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  • Ankle Anatomy

Ankle injuries can be a real pain, literally and figuratively.  Not only can they lay you up or make you hobble around, they may cause you to banish your favorite pair of stilettos to the closet or cancel that game of touch football that you had planned for the weekend.

If you are currently in pain and suffering from an ankle injury, it is important that you know the facts about this sensitive area.  After all, if your ankle injury is not given the proper attention and healed completely, you run the risk of it occurring again.

In this area of our site you will find various resources on the types of ankle injuries that you could suffer from as well as information about the steps that should be taken for fixing this problem.

Take the time and make sure you get proper attention; after all, you have better things to do than hobble around on a pair of crutches.

  • Ankle Issues

The ankle joint acts like a hinge. But it's much more than a simple hinge joint. The ankle is actually made up of several important structures. The unique design of the ankle makes it a very stable joint. This joint has to be stable in order to withstand 1.5 times your body weight when you walk and up to eight times your body weight when you run.

Normal ankle function is needed to walk with a smooth and nearly effortless gait. The muscles, tendons, and ligaments that support the ankle joint work together to propel the body. Conditions that disturb the normal way the ankle works can make it difficult to do your activities without pain or problems.

This guide will help you understand:

  • what parts make up the ankle
  • how the ankle works

Important Structures

The important structures of the ankle can be divided into several categories. These include

  • bones and joints
  • ligaments and tendons
  • muscles
  • nerves
  • blood vessels

The top of the foot is referred to as the dorsal surface. The sole of the foot is the plantar surface.


Ankle Bones

The ankle joint is formed by the connection of three bones. The ankle bone is called the talus. The top of the talus fits inside a socket that is formed by the lower end of the tibia (shinbone) and the fibula (the small bone of the lower leg). The bottom of the talus sits on the heelbone, called the calcaneus.

The talus works like a hinge inside the socket to allow your foot to move up (dorsiflexion) and down (plantarflexion).

Talus Works Like a Hinge

Woodworkers and craftsmen are familiar with the design of the ankle joint. They use a similar construction, called a mortise and tenon, to create stable structures. They routinely use it to make strong and sturdy items, such as furniture and buildings.

Mortise and Tenon

Inside the joint, the bones are covered with a slick material called articular cartilage. Articular cartilage is the material that allows the bones to move smoothly against one another in the joints of the body.

The cartilage lining is about one-quarter of an inch thick in most joints that carry body weight, such as the ankle, hip, or knee. It is soft enough to allow for shock absorption but tough enough to last a lifetime, as long as it is not injured.



Ligaments of the Ankle

 are the soft tissues that attach bones to bones. Ligaments are very similar to tendons. The difference is that tendons attach muscles to bones. Both of these structures are made up of small fibers of a material called collagen. The collagen fibers are bundled together to form a rope-like structure. Ligaments and tendons come in many different sizes and like rope, are made up of many smaller fibers. Thickness of the ligament or tendon determines its strength.


Ligaments on both sides of the ankle joint help hold the bones together. Three ligaments make up the lateral ligament complex on the side of the ankle farthest from the other ankle. (Lateral means further away from the center of the body.) These include the anterior talofibular ligament (ATFL), the calcaneofibular ligament(CFL), and the posterior talofibular ligament (PTFL). A thick ligament, called the deltoid ligament, supports the medial ankle (the side closest to your other ankle).

Three Main Ligaments

Ligaments also support the lower end of the leg where it forms a hinge for the ankle. This series of ligaments supports the ankle syndesmosis, the part of the ankle where the bottom end of the fibula meets the tibia. Three main ligaments  support this area. The ligament crossing just above the front of the ankle and connecting the tibia to the fibula is called the anterior inferior tibiofibular ligament (AITFL). The posterior fibular ligaments attach across the back of the tibia and fibula. These ligaments include the posterior inferior tibiofibular ligament (PITFL) and the transverse ligament. The interosseous ligament lies between the tibia and fibula. (Interosseous means between bones.) The interosseus ligament is a long sheet of connective tissue that connects the entire length of the tibia and fibula, from the knee to the ankle.

The ligaments that surround the ankle joint help form part of the joint capsule. A joint capsule is a watertight sac that forms around all joints. It is made up of the ligaments around the joint and the soft tissues between the ligaments that fill in the gaps and form the sac.

Joint Capsule

The ankle joint is also supported by nearby tendons. The large Archilles tendon is the most important tendon for walking, running, and jumping. It attaches the calf muscles to the calcaneus (heelbone) and allows us to raise up on our toes. The posterior tibial tendon attatches one of the smaller muscles of the calf to the underside of the foot. This tendon helps support the arch and allows us to turn the foot inward. 

Achilles Tendon

Posterior Tibial Tendon 


The anterior tibial tendon allows us to raise the foot. Two tendons run behind the outer bump of the ankle (the lateral malleolus). These two tendons, called the peroneals, help turn the foot down and out.


Muscles of the Ankle

Most of the motion of the ankle is caused by the stronger muscles in the lower leg whose tendons pass by the ankle and connect in the foot. Contraction of the muscles in the leg is the main way that we move our ankle when we walk, run, and jump.

The key ankle muscles have been discussed earlier in the section on ligaments and tendons. These muscles and their actions are also listed here.

  • The peroneals (peroneus longus and peroneus brevis) on the outside edge of the ankle and foot bend the ankle down and out.
  • The calf muscles (gastrocnemius and soleus) connect to the calcaneus by the Achilles tendon. When the calf muscles tighten, they bend the ankle down.
  • The posterior tibialis muscle supports the arch and helps turn the foot inward.
  • The anterior tibialis pulls the ankle upward.


Nerves of the Ankle

The nerve supply of the ankle is from nerves that pass by the ankle on their way into the foot. The tibial nerve runs behind the medial malleolus. Another nerve crosses in front of the ankle on its way to top of the foot. There is also a nerve that passes along the outer edge of the ankle. The nerves on the front and outer edge of the ankle control the muscles in this area, and they give sensation to the top and outside edge of the foot.

Tibial Nerve

Nerves on Front and Outer Edge


The ankle gets blood from nearby arteries that pass by the ankle on their way to the foot. The dorsalis pedis runs in front of the ankle to the top of the foot. (You can feel your pulse where this artery runs in the middle of the top of the foot.) Another large artery, called the posterior tibial artery, runs behind the medial malleolus. It sends smaller blood vessels to the inside edge of the ankle joint. Other less important arteries entering the foot from other directions also supply blood to the ankle.

Posterior Tibial Artery

Arteries Entering the Foot


As you can see, the anatomy of the ankle is very complex. When everything works together, the ankle functions correctly. When one part becomes damaged, it can affect every other part of the ankle and foot, leading to problems.

  • FAQs


Q: After a very severe ankle injury, I found out I have a hole in the ankle bone that goes clear down to through the cartilage to the bone. The surgeon is recommending something called an OAT procedure. At age 55 (and being a post-menopausal woman), will this work for me? I don't heal as well as I used to.

A: Holes referred to as "defects" in cartilage that go clear down to the bone can be treated with the technique you mentioned: osteochondral autograft transfer or OAT. Osteochondral autograft transfer (OAT) involves removing a plug of cartilage and bone from a healthy area (usually from a non-weight bearing area of the knee) and transferring it into the osteochondral lesion (i.e., hole in the surface of the same person's joint). The word "autograft" refers to the fact that the patient donates his or her own tissue for the procedure.

In a recent study from Korea, surgeons used a second arthroscopic examination a year later to evaluate the results of this procedure used on the talus (ankle bone). It is rare that a second-look arthroscopic exam is possible so the results of this study are important. Quality of bone and cartilage graft were evaluated using the second arthroscopy instead of MRI in order to get a better look at the results.

Using an analysis of many patient variables, the researchers were able to determine the most important factors affecting the final results. They investigated the role of age, gender, body mass index (BMI), duration of symptoms, severity (depth and size) and location of lesion, and presence of bone cysts as predictive factors of outcomes. They also looked at results based on patient satisfaction, pain, function, and activity level.

Ninety-five per cent (95%) of the group reported good-to-excellent outcomes. Age was not a statistically significant factor. The most important variable in the result of the OAT procedure was actually a surgical effect. The surgeon must restore the joint surface smoothly, evenly, and anatomically accurately.

Impingement (pinching) of the surrounding soft tissues must be avoided. The graft shape and size must match the defect as closely as possible. And the graft must be covered over carefully with a patch to prevent "uncovered" areas. It seems that any gaps or uncovered spots quickly fill in with fibrous cartilage. The result is an unstable defect area.

The authors of this particular study suggest longer-term studies (beyond the one-year mark) in order to evaluate changes and look for influencing factors that might not show up in the first 12-months. They also commented that their study was fairly small in terms of number of patients (52 ankles). Therefore the study should be repeated with a larger number of subjects before accepting these results as the final word on the subject.

But it does offer some evidence that your age and potentially your postmenopausal status may not make a difference. These are good questions to ask your surgeon before having this procedure. Reparative surgery is important in this condition to avoid premature arthritic changes that can cause a chronically painful and unstable ankle.


Physical Therapy in Austin for Arthritis

Welcome to the Axiom Physiotherapy’s resource about arthritis.

Arthritis is one condition that can be incredibly debilitating to a sufferer of this disease. Arthritis can cause pain, inflammation, stiffness, limitation of movement, and can keep you from fully enjoying your life.

However, there is a light at the end of the tunnel!

