Tag Archives: Injury Prevention

Protect, Stretch & Rest: General Tips

- Blog, Industrial Rehab

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These are some general healthy tips to remember during your day-to-day activities.

• If you are doing strenuous, household or outdoor work protect your hands with gloves in order to prevent injury and/or loss of moisture.
• Take frequent breaks or switch to a new activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome.
• If you find yourself sitting at your computer for hours each day, stop each hour and stretch your fingers, arms and the rest of your body to help prevent injury to your bones, joints and muscles.
• If you have pain during your activity, stop. Pain is one of the ways your body is letting you know that you are overextending a particular muscle group.

Physical Therapy Day

World Physical Therapy Day

- Blog, Events

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World Physical Therapy Day is on September 8th. The day is an opportunity for physical therapists from all over the world to raise awareness about the crucial contribution the profession makes to keeping people well, mobile and independent. This year the focus is on adding years to your life by being physically active! See how a little bit of movement can go a long way!

WPTD2016_infographic_A4_FINAL

To  learn more about World Physical Therapy Day click here.

bone health

Exercise and Bone Health

- Aging, Blog, Sports and Fitness

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Bone is living tissue that is constantly undergoing a process called remodeling. In remodeling, cells called osteoclasts are breaking down old bone, as cells called osteoblasts are replacing it with new tissue. Many factors can affect the remodeling process and leave you with bones that are less dense and more fragile.

Some factors that interfere with bone health and remodeling are:
• Increased age
• Low vitamin D—The body makes vitamin D in response to sunlight. You can also get vitamin D by eating certain kinds of food or by taking a supplement.
• A diet low in calcium
• Smoking
• Lack of exercise—especially weight bearing and resistance exercise

Why Exercise Is Good for Bone Health
Regular weight-bearing and resistance exercise helps build muscle, as well as maintain and increase bone strength. Exercise causes the muscle to contract against the bone. This action stresses or stimulates the bone, and the bone becomes stronger and denser. The 3 main types of exercise are (some activities can be more than 1 type):

Aerobic (Cardiovascular) Exercises to Improve Bone Health
In aerobic exercise, you continually move large muscles in the legs, shoulders, and buttocks. This action causes you to breathe more deeply, and your heart to work harder pumping blood, thereby strengthening your heart and lungs. Examples include:
• Walking
• Jogging
• Running
• Aerobic dance
• Bicycling
• Swimming

Weight-Bearing Exercises to Improve Bone Health
In weight-bearing exercises, your bones and muscles work against gravity, and your feet and legs bear the weight. Your bones adapt to the weight and pull of the muscle during weight-bearing exercise. Examples of weight-bearing exercises include:
• Jogging
• Walking
• Stair climbing
• Dancing
• Soccer

Resistance Exercises to Improve Bone Health (Strength Training)
Resistance exercises use muscle strength to improve muscle mass and strengthen bone. Examples include:
• Weight lifting, using:
• Free weights
• Weight machines
• Elastic tubing

• Calisthenics such as push-ups and chin-ups

tennis guy

Tips for Beginning:
Aerobic or Weight-bearing Exercises to Improve Bone Health
• Warm up for 5 minutes before activity. This can consist of dynamic stretches that involve movement and a light walk.
• Start the activity slowly for the first 5 minutes.
• Slowly increase your intensity so that your heart rate increases. A person doing moderate-intensity aerobic activity can talk. A person doing vigorous-intensity activity cannot say more than a few words without stopping to take a breath.
• Gradually increase your workout until you are working out at least 150 minutes a week at moderate–intensity or 75 minutes a week at vigorous intensity.

Resistance Exercises to Improve Bone Health
• Begin each exercise with light weights and minimal repetitions.
• Slowly (over weeks) increase weight, never adding more than 10% in a given workout.
• Do these exercises 2-3 times a week. Allow for 1 day between each workout for your bones and muscles to rest and repair themselves.
• Gradually increase the number of repetitions to 2-3 sets of 8-10 repetitions with a rest period of 30-60 seconds between sets.
• Although stiffness the day after exercise is normal, if you are in pain, you did too much. Decrease the intensity or the duration of your exercise.

Before starting any type of exercise program, check with your doctor about any possible medical problems you may have that could limit your ability to exercise.

by Mary Calvagna, MS

RESOURCES:
National Osteoporosis Foundation
http://www.nof.org

The President’s Council on Physical Fitness, Sports, and Nutrition
http://www.fitness.gov

CANADIAN RESOURCES:
Canadian Orthopaedic Foundation
http://www.canorth.org

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:
2008 Physical Activity Guidelines for Americans. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/default.aspx#toc. Published October 2008. Accessed January 21, 2016.

Bone remodeling. University of Washington website. Available at: http://courses.washington.edu/bonephys/physremod.html. Updated March 30, 2007. Accessed January 21, 2016.

How much physical activity do adults need? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html. Updated June 4, 2015. Accessed January 21, 2016.

Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 13, 2015. Accessed January 21, 2016.

Skeleton keys. Smithsonian Museum of Natural History website. Available at: http://anthropology.si.edu/writteninbone/young_old.html. Accessed January 21, 2016.

