Category Archives: Sports and Fitness

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

August 16, 2016 Teresa Stockton - Blog, Head, Industrial Rehab, Sports and Fitness

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.

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:

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

August 9, 2016 Teresa Stockton - Blog, Sports and Fitness

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.

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

Is Aquatic Therapy For You?

July 14, 2016 Teresa Stockton - Aging, Back, Blog, General Information, Sports and Fitness, Women's Health

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.

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.

The Most Common Causes of Pitching Arm Injuries

July 5, 2016 Teresa Stockton - Arm, Blog, Sports and Fitness

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.

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.

Removing Your Kinesio Tex Tape

May 17, 2016 Teresa Stockton - Blog, General Information, Sports and Fitness

Removing Kinesio Tape can seem pretty daunting. The whole point is for it to stay on, so what do you do when it’s time to remove it? Fear not friends, we have the answers here.

DON’T TAKE IT OFF TOO FAST! It’s not a Band-Aid.

1. Put some baby oil or cooking oil on the tape and let it soak for a few minutes to break down the adhesive.
2. Remove the tape in the direction of hair growth by slowly rolling down the tape and applying pressure on the skin with your other hand.
3. Use oil to remove any extra residue.

TIP: The tape can be worn for 3-5 days as long as there is no skin irritation.

To learn more about Orthopedic Kinesio taping visit our treatment technique section here

This information about removing Kinesio Tape was written by Desert Hand and Physical Therapy, a physical therapy group with locations throughout the greater Phoenix and Mesa AZ area. Desert Hand and Physical Therapy has specialized treatment centers providing therapeutic treatment and rehabilitation to restore optimal upper extremity function. For more information about the group click here.

More PTandMe articles about Kinesio Taping can be found here:

Starting a Workout Program

May 5, 2016 Teresa Stockton - Blog, Sports and Fitness

Yes, we get it, exercise is important, but that alone isn’t enough to make all of us get off of the couch. If you are having trouble starting a workout program that works for you and your schedule, get creative and start small. For most of us, we need someone or something to give us a small push in the right direction – and that’s exactly what we’re going to do. You don’t have to go to a gym with a lot of intimidating machinery, and weights – you can go to a physical therapy clinic. A physical therapist can work with you to develop a functional exercise routine that works for you and your goals… and if you need an exercise or wellness coach – they may just be able to make a recommendation. Okay, you’ve heard the sales pitch, but here are the basics you need to know. Whether you go to a gym, PT, or are starting a program on your own there are a few things you should take into consideration.

Benefits of Exercise

Improved circulation and cholesterol
Weight control
Assists with smoking cessation and addiction
Prevents/manages high blood pressure
Prevents bone loss
Boosts energy level and happy brain chemicals
Improves sleep, strength, and self confidence
Reduces risk of CHD/CVD, stroke
Delays/prevents chronic diseases
Reduces stress and anxiety while increasing relaxation
Prevents cognitive decline
Sharpens memory and boosts brainpower

Is Exercise Safe for Me?

If you have major health issues, consult your doctor before doing any exercise
Medical conditions can benefit from exercise even if you have a health issue or injury

Setting Yourself Up for Success

Set short term and long term goals THAT ARE OBTAINABLE!
Daily Reminders: schedule workouts on your calendar or set the alarm on your phone
Reward yourself for obtaining your goals (with something other than food)
Invest in a good pair of workout shoes
Workout with others
Start slowly
Do things you like and don’t focus on activities that you don’t like

How Often Should I Exercise?

Start small and build for success
American Heart Association recommends 30 min per day, most days of the week
SOMETHING IS ALWAYS BETTER THAN NOTHING!

How Hard Should I Work Out?

During cardio take the talk test: Can you speak in sentences while exercising?
Resistance training: You should be able to perform 10-15 reps with proper form

Stay Safe When You Exercise

Drink plenty of water before, during, and after a workout
Warm up, stretch, and cool down to help prevent injury
Wear good shoes that are appropriate for your foot type

This information about starting a workout program was written by Advance Rehabilitation, a physical therapy group with 15 locations throughout North and South GA, and 2 locations in North FL. Advance Rehabilitation is an outpatient physical therapy group that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. For more information click here.

