Joint Ventures Physical Therapy and Fitness - Boston, Massachusetts Kenmore Square

“Core” is a term used with reference to the lumbar spine to describe a point from which the center of gravity for all mobility is initiated. The core functions to maintain stability during movement and everyday activities. If the core is not properly engaged there is instability of the spine and pelvis. Imbalances and instablity in the core can eventually lead to problems in the extremities. Common injuries resulting from delayed activation of the core include ankle sprains, knee sprains, as well as hip and back injuries. If the spine is not stable, excessive rotation and motion is present. This can make an individual prone to disc injuries of the lumbar spine.

The core consist of many muscles, the most notable being the transverse abdominis. By activating the transverse abdominis muscle correctly, you are able to perform abdominal bracing. Abdominal bracing is achieved by pulling the navel toward the spine. Be careful not to compensate by sucking in or holding your breath. You should be able to breath while engaging your transverse abdominis. This contraction of the transverse abdominis is the foundation of the core stabilization program and should be mastered before progressing. A neutral spine and pelvis position should be achieved before a core stabilization program is to be put into effect. 

Overall, the “core” acts as a natural corset. It can significantly reduce back pain and strain on the spine if it is properly done. To establish a core stabilization program that is appropiate for you, a thorough examination should be performed by your physical therapist.

Tennis elbow or lateral epicondylitis is an injury that can typically result from microtrauma (repeated continual small stress over a period of time) or macrotrauma (a large stress applied at one time) to the elbow. Tennis elbow is an extremely common injury that appears on the outside (lateral) aspect of the forearm. This injury is not to be confused with pain on the inside (medial) aspect of the forearm (Golfer’s elbow). Tennis elbow commonly appears within the tennis playing population, but is an injury that presents in a population of people who do not play tennis at all. Tennis elbow occurs most commonly in the tendon of the Extensor Carpi Brevis muscle, which is located approximately two centimeters below the outer edge of the elbow joint or lateral epicondyle of the humerus.

Tennis elbow can be caused by a poor technique when playing tennis, or any other repetitive strain caused by repeated wrist or finger extension (bending back) against resistance-e.g. using a keyboard on a computer.

When assessing for tennis elbow, cervical, shoulder, and elbow joint pathologies must be tested for to provide a comprehensive assessment resulting in an accurate diagnosis.

Treatment of Tennis elbow is individualized depending on the lifestyle, activity level and condition of the individual. Treatment techniques for Tennis elbow include, identifying the aggravating activity, modifying the activity, icing to decrease the inflammation, soft tissue mobilization, stretching, strengthening, bracing or taping, ultrasound, iontophoresis, and if conservative treatment does not work, there may be a call for a corticosteroid injection to the area.

For each individual’s Tennis elbow pain, treatment will be modified for their individual level of pain and lifestyle. Sufferers of Tennis elbow must consider that this injury is a highly irritable condition. Symptoms may be steadily improving and then with one aggravation, usually involving some form of resisted wrist extension,the condition will can return in full force.

The term ’shin splint’ is a general symptom of a number of things that may be affecting the muscles, bones and other tissue of the front of the lower leg.  What some describe as a “burning” in the shin with walking, running, or playing sport is most commonly an overuse of the largest muscle, the anterior tibialis muscle. 

The function of this muscle is to bring the foot upward, or dorsiflex the foot and ankle.  When the opposing muscles, such as the calf muscles in the back are not long enough (or short and tight), the muscles in the front have to work harder to bring the foot up.  The importance of dorsiflexing the foot and ankle is to make sure that the toes clear the ground when swinging your leg through in the gait cycle.  More often than not, the cause of shin splints is tight calf muscles forcing the anterior tibialis to “over”-work during gait (walking or running).  We all know that “over”-working a muscle or tendon can very easily lead to an inflammation in those structures.

In order to get a proper diagnosis and rule out anything more serious, talk to your doctor when ice, stretching, and rest for a few days does not resolve your complaint.