tendonitisWhen a tendon becomes irritated, inflamed or swollen the result is called tendonitis. Tendons are the structures that join the muscle to the bone. Tendonitis can be the result of an acute injury, but is more often caused by repetitive movements or strains placed upon an area of the body. Some of the most conditions that result from tendonitis are Achilles heel, plantar fasciitis, and rotator cuff injury. Many times if bursitis occurs, the close proximity of the tendon to the bursae causes tendonitis as well.

Sports, athletic or even work-related activities can result in this painful condition. Unfortunately, many times these problems start out small but eventually become chronic and debilitating.

Medications and injections are often prescribed to help ease pain and inflammation. However, physical therapy can be very beneficial in the treatment of these conditions. A physical therapist can help to assess and identify the causes of the stress and strain to the area. Individualized stretching and exercises can be implemented and recommended for home. These plans can help to maintain strength and range of motion during recovery. The healing process can also be accelerated as inflammation is reduced and circulation is improved. Therapeutic modalities such as heat and ice may be utilized. Technologic devices such as short wave diathermy, ultrasound and electrical stimulation can also significantly reduce pain and inflammation as well as accelerate the healing process.

A combination of manual techniques, stretching, exercise plans and technological devices can help individuals to overcome the pain and discomfort associated with these conditions.

Sports Injury

sports-injuryWhether you are a competitive athlete, a sports enthusiast or a weekend warrior, there is always the risk of injury. Sports injuries fall into several categories:

Traumatic Injuries

These injuries are most common in contact sports, but can occur during many other activities. Examples of traumatic injuries include strains, sprains, wounds, bruises, fractures, head injuries or damage to the spinal cord. Many people are not aware of the benefits of physical therapy for all of these injuries. By reducing pain and inflammation, along with increasing circulation, tissues, muscles and even bone can heal much faster. Instructions can also be given to help patients maintain strength and range of motion while they recover.

Soft Tissue Injuries

Soft tissue injuries are very common among athletes. When the soft tissue is damaged, these tissues release chemicals that trigger inflammation. When inflammation occurs, you may experience swelling, heat, pain and loss of movement. Both manual and technological therapies can quickly reduce inflammation and speed recovery.

Repetitive Use Injuries

Conditions such as tennis elbow, runner’s knee or tendonitis can occur from the repetitive movements associated with a specific sport. Treatment plans may include exercise or movement modifications as well as therapeutic modalities to decrease pain and inflammation and to accelerate healing. Sometimes braces, splints or other protective devices can also be prescribed.


Jaw Pain (TMJ)

jaw-painProblems with the jaw, jaw joint and the facial muscles are called temporomandibular disorders. Many times this disorder is referred to as TMJ. TMJ is actually the acronym for the temporomandibular joint. This joint is the hinge connecting the lower jaw to the bone of the skull. These joints make it possible for many important movements to occur – especially those of talking and eating.

It is sometimes difficult to identify the cause of TMJ. Injury to the area is one cause, however stress, clenching or grinding of the teeth, arthritis or dislocation in the area can also contribute. This condition is most often seen in young adults between the ages of 20 and 40.

Most often, symptoms include pain in the joint or face. However, this pain can sometimes be referred to areas such as the shoulders or neck. Swelling may occur. Clicking or popping sounds may be heard when chewing or opening the mouth. The smooth movements of the jaw are often affected and the ability to open the mouth wide can be limited. Unfortunately, additional conditions may stem from this disorder. Headaches, pain in the neck or shoulder, hearing problems, dizziness, and even toothaches may result. Physical therapy can be beneficial in several ways. A careful evaluation can help to assess the cause of the disorder. Special stretches and gentle exercises may be recommended. Suggestions for better positioning and posture may be given. In addition, therapeutic modalities such as ultrasound can help to decrease the inflammation, increase circulation and speed healing.

