Common Orthopedic Injuries from the PT POV

Eric Armstrong, ATC, PTA, PES is a certified athletic trainer and physical therapist assistant at The Orthopedic Institute of New Jersey. As part of our continuing Q & A series, we sat down with Eric to discuss some common orthopedic injuries and their treatments from his experienced point of view…  

Q: What would you say are some of the more common injuries you encounter?

  A: In the clinical setting I’m in, we see pretty much everything. However, I think the more common injuries are shoulder injuries, like labral and rotator cuff tears. We’ve also had a good amount of ACL and Achilles injuries come through as well as a lot of low back pain patients. Back pain was less common the in athletic training settings I have had experience in; it was not something I would’ve typically seen unless it was an acute, traumatic injury. That’s because—simply speaking— most young high school aged athletes don’t have low back problems. As a physical therapist assistant, it’s a different ballgame in comparison to seeing older patients with degenerative changes or disc issues.   So, to sum up: Lately, it has been a lot of low back, shoulder, knees and Achilles. We’ve also had our fair share of plantar fasciitis, as well.  

Q: Are there certain treatment techniques for these injuries that have proven to help your patients?

  A: Coming out of my undergrad in athletic training, I didn’t have a great deal of experience in chronic low back pain. When I came into a clinical role that was something I wanted to get more comfortable with. To do so, I took a course in the McKenzie method of MDT^®, which are movement-based treatments and preferences that we combine with core-strengthening exercises, like stabilization and stretching. As a result, we’ve had great success reducing pain from conditions, such as radiculopathy caused by disc issues by taking pressure off the nerve roots.   Additionally, all of the therapists here—including myself—have recently become trained in the Graston Technique^®. We use it with Achilles injuries and it’s helped a lot. It’s ideal for identifying soft-tissue dysfunctions that occur and breaking up scar tissue that has built up from injury or surgery. It has also worked very well for the plantar fasciitis cases we’ve been experiencing by allowing us to effectively stretch out the plantar fascia. I think, in conjunction with other techniques, it has worked tremendously well to relieve people from their discomfort from some of the more common disorders we’ve been seeing.  

Q: How, in your opinion, has your treatment process evolved?

  A: I think the biggest thing for me personally has been keeping my treatments patient-centered and to always try and see the overall picture. Sometimes, the most difficult challenge is battling the feeling of the daily-grind and not becoming too complacent. I work hard to keep my sessions fun and find new ways to keep patients motivated and engaged.   I think that continuing education (such as the techniques I mentioned earlier), taking more courses and finding new things to incorporate into treatment plans—finding what works, what doesn’t, what’s more efficient—is the key. You should always continue to push yourself so you can push your patients and never feel just content.  

Q: What “pearls of wisdom” have you acquired over your career regarding injuries and treatments that you can share?

  A: For me, I always feel it’s important to stay within protocol guidelines while keeping the treatment individualized and to always think outside the box. As I stated earlier, low back pain was sort of a weak point and out of my comfort zone. So, I worked hard to educate myself on how to effectively treat it. I gained confidence through learning and then applying what I learned to my patients, their treatment and even their education.   Building on the idea of wisdom for treatments, I try to stress to my patients the importance of posture and the mechanics of the body, especially in regards to injury. Core strength is another one of those things—especially with athletes—that is important to develop from a working standpoint.   I also am a firm supporter of functional screening to help identify imbalances in order to determine risk for a soft tissue injury. It’s also a good tool for balancing out the musculoskeletal system.