Rotator Cuff Tendinopathy: Causes, Symptoms And Treatment

by Administrator 26. May 2017 10:45

Rotator Cuff Tendinopathy, also referred to as the Shoulder Tendonitis or the Impingement Syndrome, is a medical condition that causes the tendons and muscles supporting the shoulder joint to swell up. The shoulder joint is an example of a ball and socket joint that is supported by a set of muscles called the rotator cuff. These muscles prevent the ball of the humerus from slipping out of the glenoid cavity. Strong tendons made up of connective tissues also connect the muscles to the bones. These enable us to swing, lift or move our arms. Maximum movement of this joint occurs in this area and affects the rotator cuff muscles.


  • Development of Osteophytes or Bone Spurs that impinge upon the muscles and tendons
  • Sports activities that involve a lot of movement of the arm and shoulder joint such as basketball, tennis, swimming, baseball etc. stresses the joint
  • Micro-trauma may cause repeated stress to the joint and affect its stability
  • There are small fluid filled sacs in the joint called bursae that can get swollen and thus cause Tendinopathy
  • Some people are in the habit of sleeping on one particular side of the shoulder that may stress the joint
  • Maintaining a poor posture affects the neck, shoulder and thoracic spine stability. It hampers the biomechanics of the joint
  • In some cases, the rotator cuff muscles and tendons may begin to impinge into the acromion bone causing inflammation
  • Inherent muscular weakness leading to joint instability


  • Pain may be felt when the patient wakes up in the morning
  • Loss of strength and stability of the joint as well as weakness in the upper arm or hands
  • Swelling and tenderness may be observed
  • Inability or discomfort in lifting the arms above the head, lifting weights or lying on the affected side of the shoulder
  • Pain may radiate down from the arm to the elbow
  • Some patients may complain of pain even while resting. This happens in aggravated cases of Tendinopathy
  • Joint stiffness
  • Range of motion may get affected
  • A feeling of cracking or joint locking


  • Details of the patient’s medical history and lifestyle may be noted down
  • The doctor may ask the patient to move his/her arm in different directions to check the range of motion that is intact
  • The symptoms of the affected joint may be taken into consideration
  • X-ray imaging may be performed to check for bone alignment, bone spurs and other structural changes
  • Palpation is employed to check for swelling
  • MRI imaging
  • Ultrasound test to check for damage in the soft tissue such as muscles and tendons


Application of ice packs at regular intervals

  • Prescription of pain killers and anti-inflammatory medicines
  • Compression using shoulder straps, taping, bandages and slings
  • The doctor may inject corticosteroids into the affected part to provide relief
  • Rest the joint and avoid any strenuous activity
  • Using a couple of pillows under the head and shoulders while sleeping may be helpful
  • A customized physiotherapy session including gentle exercises of the joint
  • Maintaining a good posture
  • Arthroscopic surgery may be required in case no relief is attained by conservative treatment methods

For treatment of Rotator Cuff Tendinopathy, visit the doctors at OrthoTexas. Call at (972) 727- 9995 (Allen) for an appointment.

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Adolescent Anterior Knee Pain: Orthopedic Treatment

by Administrator 14. January 2017 07:47

Adolescent Anterior Knee Pain is a medical condition that affects physically active teenagers. It is characterized by pain and discomfort in the area surrounding the kneecap. The knee is the largest and one of the most complex joints comprising of three bones, femur, tibia and patella. Various ligaments and tendons support these bones as well as hold them in place. Stress or damage to any of these parts can lead to Adolescent Anterior Knee Pain. The condition is more commonly seen in girls as compared to boys.


  • Overuse of the joint
  • Sudden change in the intensity and technique of physical activity
  • Weak quadriceps or hamstring muscles
  • Inherent defects in alignment of the kneecap, leg and hip joint
  • Wearing ill-fitted shoes
  • Incorrect exercise or sports technique
  • Tight ligaments in the knee joint


  • Dull and persistent ache that may increase following a physical activity or exercise
  • Pain may also occur while resting
  • Difficulty in squatting, climbing stairs, weight lifting and running
  • Cracking or locking sensation around the knee joint while moving
  • Discomfort while getting up after prolonged sitting
  • Feeling of the joint being unstable
  • Swelling around the kneecap


