Tag Archives: Athletic injury

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

basketball

1. How Does an NBA Player Overcome Career Limiting Ankle Injury?
Written by Nick Mezyk, DPT, Clinic Director at ProCare Physical Therapy – Johnstown, PA

If you have played sports long enough, you have most likely experienced the following… You’re running down the field, court or track, and you go to make a quick cut. Except you end up crumbling to the ground because you rolled your ankle causing a popping sensation on the outside portion of that ankle. Read more

 

gym guy

3. Top Equipment Free Exercises You Should Be Doing 
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

The idea of exercising always conjures up visions of personal trainers, expensive gyms, high-end equipment, and lots of grunting, groaning, and personal torture. That’s never the case when we use the term exercise. Read more

avoid pitching injuries

Physical Therapist Tips on Avoiding Injury to Your Throwing Arm & What to Do in Case You Do

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Throwing a baseball or softball is one of the most demanding motions on the human body in sports. For each throw, the athlete generates high levels of energy in the arm and body to accelerate the baseball and softball to a high velocity. Just as it is important to understand proper biomechanics to improve performance, it is important to understand the stresses placed on the throwing shoulder and elbow by the throwing process.

Physical Therapist Tips on how to avoid pitching injuries

• Teach young athletes to be mindful of how their bodies feel. Pain is the first sign of a problem, and athletes of all ages need to pay close attention to any type of muscle twinge, tightening, or burning sensation.

• Coaches should carefully observe their pitchers’ techniques. Success on the field may be fleeting if the pitches ultimately are damaging a young player’s shoulder.

• Conditioning and strengthening exercises are most effective after mechanics are learned and put into action. If possible, begin a conditioning program at least a month before the season begins. A basic stretching regimen should be used before a player ever picks up a baseball.

• Players should start with short tosses and gradually work up to throwing the ball a greater distance. Increasing the velocity should be the final step.

• If the arm region is sore or tight, apply ice to the area for 10-15 minutes to help diminish the amount of blood that might otherwise leak into the muscle. When there is microscopic tearing of the muscle tissue, blood is leaking into the surrounding muscular tissue, causing pain and muscle spasms. Using ice will help reduce the pain, spasms, and inflammation associated with this condition.

• Before age 10, only fast ball and change-up should be permitted.

This information about how to avoid pitching injuries was written by University Physical Therapy, an outpatient physical therapy group with eight locations in New River Valley, Virginia. University PT is THE choice for outstanding sports rehabilitation, physical therapy and occupational therapy services. For more information click here.

concussion

True or False: A Person With a Serious Head Injury or Concussion Should Be Kept Awake

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All head injuries should be treated seriously. While most won’t cause lasting effects, if improperly treated, they can lead to long-term disabilities or even death.

The most common type of head injury is a concussion. It is a jarring trauma to the brain that can cause a person to lose consciousness or have amnesia.

What do you do if you are around someone who experiences a serious head injury or concussion? You may have heard that you should not let the person go to sleep, but is this true? Most health professionals don’t think so. It is generally considered safe for people with head injuries or concussions to go to sleep. In some cases, a doctor may recommend waking the person regularly to make sure his or her condition has not worsened.

Evidence for the Health Claim
Many people will go to great lengths to keep a person who has had a head injury from falling asleep. They argue that keeping the person awake will decrease the risk that he or she slips into a coma.

This misunderstanding probably stems from hearing about a rare occurrence known as a lucid interval that has been associated with certain types of severe head injuries. A lucid interval occurs when the initial bleeding in the brain does not cause loss of consciousness. The bleeding eventually worsens and brain structures become compressed. The person’s condition can rapidly deteriorate, requiring emergency brain surgery.

Evidence Against the Health Claim

Most medical professionals say it is fine—sometimes even advised—to let people sleep after incurring a head injury.

The American Academy of Family Physicians states it is not necessary to keep a person awake after a head injury. If a person needs to be watched that closely, a doctor will most likely admit him or her to the hospital. The Dartmouth College of Sports Medicine advises that it is fine to go to sleep after a concussion so long as someone wakes you up every two hours. They are to check to make sure you can be easily awakened and aren’t displaying symptoms of a worsening condition.