MDM Physical Therapy also offers Myokinesthetic treatments. Myokinesthetics is a revolutionary treatment protocol to help patients in pain. This technique effectively “re-boots” the nervous system and helps to eliminate chronic pain pathways.



fibromyalgiaFibromyalgia is a challenging condition that is difficult to diagnose as well as treat. The symptoms associated with fibromyalgia include chronic muscle and joint pain, stiffness; sleep problems, and chronic fatigue.

Many different theories exist in the medical community about this condition; it’s cause and how it can be alleviated. Some of these theories link fibromyalgia to biochemical changes in the body or hormonal imbalances. Trauma to the brain or spinal cord is sometimes suspected. Other theories attribute the problem to stress, sleep disorders, genetics and depression.

Regardless of the cause, there are certain ways that physical therapy can be of assistance. Although it typically won’t provide a cure, therapy can provide relief from pain and discomfort and can help patients find ways to improve their quality of life. Gentle exercises may be prescribed to help strengthen muscles and increase flexibility. Aerobic exercise increases and improves the circulation to the muscles. Recommendations for posture and positioning may be given to increase comfort at home or on the job. Therapeutic modalities (such as electrical stimulation) may provide short-term relief from pain and inflammation.

Many of our patients have experienced relief from their symptoms through a special muscle-nerve technique called Myokinesthetics. This technique effectively “re-boots” the nervous system and helps to eliminate chronic pain pathways.

Fall Prevention

fall-preventionFalls are the most frequent cause of injury among older adults. These injuries are more common than strokes and their consequences can be just as serious. Fortunately, in many cases they are preventable.

Statistics have shown that falling causes over 90% of broken hips. Head injuries as well as broken bones are also common consequences.

There are various reasons for falls. These include balance or dizziness conditions, medication side effects, muscle weakness, unsafe footwear, vision problems and tripping hazards.

Physical therapy can help in a variety of ways including:

  • Provide a fall risk assessment
  • Create exercise programs to increase strength and stability
  • Make recommendations to increase home safety
  • Screen and treat balance and dizziness conditions
  • Evaluate safety of footwear
  • Recommend special equipment to aid with walking difficulty

Cardiac Rehabilitation

cardiac-rehabilitationCardiac Rehabilitation programs are recommended for individuals who:

  • Have experienced a heart attack or other cardiac event
  • Have recently undergone heart surgery or procedures
  • Suffer from a heart condition (such as coronary heart disease).

When a person has experienced cardiac challenges, it is especially important to provide a safe, monitored environment as they work to return to improve upon or return to previous levels of fitness. Typically a patient will receive physical therapy following a cardiac event either in the hospital or in a rehabilitation center. Following this initial phase, however, it continues to be important to recover fully and continue to increase muscle strength and cardiovascular endurance.

MDM Physical Therapy can provide an exercise program specifically designed for your mobility and fitness level. The exercises suggested will help to increase strength, flexibility and improve aerobic capacity. Heart rate and blood pressure will be carefully monitored as progress is made. One of the main goals of a cardiac rehabilitation program is to provide the instruction and education needed to continue a safe, effective exercise program in an exercise group, gym or home setting.


bursitisThroughout the body, small, fluid filled pads cushion the muscles, tendons and bones of the joints. These are called “bursae”. These pads are filled with lubricating fluids. They decrease friction and irritation within the joint. When these cushions become inflamed, the result is called bursitis.The shoulder, hip and elbow joints are the most common areas affected by bursitis. However, other joints such as the knee, toe and heel can also be impacted.

When bursitis occurs, the most common symptoms are pain, stiffness, achiness or swelling.

Many times, bursitis is caused by frequent, repetitive motion. Many sports or athletic activities can cause this condition. Those with high-risk work activities are often affected (for example plumbers, carpenters, painters).

Bursitis can also result from sudden injuries.

Another factor can be age. Tendons in the joint can become less elastic and are more easily injured, affecting the bursae. Physical therapy treatments can significantly help the healing process of bursitis. Individualized stretching and exercise programs will be recommended to help with healing and maintain strength and flexibility.

A number of therapeutic modalities can significantly reduce pain and accelerate the healing process. These include hot or cold packs, ice massage as well as devices such as shortwave diathermy, ultrasound or electrical stimulation.