  • Physical examination which may include palpation, observing the shape of the kneecap, tightness of the ligaments and other visible symptoms
  • Range of motion tests may be done by asking the patient to perform some physical movements such as jumping, walking, bending, squatting etc.
  • The patient’s medical history and lifestyle details may be taken into consideration by the knee specialist
  • X-ray imaging may be conducted to assess the anatomical changes in the kneecap and other supporting structures
  • MRI scan may help to diagnose damage to the soft tissues


Adolescent Anterior Knee Pain can be treated through conservative methods. Some of them are listed below:

  • Use of comfortable shoes that provide adequate support to the feet and prevent stress to the knee joint
  • The intensity and duration of physical activity must be reduced till the symptoms subside. Any exercise or sport that may lead to pain should be avoided
  • Anti-inflammatory medicines may be prescribed by the doctor to relieve pain
  • Hamstring and quadriceps muscle strengthening exercises may be recommended to provide better support to the knee
  • Application of ice packs at regular intervals may help to alleviate pain and swelling
  • Orthotic devices such as shoe inserts or molded arch supports can be used to combat pain and discomfort
  • Regular physical therapy sessions may help  to enhance flexibility and range of motion

The orthopedic surgeons at OrthoTexas provide complete treatment for Adolescent Anterior Knee Pain. Patients in Allen, TX can call at (972) 727-9995 for appointment.

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Common Sports Injuries

by Administrator 25. August 2016 14:49

‘Sports injuries’ is an umbrella term used to collectively denote physical damage caused while playing a sport or during training sessions. Physical combat, inadequate warming and conditioning before as well as after an activity, use of faulty equipment or technique, wearing improper shoes or not using protective gear are the common causes of injuries. If the player is out of form, he may be at a higher risk of suffering an injury. Repetitive or excessive use of the joint may damage the tendons, ligaments or muscles and may also result in dislocation or breakage of bones.

Discussed below are some of the most common sports injuries:

Tennis Elbow

Also known as Lateral Epicondylitis, it is an injury characterized by minor tears in the ligaments of the elbow joint. Overuse of the thumb and first two fingers of the hand is one of the main cause of Tennis Elbow. It is commonly seen in tennis players, painters, plumbers, typists and carpenters.


  • Pain which radiates to the upper arm
  • Swelling and tenderness
  • Discomfort while gripping or lifting objects, shaking hands and making a fist


  • Use of elbow brace
  • Anti-inflammatory medicines
  • Rest
  • Cryotherapy
  • Injecting steroids into the joint

Ankle Sprain

Overstretching of the ligaments on either side of the ankle joint is termed as an Ankle Sprain. It can occur in isolation or may accompany an ankle fracture or dislocation. The ligaments may become loose due to stretching or there could be a complete tear.


  • Pain in the ankle
  • Swelling
  • Ecchymosis- bleeding under the skin that leads to discoloration
  • Inability to walk or bear body weight


  • RICE – rest, ice, compression and elevation
  • Physical therapy
  • Use of ankle brace
  • Surgery, in case of complete damage to ligament

Shin Splints

Shin Splints is a condition that causes pain on the outer pat of the leg. It can be a result of minor fractures in the shin bone, collapsed foot arch, weak hip or core muscles and swelling or irritation in the supporting muscles. The condition is commonly seen in athletes and dancers.


  • Throbbing pain in front of the leg, particularly after physical activity
  • Swelling and tenderness


  • Rest, ice, compression and elevation may be helpful
  • Anti-inflammatory medications
  • Use of orthotic devices and shoe inserts

Hamstring Pull/Stretch

It is an overuse injury which affects the three muscles extending from the thigh to the back of the knee joint. Lack of flexibility, weak glutes and inadequate warmup before exercise are the main causes of this injury. Pulled Hamstring most commonly affects athletes involved in running, skating, football, basketball and soccer.


  • Pain that can be severe
  • Inability to bear weight on the leg
  • A popping sensation behind the thigh or knee
  • Tenderness and bruising


  • Adequate rest
  • Apply ice packs for few days
  • Pain killers and anti-inflammatory medicines
  • Physical therapy
  • Severe damage may require surgical intervention

ACL Tear

The anterior cruciate ligament (ACL), which connects the thigh bone to the shin bone, may get torn or stretched during sports. Some of the causes of the injury are incorrect landing from a jump, stopping suddenly, twisting the leg excessively and sudden change in direction. A direct hit on the side of the knee joint may also damage the ACL.