This section of our site is designed with you, the Arthritis sufferer in mind. We want to be a resource for you, to provide you with the information and assistance you need in order to take control of your condition and let Arthritis know just who exactly is the boss.

There is no reason you shouldn't be able to do all of the activities that you love to do, whether it is dance, play a sport, lift your children or your grandchildren, or simply sit at the computer and update your Facebook status.

Arthritis doesn't have to kill your fun and if you work with us, we won't let it.

Upper Back and Neck

Welcome to Axiom Physiotherapy's patient resource about upper back and neck problems.

Physical Therapy in Austin for Upper Back and Neck

Welcome to Axiom Physiotherapy's patient resource about Cervical Spine Problems.

Knowing the main parts of your neck and how these parts work is important as you learn to care for your neck problem.

Two common anatomic terms are useful as they relate to the neck. The term anterior refers to the front of the neck. The term posterior refers to the back of the neck. The part of the spine that moves through the neck is called the cervical spine. The front of the neck is therefore called the anterior cervical area. The back of the neck is called the posterior cervical area.

This guide gives a general overview of the anatomy of the neck. It should help you understand:

  • what parts make up the neck
  • how these parts work

Important Structures

Cervical Spine Anatomy

The important parts of the cervical spine include:

  • bones and joints
  • nerves
  • connective tissues
  • muscles
  • spinal segments

This section highlights important structures in each category.

Bones and Joints

The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to form the spinal column. The spinal column is the body's main upright support.


The first seven vertebrae make up the cervical spine. Doctors often refer to these vertebrae as C1 to C7. The cervical spine starts where the top vertebra (C1) connects to the bottom of the skull. The cervical spine curves slightly inward and ends where C7 joins the top of the thoracic spine (the chest area).

Cervical Spine

The base of the skull sits on top of C1, also called the atlas. Two thickened bony arches form a large hole through the center of the atlas. The opening is large because the spinal cord is wider where it first exits the brain and skull. Compared to other vertebrae, the atlas also has much wider bony projections pointing out to each side.


The atlas sits on top of the C2 vertebra. The C2 is called the axis. The axis has a large bony knob on top, called the dens. The dens points up and fits through a hole in the atlas. The joints of the axis give the neck most of its ability to turn to the left and right.



Each vertebra is made of the same parts. The main section of each cervical vertebra, from C2 to C7, is formed by a round block of bone, called the vertebral body. A bony ring attaches to the back of the vertebral body. This ring has two parts. Two pedicle bones connect directly to the back of the vertebral body. Two lamina bones join the pedicles to complete the ring. The lamina bones form the outer rim of the bony ring. When the vertebrae are stacked on top of each other, the bony rings form a hollow tube that surrounds the spinal cord. The laminae provide a protective roof over the spinal cord.

Cervical Vertebra

A bony knob projects out at the point where the two lamina bones join together at the back of the spine. These projections, called spinous processes, can be felt as you rub your fingers up and down the back of your spine. The largest bump near the top of your spine is the spinous process of C2. At the base of the neck where the cervical and thoracic spines join together, you'll feel another large spinous process. That's C7.

Spinous Processes

Each vertebra in the spine has two bony knobs that point out to the side, one on the left and one on the right. These bony projections are called transverse processes. The atlas has the widest transverse processes of all the cervical vertebrae. Unlike the rest of the spine, the neck vertebrae have a hole that passes down through each transverse process. This hole, called the transverse foramen, provides a passageway for arteries that run up each side of the neck to supply the back of the brain with blood.

Between each pair of vertebrae are two joints called facet joints. These joints connect the vertebrae together in a chain but slide against one another to allow the neck to move in many directions. Except for the very top and bottom of the spinal column, each vertebra has two facet joints on each side. The ones on top connect to the vertebra above; the ones below join with the vertebra below.

Facet Joints

The surfaces of the facet joints are covered by articular cartilage. Articular cartilage is a smooth, rubbery material that covers the ends of most joints. It allows the ends of bones to move against each other smoothly, without friction.

On the left and right side of each vertebra is a small tunnel called a neural foramen. (Foramina is the plural term.) The two nerves that leave the spine at each vertebra go through the foramina, one on the left and one on the right. The intervertebral disc (described later) sits directly in front of the opening. A bulged or herniated disc can narrow the opening and put pressure on the nerve. A facet joint sits in back of the foramen. Bone spurs that form on the facet joint can project into the tunnel, narrowing the hole and pinching the nerve.

Neural Foramen


The hollow tube formed by the bony ring on the back of the spinal column surrounds the spinal cord as it passes through the spine. The spinal cord is a similar to a long wire made up of millions of nerve fibers. Just as the skull protects the brain, the bones of the spinal column protect the spinal cord.

Spinal Cord

The spinal cord travels down from the brain through the spinal column. Two large nerves branch off the spinal cord from each vertebra, one on the left and one on the right. The nerves pass through the neural foramina. These spinal nerves group together to form the main nerves that go to the limbs and organs. The nerves that come out of the cervical spine go to the arms and hands.

Connective Tissues

Ligaments are strong connective tissues that attach bones to other bones. (Connective tissues are networks of fiber that hold the cells of the body together.) Several long ligaments connect on the front and back sections of the vertebrae. The anterior longitudinal ligament runs lengthwise down the front of the vertebral bodies. Two other ligaments run full length within the spinal canal. The posterior longitudinal ligament attaches on the back of the vertebral bodies. The ligamentum flavum is a long elastic band that connects to the front surface of the lamina bones.

A special type of structure in the spine called an intervertebral disc is also made of connective tissue. The fibers of the disc are formed by special cells, called collagen cells. The fibers may be lined up like strands of nylon rope or crisscrossed like a net.

An intervertebral disc is made of two parts. The center, called the nucleus, is spongy. It provides most of the shock absorption in the spine. The nucleus is held in place by the annulus, a series of strong ligament rings surrounding it.

Two Parts of Intervertebral Disc


The anterior cervical area is covered with muscles that run from the rib cage and collar bone to the cervical vertebrae, jaw, and skull. The posterior cervical muscles cover the bones along the back of the spine and make up the bulk of the tissues on the back of the neck.

Spinal Segment

A good way to understand the anatomy of the cervical spine is by looking at a spinal segment. Each spinal segment includes two vertebrae separated by an intervertebral disc, the nerves that leave the spinal cord at each vertebra, and the small facet joints that link each level of the spinal column.

The intervertebral disc separates the two vertebral bodies of the spinal segment. The disc normally works like a shock absorber. It protects the spine against the daily pull of gravity. It also protects the spine during heavy activities that put strong force on the spine, such as jumping, running, and lifting.

The spinal segment is connected by a facet joint, described earlier. When the facet joints of the cervical spine move together, they bend and turn the neck.


Many important parts make up the anatomy of the neck. Understanding the regions and structures of the neck can help you be more involved in your health care and better able to care for your neck problem.

Portions of this document copyright MMG, LLC.

Mid Back

Physical Therapy in Austin for Mid Back

Welcome to the Axiom Physiotherapy’s resource about mid back issues.

Regardless of what you think, a degenerative disc isn't a music CD that you don't want your kids to listen to.  Rather it is an incredibly painful Mid Back condition that is less fun to deal with than a mini-van full of teenagers listening to the latest song by Lady GaGa.

If you currently suffer from Mid Back problems that are getting you down, both in spirit and in posture, it's time you did something about it.

This area of our site is designed to help you know what to do and how to fix Mid Back pain that could be caused from ruptured or bulging discs or to help you determine if you pulled a major muscle while cleaning your kid's room last weekend.

You don't have to live with Mid Back pain, your condition, more than likely is completely treatable when you enlist our help.  However, you might have to live with the music your kid plays, at least until they go to college.

Lower Back

Low Back Physical Therapy in Austin

Welcome to the Axiom Physiotherapy patient resource for low back pain.

If you suffer from lower back pain, there is no reason why you do have to banish yourself to the bell tower at Notre Dame a la Quasimodo.  In fact, we have designed this portion of our site with you in mind.

Whether you have lower back pain because of a herniated disc, osteoarthritis, or any other issue that is seriously impairing your outlook on life and your happiness, worry no more.  We aim to provide a solution to you and to your problem, as well as supply information that will help you stay healthy and pain free after your injury is corrected.

After all, there is no reason for you to live life hunched over in pain, there is too much to see, feel and experience when you are able to stand tall.

Trauma Disorder

Physical Therapy in Austin for Cumulative Trauma


Welcome to Axiom Physiotherapy's patient resource about Cumulative Trauma Disorder.

Cumulative trauma disorder (CTD) is a broad category that includes many common diseases that affect the soft tissues of the body. CTD in itself is not a disease. Doctors use the concept to understand and explain what may have caused, or contributed to, certain conditions. Examples of the conditions that may be caused or aggravated by cumulative trauma include carpal tunnel syndrome, tennis elbow, and low back pain.

Other terms are often used to describe the concept of CTD. These include repetitive stress injury (RSI), overuse strain (OS), and occupational overuse syndrome (OOS). This document will refer to these categories generally as CTD.

This guide will help you understand:

  • what factors may contribute to CTD
  • how doctors diagnose conditions related to CTD
  • what treatment options are available
  • how to prevent CTD


What causes CTD?

Opinions abound as to what may cause CTD, but there is very little agreement. Some of the theories about how CTD starts are described below. The theories include:

  • overuse
  • muscle tension
  • nerve tension
  • psychosocial factors
  • mind-body interaction
  • contributing factors


Using muscles and joints after they have become fatigued, or overly tired, increases the likelihood of injury. Overloaded muscles and soft tissues without proper rest have no chance to recover fully. This problem often hampers athletes who have to throw, jump, or run repeatedly. It can also affect people who work in jobs where they keep doing the same action again and again, such as typing, gripping, and lifting.