In a study in the September-October 2005 issue of the Journal of Head Trauma Rehabilitation, researchers reported greater levels of fatigue in people who have had head injuries, compared with those who have not. The researchers concluded that regular rest breaks and increasing intervals of restful sleep should be a part of the rehabilitation from head injury.

neon concussion

Conclusion
If you are around someone who has a head injury or possible concussion, monitor the symptoms closely. It is important to call a doctor or go to a hospital immediately if the person has worrisome symptoms such as:
• Open wound in the scalp or misshapen deformity of the skull
• Severe or progressive worsening headache
• Changes in behavior (eg, confusion, restlessness, irritability, lethargy)
• Dilated pupils or pupils of different sizes
• Convulsions or seizures
• Difficulty waking from sleep
• Trouble walking or speaking
• Bleeding or drainage of fluids from nose or ears
• Unusual sleepiness or decreasing alertness
• Severe or persistent nausea, or vomiting more than twice
• Weakness or numbness in the arms or legs

When a head injury is serious enough to require medical care, a doctor will give you instructions on how to monitor and treat the injury once the person is released from the hospital or clinic. These instructions will generally not include keeping the person awake and alert.

by Krisha McCoy, MS

More PTandMe articles about concussions can be found here:

concussion physical therapy   concussion treatment

   

REFERENCES:
Head injuries. KidsHealth.org website. Available at: http://www.kidshealth.org/parent/firstaid_safe/emergencies/head_injury.html. Accessed November 5, 2008.

Head injuries: what to watch for afterward. Familydoctor.org website. Available at: http://familydoctor.org/084.xml. November 5, 2008.

Head injury: concussion. Dartmouth College of Sports Medicine website. Available at: http://www.dartmouth.edu/~sportmed/concussion.html. November 5, 2008.

Radiology for traumatic brain injury. Trauma.org website. Available at:http://www.trauma.org/neuro/neuroradiology.html. Accessed July 23, 2006.

Subjective reports of fatigue during early recovery from traumatic brain injury. Journal of Head Trauma Rehabilitation. 2005;20:416-425.

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Common Football Injuries

Common Football Injuries

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Football is one of the most popular sports played by young athletes, and it leads all other sports in the number of injuries sustained. In 2007, more than 920,000 athletes under the age of 18 were treated in emergency rooms, doctors’ offices, and clinics for football-related injuries, according to the U.S. Consumer Product Safety Commission. Physical therapy can provide specific treatment to a number of specific football injuries. Here are a few injuries that can happen during a football game or practice:

KNEE INJURIES
Knee injuries in football are the most common, especially those to the anterior or posterior cruciate ligament (ACL/PCL) and to the menisci (cartilage of the knee). These knee injuries can adversely affect a player’s long-term involvement in the sport. Football players also have a higher chance of ankle sprains due to the surfaces played on and cutting motions.

Physical therapy treatment for knee injuries may include:
• Exercises to help promote recovery. Specifically, therapists will design a program to strengthen the whole leg as well improve its range of motion.
• Balance exercises to allow the return to daily activities (including work and sports) while decreasing the risk of falls and reinjury
• Hands-on treatment to keep the knee joint from becoming stiff
• Ice and vasopneumatic pressure to reduce swelling and pain

SHOULDER INJURIES
Shoulder injuries are also common. The labrum (cartilage bumper surrounding the socket part of the shoulder) is particularly susceptible to injury, especially in offensive and defensive linemen. In addition, injuries to the acromioclavicular joint (ACJ) or shoulder are commonly seen in football players.

Physical therapy treatment for shoulder injuries may include:
NON-SURGICAL
Most labral tears will respond well to non-surgical treatment and may be just one component of a multi-factored pathology of the aging shoulder. Physical therapy will typically address a labral tear from the biomechanical approach of improving the motion and reducing the repetitive injury. If the inflammation and mechanical stress on the structures can be reduced then the tissue has a chance to heal.
SURGICAL
If the athlete has had surgery to the shoulder, the therapist will follow a specific protocol to apply just the right amount of strain on the shoulder to keep it safe after surgery. A sling may be recommended in the early stages but the therapist will get the arm moving with assistance within a relatively short period of time. Physical therapists will give instructions on how to provide varying levels of assistance to the arm for motion in safe planes in front of the body, and eventually throughout the entire range of motion. Once the tissues are healed, the therapist will begin to put resistance on the support structures in order to improve the mechanics of motion and reduce the risk of another injury.

kid football player

CONCUSSIONS
Football players are very susceptible to concussions. A concussion is a change in mental state due to a traumatic impact. Not all those who suffer a concussion will lose consciousness. Some signs that a concussion has been sustained are headache, dizziness, nausea, loss of balance, drowsiness, numbness/tingling, difficulty concentrating, and blurry vision. The athlete should return to play only when clearance is granted by a health care professional. It is recommended that players go though a concussion baseline test before the start of the season. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a healthcare professional during the season if an athlete has a suspected concussion. More information here.