  • A loud pop may be heard at the time of injury
  • Instability and weakness in the knee
  • Severe pain
  • Range of motion is limited
  • Swelling and tenderness


  • RICE- Rest, ice pack, compression and keeping the leg elevated
  • Prescription of anti-inflammatory medicines
  • Physical therapy
  • Surgical reconstruction or removal of the damaged ligament

The orthopedic doctors at OrthoTexas specialize in treating a wide range of sports injuries. To schedule an appointment with the sports medicine specialists in Allen, TX, you can call at (972) 727 – 9995.

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Pes Anserine Bursitis: Allen Orthopedic

by Administrator 5. July 2016 10:56

Pes Anserine Bursitis, or Knee Tendon Bursitis, refers to an inflammation of the bursa on the inner side of the knee. The bursa is a lubricating sac located between the shinbone and hamstring tendons that prevents the two structures from rubbing against each other. The condition occurs when the bursa produces excess fluid and becomes inflamed, thereby placing pressure on the adjacent parts of the joint. Certain factors may increase a person’s susceptibility to develop Pes Anserine Bursitis. These are:

  • Sports  activities like running and swimming
  • Old age
  • Obesity
  • Medical conditions such as Knee Osteoarthritis or Medial Meniscus Tear


  • Improper training techniques
  • Running uphill
  • Sudden increase in running distance
  • Tight hamstrings
  • Overuse 
  • Trauma or contusion to the inner part of the knee
  • Outward turning of the lower leg due to Flat Feet or Knock Knees
  • Forceful twisting with the foot planted on the ground
  • Repetitive activities


  • Pain at the inner part of the knee
  • Tenderness to touch
  • Swelling
  • Stiffness
  • Difficulty bending or straightening the knee
  • Pain may increase while exercising, climbing stairs or any other stressful activity
  • Limited range of motion 


The orthopedic doctor may physically examine the knee and check for tightness in hamstring muscles. He may inquire about the patient’s medical history and nature of activities performed on a daily basis. An X-ray may be conducted to rule out a stress fracture. CT scan or MRI may be required to assess damage to the medial compartment of the knee. The doctor may take a sample of bursa fluid to be tested in case infection is suspected.


  • Rest: The patient may be advised to take rest for a few days and avoid any activities that may aggravate the pain.
  • Ice pack: Application of ice packs at frequent intervals may reduce swelling and stiffness.
  • Medications: The orthopedic doctor may prescribe anti-inflammatory medications to provide relief from pain. Antibiotics may be prescribed in case of infection of septic bursitis.
  • Injections: Injecting steroid mediations directly into the joint may be suggested in case of severe pain and swelling.
  • Physical therapy: Performing light stretching exercises may help to release stiffness and strengthen the hamstring muscles.
  • Surgery: In case the symptoms do not subside, the doctor may recommend surgical removal of the bursa.
  • Lifestyle modification: Athletes may be suggested to reduce or alter their exercise programs to prevent the condition from recurring.

OrthoTexas provides complete diagnosis and treatment for Pes Anserine Bursitis. To schedule an appointment with the orthopedic surgeons in Allen, TX, you can call at (972) 727 – 9995 or visit 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013.

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Osgood-Schlatter Disease: Orthopedic Allen

by Administrator 17. June 2016 07:37

Osgood-Schlatter Disease (OSD) is an inflammatory disorder of the knee joint that affects adolescents who actively participate in sports activities. The inflammation typically occurs at the point within the knee joint where the patellar tendon is attached to the shin bone. Adolescents experience growth spurts due to the development of tendons, bones, muscles and ligaments. Physical activity, such as running and jumping, further increases the pressure on the joints and leads to inflammation.

Growing children have special growth plates that are covered by the tibial tubercle, a bony structure, at the end of the shin bone. During a physical activity, this tibial tubercle gets pulled by the patellar tendon which may lead to inflammation of the growth plate and is termed as the Osgood-Schlatter Disease. The symptoms may occur in one or both the knees. The condition usually subsides once the growth phase is over and the growth plates solidify into bones.