Bone Fractures

Bones have a lot of nerve connections running through them. Bone fractures, even small cracks in the bone, can be painful and frustrating. In many cases the most challenging aspect of a fracture is the time it takes to heal.

When a bone is fractured, there are actually three phases that will occur in the healing process. These are:

  • Inflammation phase
  • Reparative phase
  • Remodeling phase

In the inflammation phase, specific cells are drawn into the injured area. Initially, these cells serve to clean up the location, and then repair cells will be drawn into the area. This inflammation is natural, but extended inflammation can cause pain and actually decrease the healing process.

The next phase is called the reparative phase. This phase doesn’t usually begin until approximately 2 weeks after the fracture. Proteins create what is called a soft callus on the damaged area. This will eventually become a hard callus as the bone heals.

The third phase is the remodeling phase. During this time the bone actually restructures on a cellular level. Physical therapy can be beneficial to the healing of fractures in two ways.

First of all, safe and specific exercises can actually speed up the healing process. Good circulation and blood flow to the injured area are extremely important. Specific exercises can help with range of motion and movement of the surrounding muscles and tendons without creating undo stress.

Secondly, research has shown that the use of therapeutic modalities can also accelerate healing. We use a special combination of ultrasound and electrical stimulation. This process decreases pain by reducing unnecessary inflammation. It also increases circulation to the area.

Along with rest, adequate nutrition and protection of the fractured area, physical therapy can help rebuild and restore – often in significantly less time! One of our patients shared the following:

“After cracking 2 ribs in a horse riding accident, my doctor told me it would take 6-8 weeks to heal and gave me a prescription for pain killers. Fortunately, with the special ultrasound/electrical stimulation treatments by Mark, I was completely healed 3 weeks later. Back on the horse even!”

Balance Dizziness

One in three adults may face challenges due to balance problems or dizziness. Although not as common, children and teenagers can be affected as well. Our balance is impacted by several parts of the body: the eyes, inner ear, the brain and the muscles and joints of the legs and feet.
When the balance disorder stems from the inner ear, treatment is often referred to as “vestibular rehabilitation”. The vestibular system refers to the chambers, tubes and nerves that make up the inner ear. The movement and position of our head, as well as the pull of gravity are sensed by this part of our body. If this area has been injured, impacted by a specific disease, or affected by the process of aging, balance can become a challenge.Vision problems can similarly affect our ability to control our movement and maintain our balance. Glaucoma, cataracts or eye-movement disorders are a few examples of vision conditions that can cause this type of problem.Sometimes balance issues result from a lack of proper signaling from the brain to the legs and feet. These signaling nerves are called propriocepters. Traumatic brain injuries, strokes and other injuries can interrupt this communication.Sometimes balance issues can result from imbalances or weakness of the leg or foot, especially if dizziness is NOT present. Exercise programs may be recommended to help strengthen and balance out these areas.


arthritisArthritis is inflammation of the joints. Symptoms include joint pain, stiffness, swelling and decreased range of motion. Age often plays a factor in the development of this condition.

Osteoarthritis and rheumatoid are the most common types of arthritis. Rheumatoid arthritis occurs when the lining of the joint is attacked by the immune system. The area becomes inflamed and ultimately destroys the cartilage and bone located in the joint.

Osteoarthritis is more common. In this case, the joint’s cartilage is damaged by normal wear and tear, age, injury or even infection. Eventually, this cartilage disappears and the bones rub and grind together.

There are a variety of medications prescribed to treat the inflammation and pain of arthritis. These can be taken orally or administered by injection. Physical therapy, however, can play an important role in relieving the pain and preventing the progress of arthritis.

Exercise programs can significantly strengthen the surrounding muscles of the affected joints. Range of motion can be maintained. Balance, flexibility and endurance can all be maintained and even improved. If needed, assistive devices such as braces, walkers may be recommended for safety and comfort.

Patients who consistently exercise and apply the suggestions received at physical therapy enjoy greater comfort and an improved quality of life.