Physical therapy treatment for concussions may include:
EVALUATION: The physical therapist will take time to talk with you and perform a thorough examination of your condition.
THERAPY: The physical therapist will plan a treatment program suited to your individual condition, which will involve exercises for your balance, vision, inner ear and more in order to restore brain function.
TEACHING: Physical therapists will spend time reviewing information with you regarding your diagnosis and progress as well as answering your questions. This empowers the patient to make a lifelong impact on their health.
RETURN TO SPORT: Physical therapists are uniquely qualified to guide you towards a safe return to sport. A therapist can guide recovering athletes through a stepwise protocol to keep patients symptom free,  and to prevent serious, life-threatening conditions associated with a second head injury due to early return to football.

OVERUSE INJURIES
Low-back pain, or back pain in general, is a fairly common complaint in football players due to overuse. Overuse can also lead to overtraining syndrome, when a player trains beyond the ability for the body to recover.

Physical therapy treatment for overuse injuries may include:
Pain-relieving techniques (such as ice) and decreasing or modifying painful activities. This diagnosis often occurs from muscular tightness or weakness which causes posture to get out of alignment. A physical therapist will educate and assist in proper stretching and strengthening exercises for the back. They may perform hands on, manual therapy techniques to further increase joint flexibility. The final phase of rehab will involve strengthening during functional activities and education to prevent the injury from recurring.

RESOURCES:
U.S. Consumer Product Safety Commission
www.cpsc.gov

Stop Sports Injuries
www.stopsportsinjuries.org

REFERENCES:
Preventing Football Injuries. http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Football_Skating_Injury_Prevention.aspx

Plantar Fasciitis

Hamstring Tightness and Plantar Fasciitis

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Plantar fasciitis is classically characterized by pain in the central to medial plantar heel. It is thought to be caused by chronic inflammation of the plantar fascia due to repetitive strain and trauma to the fascia. There are many other purported causes including, calcaneal spurs and increased intraosseous calcaneal pressure, among others. Many studies have shown inflammatory and histological changes at the origin of the plantar fascia and surrounding structures that are consistent with repetitive strain and degenerative changes including a thickening of the fascia.

Biomechanics has long been looked at when investigating possible causes of injuries. Alteration of the load-bearing characteristics of the foot has been suggested by several studies to be the underlying problem in plantar fasciitis. Microtears and chronic degenerative changes result from the increased tensile stress placed on the fascia due to the changes in biomechanics. Muscle tightness is one factor that can lead to changes in gait mechanics and load bearing of the foot. Hamstring tightness has recently been investigated as a factor in plantar fasciitis and has been shown to induce prolonged forefoot loading due to increased knee flexion during gait. A rapid progression through the contact phase of gait results from increased knee flexion and in turn increases forefoot pressure. The fascia is a fixed-length ligament, so an increase in forefoot pressure results in increased tension at its insertion on the calcaneus. The increased time spent on the forefoot in gait leads to a chronic traction injury that is localized to the hindfoot insertion of the fascia; which is consistent with the symptoms of heel pain.

plantar

Biomechanical deficits have long contributed to injuries. Only recently has hamstring tightness been shown to have an effect on plantar fasciitis. Hamstring tightness affects every step, resulting in a biomechanical deficit which may contribute to a tensile overload of the plantar fasciitis. Recent studies suggest that all patients with plantar fasciitis should be evaluated for hamstring tightness. Physical therapy treatment for plantar fasciitis should include hamstring stretching.

More information about Plantar Fasciitis can be found in the PTandMe injury center.

physical therapy near me

This information was written by Plymouth Physical Therapy Specialists. They are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics!

old man tennis

1. Tennis and Golf: Keep Swinging as You Age
Written by the Therapy Team at the Jackson Clinics Physical Therapy – Middleburg, VA

It’s a hard fact to swallow: Age eventually catches up with all of us, no matter how active we may be. Unless we work to maintain strength and flexibility, we slowly lose both as we age. Read more

track girl

2. Bridging the Gap
Written by Jess VandenBerg MS, AT, ATC, CSCS at the Center for Physical Rehabilitation – Grand Rapids, MI

If you have ever rehabilitated an athletic injury, you know there is a big difference between completing your rehab, and returning to competition. You are pain free, have full range of motion, and are completely functional, but are you prepared for the true demands of your sport, both mentally and physically? Read more

spine

3. Is There an Association Between Radiological Severity of Lumbar Spinal Stenosis and Disability, Pain, or Surgical Outcome?
Written by the Therapy Team at Oregon Spine and Physical Therapy – Eugene, OR

Last week I wrote a blog about a new research article about the shoulder and MRI. It helps us better understand the role of an MRI when trying to figure out the best plan to deal with a painful or injured body part. The old belief that an MRI is the “gold standard” is rapidly dying when it comes to understanding what to do with muscle and joint pain. Read more

aquatic therapy

Is Aquatic Therapy For You?