All body tissues are in a constant state of change. Minor damage occurs continuously, which the body must repair in the normal course of a day. But the damage can occur faster than the repair mechanisms can keep up with it. When this happens, the tissues become weaker. They may begin to hurt. The weaker the tissues become, the more likely they will suffer even more damage. A cycle begins that looks like a spiral--constantly downward.


Muscle Tension

Some doctors think muscle tension causes CTD. To function, or work properly, the body and each of its parts needs a steady supply of blood, rich in oxygen and nutrients. Nutrients are the body's fuel--glucose, for example. Cutting off or slowing the blood supply harms the tissues of the body.

Tense muscles are believed by some to actually squeeze off their own flow of energy and fuel. Muscles can get energy without oxygen, but the process produces a chemical called lactic acid. This chemical can be a potent pain-causing chemical. Lactic acid is a chemical that can produce a burning feeling when muscles are overexercised. Some physicians believe that lactic acid produced by tense muscles may cause some of the symptoms of CTD.

As pain develops, muscles tighten even further because they attempt to guard the surrounding area. Guarding is a term that is used to describe a reflex that all muscles in the body share. When pain occurs anywhere in the body, muscles around the painful area go into spasm (they tighten uncontrollably) to try to limit the movement in the area. As a result, blood flow is slowed down even more. The muscles begin to ache more. The nerves that have their blood supply reduced and squeezed by muscles begin to tingle or go numb.

Nerve Tension

This theory suggests that nerves become extra sensitive when they've become shortened and irritable. It is thought that poor postures used over long periods causes muscles to bulk up and interfere with blood flow. The nerves that course through the body then become shortened and may begin to stick to the nearby tissues. Moving the arm or leg puts tension on the nerve and can cause pain to radiate along the limb. The problem is thought to get worse from stress because the muscles and nerves tense up and become even tighter. Also, when the same activities are done over and over again, the tight nerve is pulled and strained to the point that it can't heal and eventually becomes a chronic source of symptoms.

Psychosocial Factors

Problems with CTD tend to be more common among people who suffer from boredom, who have poor working relations, who aren't satisfied with their jobs, and who have unhappy social circumstances. Reasons why this is so are unclear. The number of CTD cases reported may also be influenced by state worker's compensation rules. States where claims are processed quickly and with greater benefits tend to have higher volumes of CTD cases. Both of these findings suggest that many cases of CTD may be highly influenced by the patient's perception of the overall situation. Some patients may subconsciously, or consciously, rationalize their symptoms due to many factors that are not medical but have to do with their overall job and social situation.

Mind-Body Interaction

A newer theory suggests that there isn't really an injury going on in the soft tissues where symptoms are felt. Instead, the problem is said to be coming from influences within the mind. It is theorized that the brain starts producing pain signals as a cover-up for deep-rooted feelings of past emotional pain or problems. Though the idea sounds hard to believe, practitioners using this approach claim they have had success rates as high as 95 percent. Their patients are reported to have gotten swift relief from treatments aimed at the underlying and unconscious emotional triggers.

Contributing Factors

The way people do their tasks can put them at risk for CTD. Some risk factors include:

  • force
  • awkward or static postures
  • poor tool and equipment design
  • fatigue
  • repetition
  • temperature
  • vibration

One of these risk factors alone may not cause a problem. But doing a task where several factors are present may pose a greater risk. And the longer a person is exposed to one or more risks, the greater the possibility of developing CTD. Many different symptoms can arise from the accumulation of small injuries or stresses to the body. CTD is not so much a disease as it is a response to excessive demands these factors can place on our bodies without giving them adequate time to recover between.


What does CTD feel like?

The symptoms of CTD usually start gradually. Patients usually don't recall a single event that started their symptoms. They may report feelings of muscle tightness and fatigue at first. People commonly report feeling numbness, tingling, and vague pain. Others say they feel a sensation of swelling in the sore limb. Some patients with arm symptoms sense a loss of strength and may drop items because of problems with coordination. Symptoms often worsen with activity and ease with rest.


When you visit Axiom Physiotherapy, our Physical Therapist will begin the evaluation by taking a history of your problem. We’ll probably ask questions about your job, such as the type of work you do and how you perform your job tasks. Answers to other questions will give us information about your work conditions, such as the postures you use, the weights you have to lift or push, and whether you have to do repetitive tasks. We may also ask about how you like your job and whether you get along with your supervisors and coworkers.

Our Physical Therapist will then do a thorough physical examination. Your description of the symptoms and the physical examination are the most important parts in the diagnosis of CTD. We will first try to determine what conditions are affecting you. For example you may have symptoms of carpal tunnel syndrome or tennis elbow that need to be treated. Second, our Physical Therapist will try and determine if cumulative trauma is playing a role in your condition. If so, part of the treatment will be to try and eliminate the source of the cumulative trauma.

There are no specific tests that can diagnose CTD. There are many different tests that may be ordered as we look for specific conditions.

Axiom Physiotherapy provides Physical Therapist services in Austin.

Portions of this document copyright MMG, LLC.


How can I help prevent problems of CTD?

The best medicine for treating CTD is to prevent the problem from occurring in the first place. Key items to consider when attempting to prevent problems with CTD are listed below.

Use healthy work postures and body alignment. Posture can have a significant role in CTD. Faulty alignment of the spine or limbs can be a source of symptoms. Using healthy posture and body alignment in all activities decreases the possibility that CTD will strike. Incorrect posture may lead to muscle imbalances or nerve and soft tissue pressure, leading to pain or other symptoms. Most people spend many hours at their work place, and using unhealthy posture during these long hours increases the likelihood that CTD will develop.


Assessing where and how a person does work is called ergonomics. Even subtle changes in the way a work station is designed or how a job is done can lead to pain or injury.



Rest and Relax

Rest and relaxation (R and R) have recently become front-line defenses in the prevention of CTD. Methods can be as simple as deep breathing, walking, napping, or exercising.


This strategy is useful during work and off hours. Whether at home or work, our bodies need time to recover, which simply means giving them a chance to heal. Rest and relaxation allow the body to recover and provide a way of repairing these injured tissues along the way, keeping them healthy.

The following ideas may be used to foster rest and relaxation at work:

    • Be relaxed. Try to work with your muscles relaxed by pacing your work schedule, staying well ahead of deadlines, and taking frequent breaks.


    • Stop to exercise. Gentle exercise performed routinely through the day helps keep soft tissues flexible and can ease tension.


    • Change positions. Plan ways to change positions during work tasks. This could include using a chair rather than standing or simply readjusting your approach to your job activity.


    • Rotate jobs or share work duties. This can be fun by offering a new work setting, and it allows the body to recover from the demands of the previous job task.


  • Avoid caffeine and tobacco. These can heighten stress, reduce blood flow, and elevate your perception of pain.

Our Treatment

What can I expect with treatment?

Getting treated right away for symptoms of CTD can shorten the time it takes to heal. Symptoms can sometimes go away within two to four weeks when steps are taken quickly to address the factors that may be causing your symptoms. However, people who keep doing activities when they have symptoms and don't seek help right away may be headed for a long and frustrating recovery time, perhaps as long as a year.

At Axiom Physiotherapy many nonsurgical treatment approaches are used by our Physical Therapy and occupational therapists to reduce the symptoms of CTD-related conditions. Our Physical Therapist will want to gather more information and will further evaluate your condition. The answers you give along with the results of the examination will guide us in tailoring a treatment program that is right for you.

Our Physical Therapists often begin by teaching patients relaxation techniques which may include helping you learn to breathe deeply by using your diaphragm muscle. Taking the time to relax and breathe deeply eases tense muscles and speeds nutrients and oxygen to sore tissues.

We may suggest that you wear a splint initially to protect and rest the sore area. Anti-inflammatory drugs, suggested by your doctor, are often used together with therapy treatments, which may include heat, ice, ultrasound, or gentle hands-on stretching to reduce pain or other symptoms. Our Physical Therapist may use muscle stretching to restore muscle balance and to improve your posture and alignment. We sometimes apply stretches that are designed to help nerves glide where they course from the spine to the arms or legs. Strengthening exercises are also used to restore muscle balance and to improve your ability to use healthy postures throughout the day.

Our Physical Therapist will pay close attention to your posture and movement patterns. You may receive verbal instruction and hands-on guidance to improve your alignment and movement habits. Helping you see and feel normal alignment improves your awareness about healthy postures and movements, allowing you to release tension and perform your activities with greater ease.

We will spend time helping you understand more about CTD and why you are experiencing symptoms. Our Physical Therapist may provide tips on how to combat symptoms at work using rest and relaxation. You may also be given specific stretches and exercises to do at work. Our Physical Therapist may visit your work place to analyze your job site and to watch how you do your job tasks. Afterward, we can recommend changes to help you do your job with less strain and less chance of injury. These changes are usually inexpensive and can make a big difference in helping you be more productive with less risk of pain or injury.

At Axiom Physiotherapy, our goal is to help you understand your condition, to look for and change factors that may be causing your symptoms, and to help you learn how to avoid future problems. When your recovery is well underway, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of practicing the strategies and exercises you've learned as part of an ongoing home program.

Axiom Physiotherapy provides services for Physical Therapy in Austin.