Last reviewed January 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.

avoid pitching injuries

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

- Blog, Shoulder, Sports and Fitness

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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

- Blog, Head, Industrial Rehab, Sports and Fitness

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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.

Recovering from knee surgery

Self-Care: Safe Positions & Movement After Knee Surgery

- Blog, Knee

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ACTIVITY GUIDELINES
Recovering from knee surgery does not have to prevent you from moving or taking care of yourself. Listed below are guidelines on how to do some common movements and activities without hindering the healing process.

SLEEP & POSITIONING
• It is very important that when recovering from knee surgery you get enough rest following your surgery. If you cannot get comfortable in your bed, please talk to your therapist.
• Sleep on a bed with a firm mattress. Ideally, the bed should come up to your mid-thigh while you stand.
• Sleep flat on your back and position your leg so your toes and kneecaps point at the ceiling.
• Do not place pillows under your operative leg. If you wish to elevate your leg, support the whole leg with pillows while keeping the knee straight.

Sitting Up In Bed:
• If possible, get out of bed toward non-operated side so that the operated leg is supported as much as possible.

From Sitting on the Side of the Bed to Standing with the Walker:
• Straighten the operated leg in front of you before standing.
• Ensure you have good sitting balance with the walker close in front of you.
• Push up from the bed with both hands and keep weight on the non-operative leg.

From Standing to Getting Into Bed:
• Sit down on the edge of the bed; place at least one hand on the bed as you lower yourself. Remember to keep the operated leg further ahead to avoid straining it.
• Enter your bed leading with the operated side if possible.
• Bring your legs onto the bed while lowering your upper body with your hands then elbows.

BATHING/SHOWERING:
You may shower in a bathtub or shower stall only after your doctor has given their permission.

Getting Into the Tub to Take a Shower:
• Have the tub bench or tub chair placed in the direction facing your shower faucets.
• Using your walker, back up to the bench.
• Reach back with one hand to the bench and sit down with your legs outside of the tub.
• Place one leg at a time into the tub.

Getting Out of the Tub:
• While seated on the tub bench/chair turn your body and place your legs one at a time outside of the tub.
• Push up from the tub bench and stand using both hands on the walker.

knee brace

TOILET TRANSFERS:
When recovering from knee surgery the low surface may cause excessive painful bending at the knee. If this is the case, your therapist may help you with getting a raised toilet seat or a three-in-one commode that can be used over your toilet.

Getting Up and Down From a Toilet:
• Back up to the toilet.
• Reach back for the armrests/raised toilet seat/seat.
• Slide your operated leg slightly forward and lower yourself slowly onto the toilet.
• To stand, use a grab bar or place your hand at the middle of the center bar of the walker.
• Stand up and get your balance before placing both hands on the walker.

DRESSING:
• Put on your top or shirt as you normally would while seated.
• Do not twist the knee too much when dressing or putting on shoes.
• Your therapist may recommend a sock aid, dressing stick, reacher or long-handled shoe horn to help with dressing.

STAIRS:
You should only try to go up or down stairs when your doctor or therapist says it is okay. Do not try to use stairs while using a walker.
• When going up the steps, first step up with your non-operative leg, followed by the operative leg.
• When going down steps, first step down with your operative leg, followed by the non-operative leg.
• Complete only one step at a time and always have help.

CAR TRANSFERS:
While you are recovering from knee surgery you will need someone to help you with getting in and out of the car for both your safety and comfort. The seat would ideally be at the height of your mid thigh. Avoid cars with low or bucket seats.
• Have someone slide the seat back as far as possible prior to entering the car, preferably on the front passenger side.
• Slightly recline the seat back if possible.

Common Football Injuries

Common Football Injuries

- Blog, Sports and Fitness

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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

Backpack Safety

Backpack Safety 101

- Back, Blog, Pediatrics

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It’s that time of the year again when the kids are heading back to school. Learn the proper guidelines and precautions about backpack safety in this week’s PTandMe blog post.

Size
• Should Not Extend Above Shoulders
• Should Rest In Contour Of Low Back (Not Sag Down Toward Buttocks)
• Should Sit Evenly In Middle Of Back

Fit
• Shoulder Straps Should Rest Comfortably On Shoulders And Underarms, With Arms Free To Move – Tighten Shoulder Straps To Achieve This Fit
• Tighten Hip And Waist Straps To Hold Pack Near Body
• Padded Straps Help Even Pressure Over The Shoulders

Weight Of Pack
• Should Never Exceed 15% Of The Child’s Weight To Avoid Excess Loads On The Spine

backpack

Lifting Of Pack
• Proper Lifting Is Done By Bending The Knees, Squatting To Pack Level, And Keeping Pack Close To Body To Lift First To Waist Level And Then Up To Shoulders

Carrying The Pack
• Keep Both Shoulder Straps In Place And Pack Centered
• Spinal Forces Increase With Distance From The Body’s Center

Posture
• Uneven Stresses On The Spine Can Cause Muscle Imbalances. This Can Lead To Pain And Possibly Functional Scoliosis.

Plantar Fasciitis

Hamstring Tightness and Plantar Fasciitis

- Blog, Foot, Leg

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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

- Blog, 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