  • Overuse of the knee joint
  • Sports activities
  • Changing direction rapidly while running or jumping
  • Direct injury to the knee
  • Detachment of a piece of bone from the tibia due to the pull exerted by the ligaments
  • Tight quadriceps or hamstring muscles


  • Prominent outgrowth of the tibial tubercle in the form of a lump
  • Tenderness in the knee joint
  • Pain may get aggravated during physical activity
  • Swelling
  • Tightness in the thigh muscles
  • Instability
  • Redness
  • Locking of the knee
  • Inability to kneel down
  • Limping


  • Clinical examination of the knee
  • Evaluation of the child’s medical history and symptoms
  • X-ray imaging may be conducted to rule out other possible causes of knee pain
  • The patient may be asked to move the leg in different directions to assess the severity of problem
  • Blood tests
  • MRI scan to evaluate damage to soft tissues
  • Bone scan may be recommended by the orthopedic doctor


  • Rest with the leg elevated at chest level
  • Limit physical activity until the symptoms subside
  • Perform exercises to stretch to strengthen the quadriceps
  • Prescription of anti-inflammatory medicines
  • Use of patellar tendon strap
  • Application of ice packs at regular intervals
  • Wear protective gear during sports to prevent knee injury
  • Compression with an elastic bandage
  • Physical therapy may be helpful to restore the range of motion of the knee
  • Surgery may be required if the problem does not subside even after the patient attains adulthood.

For diagnosis and treatment of Osgood-Schlatter Disease, consider OrthoTexas. To schedule an appointment with the knee specialists in Allen, TX, you can call at (972) 727 – 9995.

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Tips To Prevent Shoulder Pain And Injuries

by Administrator 6. May 2016 08:56

Shoulder pain and injuries are common ailments that affect people irrespective of their age or gender. These problems are often caused by activities that involve repetitive use of the shoulder and arm. The shoulder joint is very important as it enables upper body movement and stabilizes the torso. Shoulder pain is often a result of damage to the tendons, muscles or ligaments in the joint.


  • Sports injury
  • Repeated overhead activities
  • Swimming
  • Day to day activities such as washing, cleaning windows, gardening etc
  • Weight lifting
  • Direct hit or trauma to the upper arm or shoulder
  • Excessive exercising that involves repetitive arm movement
  • A direct fall on an outstretched hand or shoulder
  • Automobile accidents


  • Pain which may get aggravated during activity
  • Pain while sleeping on the affected shoulder
  • Stiffness
  • Restricted range of motion
  • Feeling that the shoulder may pop out
  • Weakness in the arm and shoulder
  • Inability to lift or stretch the arm
  • Numbness or a feeling of warmth

Prevention Tips

  • Avoid excessive use of the upper arm and shoulder joint
  • Warm up properly before any physical activity
  • Use shoulder pads and protective gear during sports
  • Maintain a good posture to keep the shoulders stable and properly aligned
  • A proper stretching routine or before exercise is essential to maintain flexibility and body alignment as well as prevent muscle cramps
  • Specific exercises that strengthen the arm, wrist, neck and back muscles should be done regularly
  • Wear the seat belt while driving
  • Make sure you maintain proper body posture while lifting heavy weights
  • Take frequent breaks between activities that involve overhead stretching of the arms such as painting
  • Do not attempt to catch falling objects
  • Sports persons should undergo proper training and conditioning programs to prevent injuries
  • Avoid any activity at home or work place which causes discomfort

The shoulder surgeons at OrthoTexas provide effective treatment for a wide range of illnesses and injuries. Call at (972) 727 – 9995 to schedule an appointment with the orthopedic doctors in Allen, TX.

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McKenzie Therapy: Back Pain Treatment In Allen, TX

by Administrator 22. March 2016 04:42

McKenzie Therapy or MDT (Mechanical Diagnosis and Therapy) is a specific type of physical therapy designed to treat acute lower back pain, peripheral joint pain or neck pain using self-care treatment strategy. In this therapy, the patient is trained by a physical therapist based on the principles of assessment, treatment and prevention to alleviate pain. Thus, the patient’s dependence on the therapists is reduced to a minimum as the latter is required only if the patient is not completely active. The McKenzie therapy does not make use of hot or cold therapy, needles, medicines or injections for treatment and focuses on patient’s active involvement to achieve effective results.