Surgery is rarely indicated for CTD. Specific conditions that can occur as a result of CTD may require surgery. Unless the doctor is quite sure there is a structural problem, such as a pinched nerve or severely inflamed tendon, then surgery is not usually suggested.

Portions of this document copyright MMG, LLC.


Physical Therapy in Austin for Elbow

Welcome to the Axiom Physiotherapy's resource about Physical Therapy for elbow issues.

The elbow is one of those areas that is easy to injure, whether your elbow is sore from sitting at a desk all day while you watch videos on You Tube or because you had an especially competitive game of tennis where your wife showed you who was boss, we are here to help.

You have found the area of our site that we have devoted to you and we want you to know that we take your elbow injury seriously, and want to make sure we help you correct it by giving you the most up to date and accurate resources available.

After all, we know it's important for you to be able to watch all that You Tube has to offer in comfort.  However, we can't guarantee a pain free elbow is going to help you beat your wife at tennis.  We're not miracle workers after all.


Physical Therapy in Austin for Fibromyalgia

Welcome to Axiom Physiotherapy's patient resource about fibromyalgia.

Fibromyalgia has a Greek root word in its makeup.  Algia actually is Greek for pain, so right off the bat, you know a condition like this isn't something to joke about.  While this condition is often spoken about and is very common, many people still don't understand what this condition involves.

Simply put, Fibromyalgia involves being in pain, all over the body, particularly near joints, all of the time.

On top of it, outside of the pain, this condition also makes a sufferer very tired and unable to feel normal or carry on with their day-to-day life.

However, all is not lost and it is possible to recover from this debilitating condition.  It is our goal to help you navigate through the murky waters of Fibromyalgia and find relief through our counsel and advice.

Just because you are afflicted with this condition doesn't mean your life has to resemble a Greek tragedy.  With our help and our assistance, we will help you feel better and live pain-free.


Physical Therapy in Austin for Foot


Welcome to Axiom Physiotherapy's patient resource about Physical Therapy for the foot.

The foot can be the home of many problems, all of them uncomfortable and tough to deal with.  We can help you deal and recover from stress fractures, pulled muscles, torn ligaments and warts. . . . well, not the warts, we don't do warts. . . . however, we will be there for you when it comes to the other problems!

It is time for you to wake up and jump out of bed, landing with both feet firmly and comfortably on the ground.  Don't suffer another day with a foot problem that can be remedied through the information that we provide in this section of our site or through the assistance that our company can provide to you!

You deserve to be able to place one foot firmly in front of the other as you confidently walk from our office and we are looking forward to helping you!


Physical Therapy in Austin for Hamstring


Welcome to Axiom Physiotherapy's patient resource about Hamstring Injuries.

The big group of muscles and tendons in the back of the thigh are commonly called the hamstrings. Injuries in this powerful muscle group are common, especially in athletes. Hamstring injuries happen to all types of athletes, from Olympic sprinters to slow-pitch softball players. Though these injuries can be very painful, they will usually heal on their own. But for an injured hamstring to return to full function, it needs special attention and a specially designed rehabilitation program.

This guide will help you understand:

  • how the hamstrings work
  • why hamstring injuries cause problems
  • how doctors treat the condition


Where are the hamstrings, and what do they do?

The hamstrings make up the bulk in back of the thigh. They are formed by three muscles and their tendons. The hamstrings connect to the ischial tuberosity, the small bony projection on the bottom of the pelvis, just below the buttocks. (There is one ischial tuberosity on the left and one on the right.) The hamstring muscles run down the back of the thigh. Their tendons cross the knee joint and connect on each side of the shinbone (tibia).

The hamstrings function by pulling the leg backward and by propelling the body forward while walking or running. This is called hip extension. The hamstrings also bend the knees, a motion called knee flexion.

Most hamstring injuries occur in the musculotendinous complex. This is the area where the muscles and tendons join. (Tendons are bands of tissue that connect muscles to bones.) The hamstring has a large musculotendinous complex, which partly explains why hamstring injuries are so common.

When the hamstring is injured, the fibers of the muscles or tendon are actually torn. The body responds to the damage by producing enzymes and other body chemicals at the site of the injury. These chemicals produce the symptoms of swelling and pain.

In a severe injury, the small blood vessels in the muscle can be torn as well. This results in bleeding into the muscle tissue. Until these small blood vessels can repair themselves, less blood can flow to the area. With this reduced blood flow, the muscles cannot begin to heal.

The chemicals that are produced and the blood clotting are your body's way of healing itself. Your body heals the muscle by rebuilding the muscle tissue and by forming scar tissue. Carefully stretching and exercising your injured muscle helps maximize the building of muscle tissue as you heal.

In rare cases, an injury can cause the muscle and tendons to tear away from the bone. This happens most often where the hamstring tendons attach to the ischial tuberosity. These tears, called avulsions, sometimes require surgery.


Related Document: A Guide to Knee Anatomy


How do hamstring injuries occur?

Hamstring injuries happen when the muscles are stretched too far. Sprinting and other fast or twisting motions with the legs are the major cause of hamstring injuries. Hamstring injuries most often occur in running, jumping, and kicking sports.

Water skiing, dancing, weight lifting, and ice skating also cause frequent hamstring injuries. These sports are also more likely to cause avulsions.

The major factors in hamstring injuries are low levels of fitness and poor flexibility.

Children very seldom suffer hamstring injuries, probably because they are so flexible. Muscle fatigue and not warming up properly can contribute to hamstring injuries.

Imbalances in the strength of different leg muscles can lead to hamstring injuries. The hamstring muscles of one leg may be much stronger than the other leg, or the quadriceps muscles on the front of the thigh may overpower the hamstrings.


What does a hamstring injury feel like?

Hamstring injuries usually occur during heavy exercise. In especially bad cases, an athlete may suddenly hear a pop and fall to the ground. The athlete may be able to walk with only mild pain even in a severe injury. But taking part in strenuous exercise will be impossible, and the pain will continue.

In less severe cases, athletes notice a tight feeling or a pulling in their hamstring that slows them down. This type of hamstring injury often turns into a long-lasting problem.

The hamstring may be pulled, partially torn, or completely torn. The injury can happen at the musculotendinous junction (mentioned earlier), within the muscle, or where the tendon connects on the ischial tuberosity (avulsion). In the rare case of a complete tear, the pain is excruciating. The torn tissues may form a hard bunch in the back of the thigh when the leg is bent. The skin may also bruise, turning purple from bleeding under the skin. This is not necessarily dangerous but can look somewhat alarming.


How do health care providers diagnose the condition?

When you visit Axiom Physiotherapy, our Physical Therapist will take a detailed medical history that includes questions about your exercise schedule, your activities, and the way you warm up. You will also need to describe your symptoms.

Our Physical Therapist will examine the back of your thigh. The physical exam will involve flexing and extending your leg. The probing and the movement may hurt, but it is important to identify exactly where and when you feel pain.

Hamstring injuries are grouped into three categories, according to the severity. The following images show each grade of injury:

Grade One - Mild

Grade Two - Moderate

Grade Three - Severe

Grade one injuries are muscle pulls that do not result in much damage to the structure of the tissues. Grade two injuries are partial tears. Grade three injuries are complete tears.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physical Therapists at Axiom Physiotherapy have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.

Axiom Physiotherapy provides services for Physical Therapy in Austin.

Our Treatment

Non-surgical Rehabilitation

It is very important to treat and rehabilitate your hamstring injury correctly. Incomplete or improper healing makes reinjury much more likely.

Although every patient recovers at a different rate, as a general rule, for minor muscle pulls, you may need two to four weeks to safely get back to your activities. For more severe muscle tears, you may need rehabilitation for two to three months, with complete healing possibly taking four to six months.

When you begin your Physical Therapy program at Axiom Physiotherapy, within the first five days after your injury, the main goal of our treatment is to control the swelling, pain, and hemorrhage (bleeding). Hamstring injuries are initially treated using the RICE method. RICE stands for rest, ice, compression, and elevation.


Rest is critical. Our Physical Therapist may recommend a short period (up to one week) of immobilization. Severe tears may require a longer period of rest. This may mean you spend most of your time lying down. You may need to use crutches to get around. If you put too much weight on your hamstring after an injury, more damage may occur and more scar tissue may form. Our Physical Therapist can help you learn how to properly move about on your crutches.


We will apply ice to the injured hamstring. This will help to control swelling and pain but doesn't stop it completely. This is important because your body's inflammatory response actually helps your muscles heal. Cold treatments slow the metabolism and blood flow in the area. Cold also reduces your sensations of pain by numbing the nerves. And experiencing less pain helps you relax, reducing muscle spasms.

A plastic bag full of ice cubes or crushed ice, held on with an elastic bandage, is the most effective type of cold treatment. The ice should be kept on the injury for 10 to 15 minutes. You can also use cold gel packs, chipped ice, or cold sprays. We recommend that cold treatments should be repeated at least four times a day for the first two to three days. They can be done as often as every two hours if needed. Do not keep the ice on the skin too long or frostbite may occur.


Compression can help reduce the bleeding in your muscle to limit swelling and scarring. To apply compression, your Physical Therapist may wrap your hamstring firmly in an elastic bandage. It is unclear exactly how effective compression is in hamstring injuries, but patients often report having less pain with the wrap.


Elevation can help reduce swelling. It also keeps your leg immobilized. The key to elevation is to raise and support the injured body part above the level of the heart. In the case of a hamstring injury, this requires lying down and supporting the leg up on pillows.