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Aquatic therapy offers an alternative environment for therapeutic exercise. If you have tried traditional physical therapy, or have restrictions on your physical therapy program, aquatic Therapy may be the perfect solution for your physical therapy needs.

Why Aquatic Therapy is Beneficial

Less pressure: The buoyancy of the water decreases the amount of pressure, or compressive forces, on your joints and spine. When you’re immersed in water up to your neck, the weight pressing down on your body is reduced by 90%. When the water is up to your waist, the pressure is reduced by 50%.

Reduced swelling: The pressure of the water helps to move fluid from the injured area back into the body. Decreased swelling is essential for regaining the strength and motion needed for recovery.

Ease of movement:
Water is an element that supports and assists movement. It offers a safe setting for regaining strength and joint range of motion.

Faster progress: Aerobic conditioning can often be performed in the water, even when it may be too soon or too difficult to do in the clinic. Staying stable in the water, challenges your core and balance. Plus, sports specific activity can begin earlier than on land.

old man swimming

Who Can Benefit From Aquatic Therapy

• Chronic pain patients requiring a more gentle form of therapy
• Patients at risk of falls due to balance and gait disorders
• Patients with severe arthritis or other weight-bearing restrictions
• Prenatal and postnatal patients
• Patients with general deconditioning
• Sports medicine and orthopedic patients requiring an accelerated component to their rehab protocol

This information was written by Life Fitness Physical Therapy, a privately-owned, outpatient physical therapy practice operating 14 clinics in the metro and surrounding Baltimore, Maryland area. Life Fitness Physical Therapy was founded in 2000 based on the core values of providing the highest level of customer service and clinical excellence in outpatient physical therapy. For more information click here.

causes of pitching arm injuries

The Most Common Causes of Pitching Arm Injuries

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The most common causes of pitching arm injuries to high school, college and professional pitchers are overload, overuse, lack of proper conditioning and improper throwing mechanics.

• Overload is the result of throwing too many pitches during one outing. Maximum pitch counts for various age groups, or for an individual pitcher’s normal strength and stamina, are effective in preventing overload.

• Overuse is the result of pitching too often and not having an adequate recovery time or a good arm maintenance program (stretching, running, strengthening, throwing) between pitching assignments. Coaches and trainers should be aware that each individual pitcher varies in arm strength, arm fatigue, arm tightness and soreness and require different recovery time needs. Make certain you provide your pitcher with a good active recovery program between pitching assignments.

• Proper conditioning involves the entire body; the legs and core muscles as well as the throwing arm. Coaches should supervise a proper stretching and warm-up procedure that is performed daily before throwing a ball.

• Pre-season is one of the most frequent times for arm injuries. Pitchers throw too much and too hard, too early. Also, they have not ingrained their normal rhythm and often are attempting to learn new techniques or new pitches. Another major factor of injury during pre-season is that pitchers are not working with a normal in-season rotation schedule and do not get enough recovery time from a lot of necessary drill work that involves throwing (pick-offs, defensive plays, etc.).

• Improper throwing mechanics. If a pitcher has improper throwing techniques, with the body or arm, there is a great chance of early fatigue of the throwing mechanism, and of course injury. The more power and force generated, the greater the chance of injury. In a competitive situation, most pitchers will not admit they are fatigued, experiencing minor pain or have a minor injury. It is important that you, a coach, trainer or physical therapist be able to recognize changes in the pitcher’s mechanics, performance, or mannerisms.

night pitcher

This information about common causes of pitching arm injuries was written by University Physical Therapy, an outpatient physical therapy group with eight locations in New River Valley, Virginia. University PT is THE choice for outstanding sports rehabilitation, physical therapy and occupational therapy services. For more information click here.

What Should I Tell My Physical Therapist?

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If you have never been to a physical therapist before you may have some questions about your care and expectations. Here are some general questions and points about physical therapy you may want to talk about during your initial evaluation.

Talk about the pain you are experiencing.
Go into detail about what sort of activities you have trouble with and where the pain is coming from.  The more details you can provide the more it will help your therapist develop a treatment plan.