Goal Of The Therapy

  • Treat the actual source of pain rather than symptoms
  • Train the patients to manage back pain
  • Enable the patients to resume their daily activities and range of motion
  • Minimize the pain and prevent it from recurring

Procedure Of The Therapy

The clinician begins the MDT in the following manner:

  • Assessment- Detailed evaluation of the patient’s medical history, symptoms and movement. The patient may be asked to move in certain directions or rest in a specific position to assess the changes in the severity of symptoms.
  • Classification- The therapy classifies the spinal disorders after conducting a few initial assessments and the method of treatment is based on the category of disorder. These are as follows:
  • Postural Syndrome- Certain postures may cause stress in the soft tissues leading to back pain
  • Derangement Syndrome- The repositioning of the fluidic disc in the spine may change the position of the vertebrae, resulting in back ache
  • Dysfunction syndrome- Presence of a scar tissue in the spine may lead to intermittent pain and restricted movement
  • Treatment- Based on assessment and classification, a specific set of exercises is prescribed. The therapist may recommend certain postures that need to be performed and also the ones that should be avoided. The aim is to train the patient to perform easy exercises 5-6 times a day and get rid of pain or discomfort
  • Prevention- The therapist helps the patient know about the safe methods not only to treat the back pain but also to prevent its reoccurrence in the future. The patient is given a complete understanding of the underlying problem so that he/she can take care of the symptoms in the future as well.

The physical therapists at specialize in the use of McKenzie protocols for the treatment of back pain. To schedule an appointment for physical therapy in Allen, TX, call at (972) 727-9691.

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Tips To Prevent Knee Pain And Injury

by Administrator 15. March 2016 08:47

The knee joint is the meeting point of the thigh bone (femur) and the lower leg bone (tibia). It is supported by muscles, tendons, ligaments as well as disc-shaped menisci. Since it bears maximum body weight and is put to constant use, it is prone to injury as well as wear and tear. Knee injuries may vary from a fracture, tendon or ligament tear, bone displacement or sprains and strains.


  • Direct hit or trauma to the knee joint
  • Sports injury
  • Overuse of the joint
  • A fall, jump or twist
  • Arthritis or Osteoporosis


  • Pain which can be mild to severe. It may tend to aggravate during or after an activity
  • A popping sound or sensation may be heard or felt in the knee
  • The joint may feel weak and loose
  • Swelling, bruising, tenderness or redness
  • Inability to bear body weight, stand, walk or bend
  • Numbness in the joint
  • Pricks and needles may be felt
  • Visible deformity

Prevention Tips

  • Orthopedic doctors recommend wearing knee straps or guards during sports or recreational activities to lend adequate support to the joint.
  • Refrain from carrying excessive loads as it may stress the joint.
  • Maintaining a healthy weight reduces the risk of developing Osteoarthritis which may weaken the knee joint and make it prone to injury.
  • Adequate warming up before playing or exercising stretches the thigh muscles, prevents stressing of the tendons and reduces pressure on the knee joint.
  • Wear shoes that enable proper alignment of the feet, knee joint and the legs during any activity.
  • The intensity of workout whether at the gym or outdoors should be enhanced gradually to prevent injury to the knee joint
  • Physical therapy helps to strengthen the knee joint and support muscles in case the person is already experiencing pain or discomfort in the joint
  • Regular exercise and use of the joint helps to maintain its flexibility
  • A diet rich in calcium helps to maintain bone strength and reduce the risk of a fracture
  • Learn the right techniques and methods of playing a sport, exercising or using an equipment from a trainer before practicing them

For diagnosis and treatment of knee pain and injuries, visit OrthoTexas. To schedule an appointment with our orthopedic surgeons in Allen, TX, call at (972) 727 – 9995 or visit 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013.

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Pilon Fractures: Orthopedic Allen, TX

by Administrator 19. August 2015 06:09

A Pilon Fracture, also known as Plafond Fracture, is a break or crack in the distal part of the tibia (shinbone) near the ankle. It is usually caused due to high impact injuries to the ankle, which cause the bones to crush into several pieces. In some cases, a Pilon Fracture may affect both the bones in the lower leg, tibia and fibula.  

