Tendon Pain

Hip bursitis, greater trochanteric pain syndrome, gluteal tendinopathy

Lateral hip pain is an extremely common presentation in our office. We have excellent results with our treatment methodology and typically see patients who have seen other providers including chiropractors, physical therapists and even sports medicine physicians for injections. The methodology includes specific soft tissue mobilization procedures with high intensity laser therapy and specific activity modifications and hip strengthening exercises.

Achilles tendinitis

Achilles tendinitis or Achilles Tendinopathy is a very common condition that we treat here. Interestingly, the clinical research on this condition has been evolving quite nicely over the last 5 to 10 years. We are dedicated to staying on top of this evolving research and continue to offer the most advanced scientifically proven treatment methodologies.

We are comprehensive in our evaluation and specific with our treatment for this condition. We usually start with a diagnostic ultrasound to evaluate the tendon. This can be helpful to rule out Achilles tendon tears including Achilles tendon partial thickness tears. We also like to differentiate between Achilles tendinosis and Achilles paratendinitis which does have a slightly different care pathway. Additionally, we make it very clear and distinct diagnostic difference between the Insertional Achilles tendinitis or the midsubstance Achilles Tendinopathy.

Treatment includes:
1. Soft tissue treatment techniques to the Achilles tendon and the heel cord as well as joint mobilzations and manipulation to the ankle joint.
2. High intensity laser therapy which can shave weeks off of the standard rehabilitation.
3. Specific exercise the tendon.
4. Evaluation up the kinetic chain.

For recalcitrant or difficult to treat Achilles tendinitis, we also have access to shockwave therapy. We reserve this by request only or if we’re not making progress with our standard approach. Tendon pain and tendon injuries are really one of our bread-and-butter conditions here at Valley Spine & Sport. If you’re struggling with this frustrating condition we completely understand your pain and look forward to helping. Book an appointment online here.

Tennis Elbow

Tennis elbow or lateral epicondylopathy or lateral epicondylitis is very common and we have great success treating this condition. Many of the patients who we treat with this condition have already seen other providers including physical therapists, chiropractors, or other sports medicine providers. This is one of the conditions where we are examining the use of diagnostic ultrasound to help direct people down the appropriate care pathway. Standard treatments include soft tissue mobilization in the form of active release technique and deep transverse friction massage as well as laser therapy and specific tendon loading exercises which helps speed healing. Other standard of care procedures include bracing and taping . We also look up the chain as some of the latest guidelines suggest scapular/shoulder blade stabilization exercises can be helpful.

Shoulder Impingement

Shoulder impingement is a broad term for anterior(front side) shoulder pain usually worse with overhead activities. There’s a few specific kinds of of impingement (subacromial, subcoracoid and posterior impingement) but the most common is the subacromial type. Some practitioners are getting away from using this term because it doesn’t really tell us which structure is injured. I still use it, but then try to identify the specific area involved. Sometimes we utilize diagnostic ultrasound to look at the rotator cuff, the bursa and some of the other surrounding structures including the biceps tendon. We also look at the intrinsic risk factors for shoulder impingement which include stiffness in the upper thoracic spine, muscle imbalances around the shoulder girdle. Some sports actually require an entire kinetic chain assessment as in baseball players and golfers. We try to be specific for the individual’s impairment and goals.

Shoulder impingement treatments

  • Specific stability exercises for the shoulder and scapula.
  • Manual therapy including soft tissue mobilization to the shoulder, thoracic spine and cervical spine.
  • Laser therapy to speed recovery and decrease pain.
  • Mobility exercises for the spine and shoulder.
  • Taping techniques for posture or shoulder positioning

Golfers elbow

Golfers elbow is tendinitis or tendinopathy on the medial/inside portion of the elbow. We have great success treating this condition in our office. The local treatment procedures include active release technique, laser therapy and deep friction massage. We also may utilize instrument assisted soft tissue mobilization (Graston technique is a brand name). The local exercises include specific exercises to load the tendon which helps to stimulate healing. We also like to look up the chain and identify any associated risk factors.

Knee Pain

We are here to help with your knee pain.

Here is a list of the most common conditions we see: Patellar Tendonitis or Tendinopathy; knee arthritis; runner’s knee or patellofemoral pain syndrome; knee ligament sprains; knee meniscus; IT band syndrome. We use a systematic approach to diagnose the condition which leads us down the most effective care pathway.