Our Physical Therapist may also recommend a short course of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help relieve the swelling and pain. For muscle injuries, pain relief may be the major benefit of NSAIDs. They do not always treat the swelling of muscle injuries very effectively.

Health care providers disagree on when to give NSAIDs. Some think you should start using them right after the injury and stop using them after three to five days. Others think you should not use them for two to four days so you don't interrupt your body's natural healing response. The inflammation is an important part of your body's work to heal your injury. It is important that you follow your health care provider’s advice.

Stretching & Exercise

As your hamstrings begin to heal, it is critical that you follow your Axiom Physiotherapy exercise program to regain your strength and mobility. Our specially designed exercises encourage your body to rebuild muscle instead of scar tissue. The exercises also help prevent reinjury. Rehabilitation can be slow, so you will need to be patient and not push yourself too hard or too fast.

Early in your rehabilitation, our Physical Therapist may recommend that you do some of your exercises in a swimming pool or on a stationary bike set to low resistance. These exercises allow you to take your hamstrings through a range of motion without having to hold up your weight. When you can walk without a limp and feel very little tenderness, we will have you start a walking program. Eventually you can work up to jogging.

Stretching will be a key feature of your Axiom Physiotherapy rehabilitation program. Our Physical Therapist will show you how to stretch properly. Plan to continue these stretches even after you heal, because a reinjury of the same hamstring is common. Increasing your flexibility may help you avoid another hamstring injury in the future. It is important that you maintain good flexibility to keep your hamstrings healthy.

We may begin your strengthening exercises with isometric exercises. These exercises involve contracting the muscles without moving your leg joints. As your hamstrings get stronger, we will add light weights. It is important that you feel no pain during these exercises.

You should maintain your general level of fitness throughout your rehabilitation. Our Physical Therapist can suggest workouts that don't stress your hamstrings.

Most hamstring injuries get better with treatment and rehabilitation. Even world-class athletes with severe hamstring injuries are usually able to return to competition. By keeping the hamstrings flexible and giving the body time to heal, you should be able to return to the activities you enjoy.

Post-surgical Rehabilitation

Surgery is rarely needed, and only if there is a complete avulsion or tear. If you do have surgery, you will begin your recovery with a period of rest, which may involve using crutches. Our Physical Therapist can show you how to properly use your crutches to aviod putting too much weight on your healing leg. After surgery our Physical Therapists can start you on a careful and gradual exercise program for your post-surgical rehabilitation.

When your recovery is well under way, regular visits to Axiom Physiotherapy will end. Although we will continue to be a resource, you will eventually be in charge of doing your exercises as part of an ongoing home program.

Axiom Physiotherapy provides services for Physical Therapy in Austin.


Avulsion Repair

Surgery is rarely needed for hamstring injuries. However, it may be needed for an avulsion to reattach the torn hamstring tendon to the pelvis. If surgery is delayed after an avulsion, the tendon may begin to retract further down the leg, and scar tissue may form around the torn end of the tendon. Both of these factors make it more difficult to do the surgery.

To begin the operation, an incision is made in the skin over the spot where the hamstring tendon normally attaches to the pelvis. The surgeon locates the torn end of the hamstring tendon. Forceps are inserted into the incision to grasp the free end of the torn hamstring tendon. The surgeon pulls on the forceps to get the end of the hamstring back to its normal attachment. The surgeon cuts away scar tissue from the free end of the hamstring tendon.

The original attachment on the pelvis, the ischial tuberosity, is prepared. An instrument called a burr is used to shave off the surface of the tuberosity. Large sutures or staples are used to reattach the end of the hamstring tendon to the pelvis.

When the surgeon is satisfied with the repair, the skin incisions are closed.

Muscle Repair

Surgery may be needed to repair a complete tear of a hamstring muscle. An incision is made over the back of the thigh where the hamstring muscle is torn. The muscle repair involves reattaching the two torn ends and sewing them together.

Portions of this document copyright MMG, LLC.

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Introduction to Hand

Physical Therapy in Austin for Hand

Welcome to Axiom Physiotherapy's patient resource about hand problems.

Hand AnatomyCan you imagine not being able to use your hands?  Can you imagine suffering an injury that leaves you with a decreased ability to take care of yourself and perform everyday tasks?  This is the position you will be left in if you don't take care of your hands.  When you injure one or both of your hands, you not only will be left out of your favorite sport, you will be left out of life.

No one wants to depend on others for help in completing simple tasks like cooking food, driving a car, or opening a door.  Therefore, this area of our site is designed to help you learn about and prevent a hand injury.

Whether you are an active athlete or like to sit on the sidelines, we want to make sure you stay safe and healthy and keep your hands protected from debilitating injuries that will bench the fun in your life.


Physical Therapy in Austin for Head Issues

Few movie fans cannot forget 6 year old Ray precociously informing Jerry Maquire that, "The human head weighs 8 pounds!"  In fact, the human head weighs 10 to 11 pounds (4 to 5 kg).

Although you wouldn’t know it from the outside, the human head is made up of 22 bones, which includes that of the mandible (better known as the jaw). These 22 bones not only encase the most important structure to our conscious being, the brain, but they also create the solid framework for important sensory structures such as the eyes and ears. Injuries involving the head could mean injury to the brain or other vital structures of the head and should be considered serious.

In this area of our site you will find various resources on injuries related to the head, from headaches, to concussions, to those injuries affecting the jaw, the balance system of the ear, and other head-related structures.  If you are currently suffering from any of these types of injuries, ‘head’ straight to this resource to learn about the facts related to your injury and find ways that your Physical Therapist can assist you in dealing with your problem. Help in dealing with your injury is right here, so keep your chin (and head) up!


Physical Therapy in Austin for Hip

Welcome to Axiom Physiotherapy's patient resource about hip problems.

A hip injury is nothing to joke about, it is one of the most serious injuries a person can suffer through and one that can lead to long-term health problems if not addressed correctly or inevitably prevented.  Athletes who play active sports like football, soccer, and rugby are more prone to suffering through a hip injury than athletes in other sports, however, hip injuries can also occur by accident, whether through a bad fall or quick and awkward movement.  Therefore, you must know how to take care of yourself so you do not fall victim to this debilitating injury.

This area of our site covers everything you need to be aware of as it relates to your hips and keeping them healthy.

Remember, good health and a little prevention now will protect this sensitive area as you age.  We want to be there with you to proactively protect and prevent against hip injuries.


Physical Therapy in Austin for Knee

Welcome to Axiom Physiotherapy's patient resource about knee problems.

The knee is a sensitive area of the body and one that can be injured doing almost any activity.  The knee is normally exposed and vulnerable and a simple twist can lead to a serious injury as well as ongoing problems and a long recovery time.  Therefore, whether your sport is rugby or racquetball, bowling or badminton, you cannot take chances with this body part.

This section of our site has everything you need to know about preventing or correcting a knee injury.  It is our goal to provide you with resources, exercises and other knee related information that will allow you to learn about how easily this sensitive area can be injured.

When you take the necessary steps in preventing an injury, you will enjoy your chosen sport more and avoid Physical Therapy and other painful and time consuming tasks that come with nursing a knee injury.


Welcome to Axiom Physiotherapy's resource about Osteoporosis.


Osteoporosis is a very common disorder affecting the skeleton. In a patient with osteoporosis, the bones begin losing their minerals and support capabilities, leaving the skeleton brittle and prone to fractures.

Osteoporosis affects an estimated 75 million people in Europe, USA and Japan.

Bone fractures caused by osteoporosis have become very costly. Half of all bone fractures are related to osteoporosis. A person with a hip fracture has a 20 percent chance of dying within six months as a result of the fracture. Many people who have a fracture related to osteoporosis spend considerable time in the hospital and in rehabilitation. Often, they need to spend some time in a nursing home.

This guide will help you understand:

  • what happens to your bones when you have osteoporosis
  • how health care professionals diagnose the condition
  • what you can do to slow or stop bone loss
  • Axiom Physiotherapy’s approach to rehabilitation


What happens to bones with osteoporosis?

Most people think of their bones as completely solid and unchanging. This is not true. Your bones are constantly changing as they respond to the way you use your body. As muscles get stronger, the bones underneath them also get stronger. As muscles lose strength, the bones underneath them weaken. Changes in hormone levels or the immune system can also change the way the bones degenerate and rebuild themselves.

As a child, your bones are constantly growing and getting denser. At about age 25, you hit your peak bone mass. As an adult, you can help maintain this peak bone mass by staying active and eating a diet with enough calories, calcium, and vitamin D.  Maintaining this bone mass, unfortunately, gets more difficult as we get older. Age alone makes building bone mass more difficult. In women, the loss of estrogen at menopause can cause the bones to lose density very rapidly.

The bone cells responsible for building new bone are called osteoblasts. Stimulating the creation of osteoblasts helps your body build bone and improve bone density. The bone cells involved in degeneration of the bones are called osteoclasts. Interfering with the action of the osteoclasts can speed up bone loss.

In high-turnover osteoporosis, the osteoclasts reabsorb bone cells very quickly. The osteoblasts can't produce bone cells fast enough to keep up with the osteoclasts. The result is a loss of bone mass, particularly trabecular bone, which is the spongy bone inside vertebral bones and at the end of long bones. Postmenopausal women tend to have high-turnover osteoporosis (also known as primary type one osteoporosis). This relates to their sudden decrease in production of estrogen after menopause. Bones weakened by this type of osteoporosis are most prone to spine and wrist fractures.