How did your injury happen and/or when did your pain begin?
Did you have an injury or accident, or did the pain develop gradually over an extended period of time? Whether it’s sports, work or surgical post-op related your PT can guide you to recovery following an injury. As part of physical therapy, they can teach you exercises, stretches, and techniques using specialized equipment to address your pain.

What are your recovery goals?
If you have specific goals in relation to your recovery, let your therapist know. Do you want to be able to run a marathon, or is the goal to cook dinner and be able to reach up into your cabinets? Maybe your goal is to have enough strength to play with the grand kids. Your Physical Therapist needs this information when designing a treatment plan that best suits your needs. Whether you’re a professional athlete who’s suffered an injury or an orthopedic patient who needs assistance following surgery, your recovery starts with physical therapy.

old_guy_at_PT

Give your physical therapist you primary care provider’s information.
Good communication between your physical therapist and your primary care provider can help eliminate the need for unnecessary drugs/medications and provide great detail about your medical history. Your physical therapist can help clarify referral guidelines and the decision-making process as well.

Tell your physical therapist about any medications you are currently taking.
Different medications can cause adverse side effects due to physical activity and your physical therapist wants to make sure you are ready for physical therapy. Make sure you have a detailed list of your medications and be ready to discuss them at your evaluation.

Always tell your physical therapist your pain levels and how you feel your progress is going.
Physical Therapy is intended to make changes in your body.  As physical therapists make changes to your tissues and mechanics, the stresses on your body will change, and may change where you feel the pain or symptoms. Be open with your physical therapist. If you have any questions about your treatment or want to go over any pain you are experiencing let your physical therapist know and they can go over it with you. Chances are what you are experiencing is completely normal and part of the healing process.

For more information about physical therapy programs and treatment techniques visit our About Physical Therapy section by clicking here.

Need to find a physical therapist? Visit our Find A PT Page

Low back pain

Exercise May Reduce Risk of Low Back Pain

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Low back pain is a common complaint that can last a few days or weeks or become a chronic condition with significant impact on well being. Treatments can vary depending on the cause.Chronic back pain can be difficult to successfully treat and it may take some time to find what treatment works best for each person. Since treatment is not guaranteed to work, prevention is the best option. Back pain is often the result of long term stress on the back such as poor posture, sedentary behavior, or regular strain on the back. Prevention will likely involve a number of different steps to reduce these stresses. However, existing studies have not found clear recommendations for the best methods to go about it.

Researchers wanted to investigate the effectiveness of a number of interventions for the prevention of low back pain. The study, published in JAMA Internal Medicine, found that exercise alone or in combination with education was most effective for preventing low back pain.

About the Study
The systematic review of 21 randomized controlled trials included 30,850 men and women without low back pain. The participants were randomized to 6 different prevention strategies, including exercise, education, exercise plus education, back belt, and shoe insoles. The control groups received no intervention, minimal interventions, or placebo.

When compared to the control group exercise was associated with:
• Fewer low back pain episodes in the first 12 months (in 4 trials with 898 people)
• Fewer sick days due to back pain in follow up 12 months or longer (in 2 trials with 128 people)
• Reduction in short-term (4 trials with 422 people) and long-term low-back pain episodes (2 trials with 138 people) when combined with education

Education alone, back belts, and shoe insoles did not appear to have any benefit during the trials.

man stretching

How Does This Affect You?
A systematic review combines the results of several smaller studies to arrive at one result. The benefit of this type of review is that it increases the number of participants which increase reliability of results. However the review is only as reliable as the studies that are included and the method used to combine the results. There were some flaws in every trial that were included in this analysis. For example, many of the included trials had a high dropout rate during the trial which decreases the reliability of their results.

Low back pain is often associated with an imbalance or weakness of certain back muscles. An exercise program will improve your physical fitness, strengthen your back muscles, and help you maintain a healthy weight. Regular physical activity may also help maintain a healthy weight which can also put strain on your back. Choose exercises or activities that you enjoy and will make a regular part of your day. For most people, this could include 30 minutes of moderate aerobic exercise per day.

Check with your doctor before starting any exercise program.

by Cynthia M. Johnson, MA

RESOURCES:
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Ortho Info—American Academy of Orthopaedics
http://orthoinfo.aaos.org

SOURCES:
Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 2, 2016. Accessed March 22, 2016.

Steffens D, Maher CG, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016 Feb 1;176(2):199-208.

Last reviewed April 2016 by Michael Woods, MD

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.