Baseball Video Throwing Analysis

May 3, 2016 Teresa Stockton - Blog, Sports and Fitness

Slow motion 2-D video throwing analysis for baseball players of all skill levels. The purpose of a baseball video throwing analysis is to break down the act of throwing to screen for abnormalities and deviations that may cause potential damage to the shoulder or elbow. Goals are injury prevention and optimizing performance by instructing players on the most efficient and effective mechanics of throwing. Includes evidence-based strengthening exercises and stretches from a certified strength & conditioning specialist. Provides player with proper arm care techniques, systematic warm-ups, cool-downs, throwing protocols, bullpen guidance and much more.

VIDEO ANALYSIS PROGRAMS TYPICALLY INCLUDE:
• Private Evaluation with a Physical Therapist
• Videography
• Biomechanical Analysis and Grading
• Recommendations on Areas for Improvement

WHY YOU SHOULD CONSIDER A VIDEO ANAYLSIS AS A PITCHER:
• Physical Therapy has proven to be immediately valuable in the rehabilitation of injuries and prevention of further damage to the shoulder or elbow
• Video analysis is the only technology available to view each phase of the throwing motion from all possible angles to screen and detect mechanical flaws that are causing injury
• Objective data obtained from the analysis is put through a rigorous grading process (The 8 Cylinders of Pitching) which determines the biomechanical efficiency of the throwing motion
• A structured rehabilitation and prevention program that incorporates the latest evidence-based interventions proven to be effective specifically to baseball players
• A baseball program will rehabilitate and optimize a player’s performance in a safe, scientifically sound manner and maintain good health through their careers.

March is Athletic Trainers’ Month

March 24, 2016 Teresa Stockton - Blog, Events, Sports and Fitness

This month, we recognize all athletic trainers and their hard work making everyone look and feel better. Here are some key messages from NATA (National Athletic Trainers’ Association):

ATHLETIC TRAINERS ARE EXPERTS
Working to prevent and treat musculoskeletal injuries and sports-related illnesses, athletic trainers offer a continuum of care unparalleled in health care. ATs are part of a team of health care professionals – they practice under the direction of and in collaboration with physicians. ATs work with those individuals who are physically active or involved in sports participation through all stages of life to prevent, treat and rehabilitate injuries and medical conditions. Athletic trainers should not be confused with personal trainers or “trainers” who focus solely on fitness and conditioning. Always refer to an “athletic trainer” or “AT” to ensure clarify of profession and quality of care.

ATHLETIC TRAINERS SAVE LIVES
Sports injuries can be serious. Brain and spinal cord injuries and conditions such as heat illness can be life threatening if not recognized and properly handled. ATs are there to treat acute injuries on the spot. Athletes have chronic illnesses, too. People with diabetes and asthma can and do safely work and exercise, and the athletic trainer can help manage these critical health issues as they relate to physical exertion.

NOT ALL ATHLETES WEAR JERSEYS
The duties of many workers – such as baggage handlers, dancers, soldiers and police officers – require range of motion and strength and stamina, and hold the potential for musculoskeletal injuries. ATs work with individuals in various settings to help with the prevention and treatment.

THE ATHLETIC TRAINER IS THE HEALTH CARE SYSTEM FOR ATHLETES AND OTHERS
Athletic trainers are on site. They work with patients to avoid injuries; they’re there when injuries happen and they provide immediate care; and they rehabilitate patients after injuries or surgery. It’s a continuum of care. They know their patients well because they are at the school, in the theater or on the factory floor every day.

ATHLETIC TRAINERS TAKE RESPONSIBILITY AND LOWER RISK
School administrators, athletics directors and coaches have their own jobs, which may pose a conflict of interest with athlete safety; they are not experts in managing injuries or sports-related illnesses, nor should they be responsible to do so. Handling injuries at school or at work, rather than sending the patient to the emergency department, saves money and time loss – and gets them back to their activity faster. Just as professional athletes do, recreational athletes should have access to athletic trainers.

For more information please visit: www.nata.org

The Most Common Reasons People Do Not Adhere to Exercise Routines

March 1, 2016 Teresa Stockton - Blog, Sports and Fitness

Nearly 50% of Americans will make New Year’s Resolutions in 2016, and the two most common goals are weight loss and exercise. Considering in 2008 that 34% of the U.S. was classified as obese, these resolutions are important.Currently, less than 50 % of Americans meet the physical activity requirements per the CDC. Despite the large spike in exercise at the beginning of each New Year, most resolutions fail by February. There are countless reasons, and they are directly paralleled to the most common reasons people do not adhere to exercise, and pain.