In low-turnover osteoporosis, osteoclasts are working at their normal rate, but the osteoblasts aren't forming enough new bone. Aging adults tend to have low-turnover osteoporosis (also known as primary type two osteoporosis). Hip fractures are most common in people with this type of osteoporosis.

Secondary osteoporosis describes bone loss that is caused by, or secondary to, another medical problem. These other problems interfere with cell function of osteoblasts and cause over-activity of osteoclasts. Examples include imbalances in hormones, certain bone diseases and cancers, and medical conditions that result in inactivity. Some medications, especially long term use of corticosteroids, are known to cause secondary osteoporosis due to their impact on bone turnover.

Osteoporosis basically creates weak bones. When these weak bones are stressed or injured, they often fracture. Fractures most often occur in the hip or the bones of the spine (the vertebrae). They can also occur in the upper arm, wrist, knee, and ankle.


What causes osteoporosis?

Aging is one of the main risk factors for osteoporosis and osteoporotic fractures. If you are lucky enough to live a long life, you are much more likely to develop weakened bones from osteoporosis. In women, the loss of estrogen at menopause causes bone loss of up to two percent per year. Caucasian women over age 50 have a lifetime risk of fracture of about 50 percent. This figure increases with increasing age.

A number of factors contribute to or put you at risk of developing osteoporosis:

  • advanced age
  • female gender
  • low body weight or a thin and slender build
  • recent weight loss
  • history of fractures
  • family history of fractures
  • tobacco use
  • alcohol abuse
  • lack of exercise
  • extended use of certain medications (e.g., corticosteroids, anticonvulsants, and thyroid medicine)
  • eating disorders such as anorexia or bulimia
  • Asian or Caucasian race

These risk factors are just as relevant as a bone mass measurement in determining how likely you are to have a fracture. People with low bone mass but no additional risk factors often don't develop fractures. People with small amounts of bone loss but many risk factors are more likely to eventually develop fractures.


What does osteoporosis feel like?

Fractures caused by osteoporosis are often painful. Osteoporosis itself, however, has no symptoms. It is often called the ‘silent disease’ or ‘silent thief’ as many people don’t recognize they have it until a fracture occurs.  For this reason it is especially important to get tested if you are a woman past menopause and have any of the above risk factors. Women over 65 should be tested whether or not they have other risk factors. People with other bone problems or who take drugs that weaken the bones should also be tested. An initial screening for osteoporosis is painless and easy.


How do health care professionals diagnose osteoporosis?

Free osteoporosis screenings that estimate your bone density measure (BDM) are available in many drug stores and malls. Most of these screenings use a machine that scans the bone in the heel of your foot. It is a fast and simple way to get an idea of your bone density. However, this test is not entirely accurate. Due to the heel bone bearing a lot of weight in normal activity, the test may show normal bone in the heel, even though the hipbones or spine may have low bone density. If however the foot scan shows a low bone mass, you should talk to your doctor. If the scan is negative however, and you suspect you may have osteoporosis or have some of the risk factors for developing the disease that are listed above, it is still recommended that you consult with your doctor.

When visiting your doctor he or she will take a detailed medical history to help weigh your risk factors for osteoporosis. If osteoporosis is suspected or you are at risk of developing it, your doctor may also recommend more precise testing. A bone density test, or in medical terms a dual-energy X-ray absorptiometry (DEXA) test is the most common method of measuring bone mass. A DEXA test is painless and uses special X-rays of the bones of your hip and spine to show your bone mass in these areas. The bone mass is then compared to that of a healthy thirty-year-old, called a T score. If you are within one standard deviation (SD) for bone density, you have normal bone. (SD is a statistic to measure variations in how a group is distributed.) If you are between one and 2.5 SDs below ideal levels, you are considered to be osteopenic. This means you have a mild form of osteoporosis. If the bone mass is more than 2.5 SDs below ideal levels, you have osteoporosis.

Unfortunately a single DEXA scan cannot show your doctor whether your bone mass is stable, increasing, or decreasing. Your doctor may have you take certain medications that create markers in the blood or urine to show what is happening in your bones. These tests will tell your doctor if you have high-turnover or low-turnover osteoporosis.

Be aware also that DEXA scans are not perfect. Different equipment or different technicians can get somewhat different readings. If you need to have more precise data, your doctor may recommend additional types of scans or tests.
Although a DEXA scan is the most common method of measuring bone density, other tests such as ultrasound, quantitative computed tomography (CT) scans, or single-photon absorptiometry may also be used instead of or in addition to the DEXA scan to confirm the diagnosis of osteoporosis.

If bone density tests show that you have weakened bones, your doctor will need to rule out other causes for this other than osteoporosis. In some cases, problems with bone marrow or hormone levels can cause bone loss. Blood tests can show these conditions.
In other cases the bone weakening is actually from a condition called osteomalacia.

Osteomalacia involves a softening of the bones caused by a lack of vitamin D. Vitamin D in your body comes from food and sunlight. Due to a lack of sunlight, almost 10 percent of people with hip fractures in the northern parts of the world have osteomalacia rather than osteoporosis. Urine and blood tests can help rule out osteomalacia.

In some cases, your primary care physician may refer you to a doctor who specializes in osteoporosis. For instance, if you are on medication to prevent bone reasbsorption and still have significant bone loss you may need to see a specialist. Referral is also advised for patients who have recurring fractures during therapy or repeated, unexplained fractures. Your doctor will help you find the right specialist for your situation.

Treatment Options

What can be done for osteoporosis?

The goal of your treatment plan will be to prevent fractures. This is especially important if you've already suffered a fracture from osteoporosis. To prevent fractures, you need to increase your bone mass. If you have high-turnover osteoporosis, you also need to prevent rapid bone reabsorption.

You need to take several steps to increase your bone mass:

  • If you smoke, quit immediately.
  • If you drink alcohol, do so moderately.
  • Make sure you get enough calcium and vitamin D. (Vitamin D helps your body absorb calcium.) Researchers think that increased calcium intake alone could reduce the number of fractures by 10 percent. Many people don't get enough calcium or vitamin D, especially as we age. It is difficult to get recommended levels from the food we eat, so supplements are probably necessary. Talk to your doctor about what kind of supplements to buy. Calcium comes in many forms, for example, calcium carbonate, calcium citrate, calcium phosphate, and calcium from bone meal. Some forms of calcium can be taken with any type of food, and others need to be taken with certain types of food. Taking extra calcium and vitamin D improves the effectiveness of all other treatments for osteoporosis.
  • Eat enough calories to maintain a healthy weight. Being too thin increases your risk of osteoporotic fractures. Weight loss can be a cause of bone loss.
  • Exercise. Your bones are constantly adjusting to the demands you put on them. Even low levels of exercise can help you maintain better bone mass. Low-impact exercises, muscle-strengthening exercises and balance training are all recommended (see section below.)

Physical Therapy

Patients with osteoporosis or those at risk of developing osteoporosis will benefit from working with a Physical Therapist at Axiom Physiotherapy.

The goals of our Physical Therapy treatment is to educate you on proper posture, teach you safe ways of moving and lifting, and to provide you with exercises you can do at home to help prevent a decline in bone mass and prevent fractures. The exercises we prescribe will particularly focus on activities that help to increase the strength in your bones, as well as exercises that help to maintain or improve your balance. Optimum balance helps to decrease your risk of falling, which can easily fracture an osteoporotic bone. We will also suggest exercises for your flexibility to help decrease the stress placed on the bones by tight muscles as well as improve your overall mobility. If you have experienced a fracture from osteoporosis, Physical Therapy at Axiom Physiotherapy can also help with controlling your pain and gradually returning you back to your regular activities.

Maintaining good posture is of utmost importance if you have osteoporosis. A stooped upper spine posture, called kyphosis, is common in osteoporosis due to the wedge-like fracturing of the thoracic spine that often occurs (the front part of the vertebrae collapses leaving the posterior portion higher and the overall vertebrae appearing wedge-like.)  Losing height as a result of these fractures is a common occurrence in osteoporosis. For this reason accurately measuring and recording your body height is a key part of our Physical Therapy evaluation. A height measurement gives your Physical Therapist an idea of how osteoporosis is affecting your bones and posture, and by comparing the recordings over a period of time it can help us track your success with treatments.

With posture exercises, the goal is to get your body lined up from head to toe, with weight going through your hips. In a healthy spine posture, the head is balanced on top of the spine rather than jutted forward which is common in osteoporosis. In people with advanced osteoporosis, the upper body is also commonly bent forward at the hips. This prevents the hip bones from getting the right amount of stress and weight through them. As a result, the bones weaken and become more prone to fracture.  It is therefore important at all times to try to “be tall” which can both prevent a loss of height as well as help you regain height lost from an already fractured osteoporotic spine.
Your Physical Therapist will explain ways you can put good posture into practice. This is called body mechanics, which is the way you align your body when you do your daily activities. Remember that a healthy posture is balanced with the body aligned from the head to toes. The same posture should be used when you bend forward to pick things up. Instead of rounding out your shoulders and upper back, keep the back in its healthy alignment as you bend forward at the hip joint. This keeps your back in a safe position. When bones are weakened from osteoporosis, rounding the spine forward when bending and lifting pinches the front section of the vertebrae and increases the risk of a spine fracture. This pinching is exacerbated when any weight at all is lifted in this position. Even the weight of a purse or shopping bag can add detrimental stress to an osteoporotic spine leading to a fracture. Along with maintaining proper posture, gently tightening the muscles around your core area can also help to protect the back during activities such as lifting.  Your Physical Therapist will educate you on how to use your core muscles to protect your spine.  Rapid bending forward of the osteoporotic spine, such as that experienced when one sneezes or coughs, can be enough to cause a fracture of the osteoporotic spine. For this reason, your Physical Therapist will educate you on consciously extending rather than flexing your spine during these activities.
Another motion particularly stressful for the osteoporotic spine is a twisting motion. The normal structure of bone is not designed to withstand twisting very well so combined with the weakened bone state of osteoporosis, the motion of a twist can easily cause a fracture. Although difficult to eliminate from every day life, twisting should be avoided whenever possible especially in combination with higher velocity motions such as a golf swing, tennis swing or bowling action.