Mainly, Pilon Fractures can be categorized as:

  • Type 1 Fracture: This is caused by low energy injuries in which the bone fragments are almost aligned and the joint surface is also appropriate.
  • Type 2 Fracture: This is a moderate energy injury in which the joint surface becomes incongruous.
  • Type 3 Fracture: This is a high impact injury in which the joint surface becomes inconsistent and the fracture extends up to the tibia.


  • Fall from a height
  • Motor vehicle injuries
  • Sports related injuries
  • Skiing accidents
  • Direct blow to the lower leg near the ankle


  • Severe pain
  • Swelling in the lower leg and around ankle joint
  • Bruising and discoloration near the ankle
  • Tenderness on touch
  • Formation of blisters
  • Inability to stand or walk
  • Visible deformity in the ankle joint


Most Pilon Fractures require surgery to be treated completely. However, for patients with certain health problems or minimal physical activity, conservative treatment may be recommended.

Non-Surgical Treatment:

  • Immobilization: If the broken bone pieces are stable and not entirely misaligned, the orthopedic doctor may immobilize the ankle with the help of a cast or splint. Once the swelling subsides, the cast may be substituted with a brace that need to be worn for around 8 to 10 weeks.
  • Anti-Inflammatory Medications: The orthopedic doctor may prescribe certain anti-inflammatory medications to provide relief from pain and compress swelling.

Surgical Treatment:

  • External Fixation: It may be recommended in Pilon Fractures involving considerable damage to soft tissues. Certain external fixation devices, such as metal frames or screws, are used to stabilize the bones and allow the soft tissues to heal.
  • Internal Fixation: It may be suggested in type 2 or 3 fractures. Metal plates, screws or rods may be implanted to hold the tibia fragments in place till the time they heal.
  • Ankle Fusion: Surgery may be recommended in severe case of Pilon Fractures where the bone fragments are completely out of place. During the procedure, the orthopedic surgeon may reposition the fractured bone pieces into their original place.

The orthopedic surgeons at OrthoTexas, Allen provide complete diagnosis and treatment for Pilon Fracture. To schedule an appointment, you can call at (972) 727 – 9995 or visit 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013.

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Graston Technique: Physical Therapy, Allen, TX

by Administrator 5. February 2015 07:08

Graston Technique is a manual soft tissue technique invented by David Graston, an athlete. This technique is a soft tissue mobilization, instrument assisted, therapy, which is based on cross-friction massage. The technique helps in breaking up scar tissue adhesions, fascial restrictions and detecting areas of fibrosis and chronic inflammation. Athletes often use the massage style therapy when they fail to recover from an injury.

What instruments are used?

The physical therapists  use stainless steel tools to diagnose and treat various conditions. They glide the instrument over the patient’s muscles, ligaments and tendons to detect any restrictions or scar tissue. Once they find the knots or bands of scar tissue, they use the instrument to break up the restriction or adhesion. The treatment helps in re-aligning the fibers into normal pattern and the tools are chosen on the basis of the body parts that have to be treated. Areas of the body often treated by Graston technique include the shoulders, calves and wrists.

The Graston process involves some warm up exercises followed by the treatment, some stretching, strengthening and then icing of the affected area. It boosts the cellular activity and minimizes the inflammation in the site of injury or pain.

Benefits of the Graston Technique

The Graston technique is quite effective in resolving various chronic orthopedic conditions and decreasing the overall time in treatment. The technique allows for faster recovery and eliminates the need for anti-inflammatory medications. It treats the scar tissue, which limits the range of motion and causes pain. The therapy assists the patient in returning to normal life and reduces the level of discomfort. The therapist detects the scar tissue, adhesions in the affected area and uses the tools to break this scar tissue. The patient may experience slight discomfort during the procedure along with some bruising; however, these subside after some time.

The biggest benefit of Graston Technique is that people can continue training while receiving the treatment; depending upon the amount of pain they are suffering from. The technique has high success rate and reduces the healing time. This technique can eliminate the need to have surgeries, injections and medication. The technique is widely in use because of its positive outcome and effectiveness.

The physical therapists at OrthoTexas, Allen, specialize in Graston Technique. To schedule an appointment, call at (972) 727- 9691 or visit 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013.

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