains unclear as to how much pain is ideal in the treatment of tendinopathies. Clinical experience suggests that a low level of pain, which does not worsen with training, is likely to not be harmful for tendon healing. However, some patients require relative rest, application of ice and analgesia for comfort.

Acute Spinal Cord Injury

Your spine is made of many bones called vertebrae. Your spinal cord runs downward through a canal in the center of these bones. Acute spinal cord injury (SCI) is due to a traumatic injury that bruises, partially tears, or completely tears the spinal cord.