Strengthening exercises for your bones are of utmost importance in maintaining the health of osteoporotic bones. As mentioned above, as your muscles get stronger, the bones underneath them also get stronger as they react to the added stress placed on them. In this way, strength training and weight-bearing activities force the bones to build mass. Your Physical Therapist will prescribe some gentle weighted exercises, using either elastics or weights, for your upper and lower extremities. Using an appropriate weight is of utmost importance and your Physical Therapist can educate you on how much resistance is appropriate for you. If using free weights, handling the weights is just as important as doing the exercises themselves. Never lift weights in the flexed forward posture described above, and be careful to gradually increase the resistance you use as weights that are too heavy will naturally cause your body to slip into the flexed forward posturing that is detrimental to people with osteoporosis. Performing exercises while your upper back is supported in good alignment is also recommended to avoid added stress on the thoracic spine. Exercises that incorporate flexing of the spine, such as toe touches, abdominal crunches, and dead lifts should strictly be avoided. Strengthening exercises for your upper back, however, will be encouraged by your Physical Therapist in order to counteract the stooped forward posturing.

Weight bearing cardiovascular exercises such as walking outdoors or on a treadmill, gentle non-pounding forms of dance, and stair climbing are useful activities to put weight through the bones and encourage an upright posture while also improving cardiovascular health. Cycling is not a recommended activity as it does not provide the benefits of weight bearing and it also encourages the detrimental flexed forward posturing of the spine. Pool exercises are not weight bearing either so are not recommended unless severe pain from osteoporosis limits physical activity on the land in which case exercising in the pool would be acceptable and recommended. High impact activities such as running, jumping, and pounding forms of dance should be strictly avoided. Your Physical Therapist at Axiom Physiotherapy can educate you on safe cardiovascular activities specific to your interests and your physical needs.

The next part of our treatment will focus on your balance. As stated above, poor balance can lead to a fall which can easily fracture an osteoporotic bone. In some cases a fracture from a fall can be a potentially life-threatening situation. Exercises to improve your balance can be as simple as standing with your feet close together, standing on one foot, or standing with one foot in front of the other. Closing your eyes can make any of these activities even more difficult. By challenging your balance, your reaction time to unexpected situations such as tripping will improve and your likelihood of falling will decrease. The most important aspect of working your balance is ensuring that you are doing it in a safe environment. Your Physical Therapist will provide you with exercises that are specific and challenging to your current level of balance.  As your balance gets better, more challenging exercises will be provided. Tai chi, which is an exercise form originating in China, is another great way to improve one’s balance, and many patients benefit from practicing this on a regular basis.

The final component to our treatment at Axiom Physiotherapy will be to provide you with some flexibility exercises. By improving and maintaining your flexibility, the stress put on your bones by tight muscles will decrease and the ability to practice good posture and body mechanics will be improved. Good flexibility also improves your mobility, which in turn improves you balance and decreases your risk of falls. Stretches for your upper back and chest in particular will be prescribed to decrease the likelihood of developing a stooped posture. Stretches for your hips, calves, and neck are also important if you have osteoporosis and will be included in your stretching regime.

Your Physical Therapist will continue to compare your test results of body height, posture, strength, balance, and flexibility to see how well you are improving and to encourage you in continuing with your exercise program.  Once you can safely and proficiently perform your home exercise program, regular visits to Axiom Physiotherapy will not be required, however, we will continue to be a resource for any further questions you may have or problems you may encounter.
If you are seeing one of our Physical Therapists at Axiom Physiotherapy because you have recently had a fracture related to osteoporosis, our treatment will start with a  focus on decreasing your pain. We may use hands on treatment as well as modalities such as ice, heat, ultrasound, or electrical current to assist in managing your pain. We will liaise with your doctor to determine the most appropriate time for you to begin the more advanced exercises involving strengthening, balance, and flexibility as outlined above, and will proceed with them as appropriate in order to allow you to return to your normal activities as quickly as possible.

Axiom Physiotherapy provides services for Physical Therapy in Austin.


Depending on your situation, your doctor may prescribe medications to slow down your body's reabsorption of bone.

Many drugs are now available for the prevention and/or treatment of osteoporosis. Finding the right drug for each patient takes into consideration the benefits and risks of the drug. These are matched against specific patient characteristics and risk factors. Ultimately, the best drug is the one most likely to be taken consistently and/or correctly by the patient.

If you are past menopause, hormone replacement therapy can be very effective. Bisphosphonates and calcitonin can also slow your body's reabsorption of bone.
Studies have shown that 80 percent of women actually build bone mass up to two percent per year while on estrogen replacement therapy. Estrogen has been shown to decrease the occurrence of fractures in the vertebrae by 50 percent and fractures in the hip by 25 percent. Fortunately studies have also shown that hormone replacement therapy can also lower rates of coronary artery disease, relieve some symptoms of menopause, and maybe even prevent or postpone Alzheimer's disease.

Hormone replacement therapy, however, worries many women. Studies have shown that it may increase the risk of breast cancer. For women with a family history of breast cancer or who have had a stroke or thrombophlebitis (blood clots), hormone replacement therapy is probably not appropriate. Other women however, should at least consider taking estrogen as its effects on osteoporosis are dramatic. Researchers estimate that, if estrogen were widely used, it could reduce all osteoporotic fractures by 50 to 75 percent.

Hormone replacement therapy must be continued to be effective, however. When a woman stops taking estrogen, she'll start to lose bone at a very fast rate again. Within seven years, her bone density will be as low as that of a woman who never took estrogen.

Doctors often prescribe calcitonin to patients with fractures. Calcitonin is a non-sex, non-steroid hormone. Calcitonin binds to osteoclasts (the bone cells that reabsorb bone) and decreases their numbers and activity levels. Calcitonin used to be given only by injection, but now it is available in a nasal spray and a rectal suppository. Nasal calcitonin is used most often for women with osteoporosis who are five years or more past menopause and unable to take other approved agents. For unknown reasons, calcitonin also seems to relieve pain.

You and your doctor need to work together to monitor the effects of calcitonin. It is a new drug, and its long-term effects and benefits are still not fully known. More than 20 percent of patients develop a resistance to calcitonin over time, and it stops working for them.

Bisphosphonates also slow reabsorption by affecting the osteoclasts. Some common bisphosphonates are Alendronate (Fosamax), Risedronate (Actonel), or Ibandronate (Boniva).

Some bisphosphonates are taken orally (pill form) on a daily basis. Others are available in weekly or monthly doses. A new injectable bisphosphonate (Zoledronate) can be given annually (once a year). Boniva comes in pill form and can also be injected once every three months. The injectable forms of this drug are used in the management of postmenopausal osteoporosis.

Studies have shown that bisphosphonates increase bone mass and prevent fractures. No one is sure how well bisphosphonates work when used for a long time however stopping the drug doesn't seem to cause the rapid bone loss that occurs when a patient stops taking estrogen. Due to the potential of side effects with these medications, you need to liaise closely with your doctor if you take them.

Some new drugs that may be used to treat osteoporosis are currently being researched. Some of these drugs, such as sodium fluoride, can be helpful in low-turnover osteoporosis. These drugs affect your osteoblasts in ways that cause them to create more bone. Sodium fluoride may be available in the near future. Another drug used for the treatment of osteoporosis is Raloxifene (Evista) which is an anti-estrogen.

Anti-estrogens are also called selective estrogen-receptor modifiers (SERMs). SERMs improve bone density and prevent fractures similar to estrogen, but without increasing the chances of hormone-related cancers. Their main benefit over hormone replacement therapy is that they do not increase the risk of breast cancer.

Raloxifene is used most often for postmenopausal women younger than 65. They must not be at risk for blood clots or have cardiovascular disease. Men may be prescribed the only anabolic agent (Teriparatide/Forteo) approved for the management of osteoporosis. Anabolic usually refers to hormones that build up muscle or bone mass. Forteo is a form of parathyroid hormone used for patients at high risk of fracture. An agent with antiresorptive effects, such as a bisphosphonate, usually follows it.

Lifestyle changes, hormone replacement therapy, exercise prescription, and recent advances in drug therapy can help you take control of your osteoporosis. You and your doctor should be able to find ways to help you prevent the debilitating fractures of osteoporosis.

Portions of this document copyright MMG, LLC.

Pediatric Issues

Physical Therapy in Austin for Pediatric Issues

As adults, we are able to identify where pain is coming from and verbalize it correctly to a Physical Therapist or other pain management professional.  However, when it is a child who is experiencing pain, or dealing with some level of injury, it is more complicated to figure out what is wrong in order to determine the type of care the little one in our life needs.  Furthermore, because a child's body is always growing, it is important for an adult to understand how this can contribute to a healthy existence and promote good playtime activities and responsible practices for staying fit and healthy.