Time:
Time is the most cited reason people do not exercise. With a finite amount of hours per day, plan your day around your exercise plan – not the other way around. This allows you to prioritize your efforts toward the one thing that improves every aspect of your health, exercise. Also, you can break your activity up into 10 minute bouts throughout the day. You can take the long way in a walk to work, use the stairs, walk on your lunch break, etc. The goal is to get at LEAST 30 minutes of aerobic activity 3-5 times per week.

Fatigue:
If you are beat at the end of a long work day, don’t try to work out at the end of the day! Plan your workouts when you have the most energy. While this is easier said than done, take stock of your current daily routine. If you are a morning person, hit the gym before work. If you are a midday warrior, utilize your lunch break. If you like to work out a little later, take your athletic clothes with you and hit the gym before you get home. A benefit of exercise is increased energy, but it takes energy to make energy.

Lack of Experience:
Exercise doesn’t have to be complicated. The ultimate goal is to raise your heart rate and challenge your muscles. The spectrum of ways to exercise is enormous, but it is best to choose routines or activities that interest you and correlate with your goals. However, it is important to chose activities that fit your current level of fitness initially, and you are more likely to continue a program if you are successful at the start. If you can, work out with a partner to help keep you motivated. Lastly, set yourself realistic and specific goals: weight loss is not specific; losing 10 pounds in 12 weeks is specific. When initiating a new routine, consult your doctor to make sure you’re ready for the stress of exercise.

Pain:
Many people don’t exercise due to pain, fear of injury, or the discomfort of delayed onset muscle soreness (DOMS). In a recent study, those with arthritis who exercised 2 days per week or more actually had less pain than those who were sedentary. Lower back pain and knee pain are common deterrents to exercise, but countless studies show regular exercise improves these aches when performed correctly show regular exercise improves these aches when performed correctly. It is also important to seek a fitness professional such at a physical therapist or certified personal trainer when initiating an exercise routine to make sure your form is correct and you are performing movements safely. If you are currently in pain, a licensed physical therapist can address your pain with manual therapy and specific exercise, as well as address your fitness goals.

Don’t wait to begin changing your health and fitness. Begin today by taking the first steps towards better health!

Written by Spence Tomlinson, PT, DPT, Cert. MDT, Clinic Director of STAR Physical Therapy, Kingston Springs, TN

Post Workout Nutrition Tips for an Intense Workout

January 19, 2016 Teresa Stockton - Blog, Sports and Fitness

After an intense workout you need to replenish your body with the nutrients and vitamins that were lost while exercising. We have compiled a post workout nutrition guide to help you make good choices as you refuel your body.

PROTEIN, CARBOHYDRATE AND WATER:
Intake within 30-60 minutes post workout for optimal nutrient uptake (muscles and energy system get the most out of the nutrients).

PROTEIN TO CARBOHYDRATE RATIO OF 3:1 (chocolate milk is perfect: 8g Carbs/ 24g Protein)
TAKING IN PROTEIN WITH CARBOHYDRATES
• Slows nutrient uptake into the bloodstream (keeping blood sugar from spiking up, minimizing production of insulin which in turn slows fat storage)
• Maintains a steady burning metabolism
• Helps to more effectively restore muscle glycogen (energy)
• Begins to heal muscle tissue quicker.

BASIC POST WORKOUT MEALS INCLUDE:
• Wheat Bagel with Almond Butter
• Tuna on Wheat Crackers
• Cereal with Skim Milk
• Greek Yogurt with Fruit
• Stir Fry
• Turkey/Chicken Sandwich
• Protein Bar
• Hummus with Whole Grain Pita
• Sports drink with Protein Shake
• Water, Water, Water!!!!

There are many more choices, and creativity is always an option. The important part is to choose a lean meat or protein source (chicken, turkey, fish, lean beef, tofu, beans, nuts), healthy carbohydrate source (whole grain, fruits, vegetables, nuts) and a small amount of healthy fat (Unsaturated: Avocadoes, almonds, walnuts, olive oil). Mixing and matching these is the best approach. This guarantees the widest range of vitamins and minerals in your meal.