Click on a link below to learn more about:

As is the case with any type of pediatric care, a parent or guardian wants to make sure they are taking the correct steps and working with the right professionals in order to benefit their child.  An adult never wants to worry that they are overdoing or under-doing treatment, or doing something unnecessary altogether, just because their child may not be able to correctly tell them where or how it hurts or verbalize the issue they may be having.

This area of our site is dedicated to help parents, aunts, uncles, grandparents, or any responsible adult who has a child, understand how to keep them healthy and happy when they are playing hard and having fun.  It is this area where you will find resources to support and care for your child regardless of their activity, their sport, or their age.

It is our aim to provide resources to you that cover a wide variety of pediatric issues in order for you to help your child run, jump, play and feel the way a kid should feel....great!

Axiom Physiotherapy provides services for Physical Therapy in Austin.

Shoulder Issues

Physical Therapy in Austin for Shoulder

Welcome to the Axiom Physiotherapy’s resource about shoulder issues.

A shoulder injury can happen in any sport, and shoulder pain can be brought on from something as simple as sleeping in the wrong position.  Whether you have damaged your rotator cuff because you were a little too overzealous at touch football with your friends on Sunday, or you are sore from trying to weed the garden and paint the garage in one afternoon, this is the part of our website that we have designed with you in mind.

It is our aim to provide you with the information and tools to help you recover from a shoulder injury and to prevent future injuries from occurring.

When you have proper information about how to stay healthy, you will find that your playtime will be more rewarding, your sleep with be more sound and your daily grind won't wear you down.


Physical Therapy in Austin for Tendonitis

Welcome to Axiom Physiotherapy's patient resource about Tendonitis.

Chronic, or long-term, tendon problems are common. Tendon problems are especially common in people who play certain types of sports. Tendon problems account for almost 30 percent of all running injuries and 40 percent of all tennis injuries.

We use the term tendonitis, which means inflammation of the tendon, to refer to these chronic tendon problems. Doctors now know that the tendon does not always become inflamed when it is injured. Other changes in the tendon can cause tendon pain. However, tendonitis is still the most commonly used term.

This guide will help you understand:

  • how tendonitis develops
  • how doctors diagnose the condition
  • what can be done for tendonitis


Where does tendonitis develop?

Tendons connect muscle to bone. A tendon is made of material called collagen. Collagen is a key building block of the body. Collagen is considered a connective tissue because it forms tough strands that are like the strands of a nylon rope. Like the strands in a rope, the strands of collagen line up. The more strands, and the better they line up, the stronger they are. The tendon is wrapped in a thin, slippery covering called the tendon sheath. The tendon sheath allows the tendon to slide easily against the tissues around it.

Many parts of the tendon can be injured. Tendon problems can involve the area where the tendon attaches to the bone, the tissue that surrounds the tendon (the tendon sheath), or the main tissues of the tendon. Doctors use different terms to refer to injuries of different parts of the tendon.

Tendon injuries can show up anywhere in your body. Doctors see tendonitis most often in certain sites.

Achilles Tendonitis

The tendon sheath, the tissues of the tendon, and the attachment to the bone can all become injured in the:

Achilles Tendon

found in the lower leg. Damaged Achilles tendons carry a higher risk of rupturing because of the weight they bear while standing and walking.

Related Document: *client_company's Guide to Achilles Tendon Problems

Posterior Tibial Tendonitis

Tendonitis along the inside edge of the ankle and into the instep of the foot is called:

It is usually caused by age-related degeneration. If this tendon breaks, it can cause the arch of the foot to become flat and painful.

Related Document: Axiom Physiotherapy's Guide to Posterior Tibial Tendon Problems

Patellar and Quadriceps Tendonitis

Problems in the:

Tendons of the Knee

occur mostly in people whose exercise involves running or jumping. Patellar tendonitis is also called jumper's knee.

De Quervain's Disease and Trigger Finger

Tendon problems are common in the hand and wrist. De Quervain's disease causes pain in the wrist just above the thumb.


Trigger finger generally causes pain in the palm just below the knuckles, but it eventually causes problems with movement.

Trigger Finger


Related Document: Axiom Physiotherapy's Guide to Trigger Finger and Trigger Thumb

Lateral Epicondylitis

Lateral epicondylitis, also called:

Tennis Elbow

affects the area where the tendons of the elbow attach to bone on the outside of the elbow. It causes pain when using the wrist and hand.

Medial Epicondylitis

Medial epicondylitis, also called:

Golfer's Elbow


affects the area where the tendons of the elbow attach to bone on the inside of the elbow. It causes pain when using the wrist and hand.

Rotator Cuff Tendonitis

Rotator cuff problems of the shoulder range from mild damage to:

Complete Tears

They can cause pain even when resting.

Related Document: Axiom Physiotherapy's Guide to Rotator Cuff Disease

Often, the muscles or other tissues of the joints become tight, misaligned, or weak around the area of tendon injury. Some of the pain and swelling of tendonitis may actually be in the surrounding tissues.


Why do I have this problem?

Doctors don't know exactly what causes most tendon problems. They think that repetitive stress on the tendon is the most common cause. The tendon can be injured by the repetitive pounding of running and jumping, or by the stress caused by lifting heavy loads over and over again. Tendonitis usually builds up over weeks or months.

If the tendon is too damaged, or if it doesn't get time to heal, the problem becomes chronic (long-lasting). In general, the heavier the load or the more often the stress is repeated, the more likely you are to develop tendonitis.

Too much stress on the tendons can be made worse by other factors. Lack of flexibility or weakness in your muscles can make tendonitis more likely. Shoes that don't fit right, poor equipment, or incorrect technique can also increase your risk of tendon injury. Don't underestimate the benefit of upgrading your equipment. The improved design of athletic shoes over the past few decades seems to have decreased tendon injuries.

Aging seems to cause tendon damage in some cases. As we age, the tissues of the tendon can break down, or degenerate. Age-related tendon problems do not seem to cause inflammation. The tendon material itself is more affected in these conditions and some surgeon's refer to this type of tendon problem as tendonosis.

Some researchers think that a decreased blood supply to the tendons can cause the tendon damage in tendonosis. The decreased blood supply does not allow the tendon to get enough oxygen from the blood. This leads to a condition where the tendon degenerates. The collagen material that makes up the tendon actually becomes weaker and loses its nylon rope appearance. This type of degeneration has been noted in the rotator cuff around the shoulder, in the Achilles tendon in the heel and in the tendons of the elbow.

Many factors can work together to cause tendonitis. For instance, a woman in her forties who takes up running may have tendonitis caused jointly by the degeneration of aging and the mechanical stress of running.


What does tendonitis feel like?

Tendonitis causes pain. This is the primary symptom of tendonitis and tendonosis. The affected tendons are sometimes swollen. In some cases this swelling occurs from actual thickening of the tendon itself. In other cases the swelling comes from thickening or swelling of the tendon sheath. Tendon problems often cause pain after resting, such as when you first get up in the morning. This pain usually goes away within minutes, or even seconds.

The pain or swelling in your tendon may make your joint hard to move. Some types of tendon problems cause crepitus, a crackling feeling when the joint moves. In rare instances the weakened tendon may actually rupture, or break, with a sudden force. This may require surgery to repair.


How do health care providers identify tendonitis?

When you visit Axiom Physiotherapy, our Physical Therapist will take a detailed medical history, including many questions about your activities, your job, and your symptoms. We will also physically examine the sore area. The probing and movement may cause pain, but it is important for us to know exactly where it hurts.

Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the Physical Therapists at Axiom Physiotherapy have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.

Our Treatment

What can be done for the problem?

Tendon problems can be difficult to treat effectively. They can last for many months to several years, even with treatment. Although the amount of time needed for recovery varies, you should expect your treatment to take from six to nine months. Even if treatment is effective, your pain may come back. The exact treatment your Physical Therapist at Axiom Physiotherapy recommends depends on which tendon is affected.

If there are signs of true inflammation, our Physical Therapist will probably suggest that you use nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, to help control the inflammation and pain. NSAIDs are usually used for a short time with tendon problems. We may also suggest ice or heat treatments.

You will need to rest and give your body time to heal. If playing tennis injured your tendon, stop playing tennis until it is completely healed. You should only take part in activities that don't strain the injured tendon.

When you begin your Axiom Physiotherapy rehabilitation program, our Physical Therapist will teach you stretches and exercises to help your tendon heal and regain its strength. We can also assess your work site and athletic equipment and recommend changes to reduce the strain on your tendon. Depending on your type of injury, we may ask you to try such special equipment as arch supports, heel lifts, and splints.

Most people with chronic tendon problems can find ways to relieve the pain and take part in their normal activities, even if the problem doesn't completely go away. In a few cases, patients can't find ways to manage the pain even after six months. For these few patients, surgery may be necessary. Surgery may be successful in relieving the pain of chronic tendonitis.

Axiom Physiotherapy provides services for Physical Therapy in Austin.

Wrist Issues

Physical Therapy in Austin for Wrist

Welcome to the Axiom Physiotherapy’s resource about your wrist.

Wrist injuries are very common because we use our hands and arms for so many of our daily activities, and if we fall, it's most natural for us to put our hands out to catch ourselves or break the fall.  Overuse injuries in the workplace occur frequently in jobs that are repetitive, as in working on a computer or on a line in a factory. Sports injuries to the wrist occur often, they can happen in almost any sport, and are likely to keep you off the field or court while you are healing.

To help you to better understand wrist injuries, their rehab and possibly how to prevent them, we've put together a collection of resources for you to review.  We hope you find them helpful, and feel free to ask your Axiom Physiotherapy therapist any questions you might have about something you've read.