Tag Archives: Sports Medicine

ATC Tip: The Labrum

December 13, 2017 Teresa Stockton - Blog, Shoulder

Anatomy of the Shoulder
The shoulder can move in almost every plane of motion, it’s the most mobile joint in the human body; but more mobility = more instability. The shoulder joint is often described as a “ball in socket,” but it’s wide range of motion makes it a highly vulnerable joint. We have a network of soft tissue structures, such as the rotator cuff and ligaments, whose main job is to keep the humeral head in its assigned seat. However, often these muscles alone are not sufficient as they can become weak or tight and thus less efficient. The labrum is a small ring of cartilage that provides additional stability to the shoulder joint.

How Does a Labrum Become Damaged?
Direct trauma, shearing forces, or repetitive stress can cause damage to the labrum. Often, this damage will present as a tear in the labrum, which can restrict motion, decrease strength, and cause pain in the shoulder. Picturing that ring of cartilage, imagine a roughening of the edges of the bowl-like golf tee, or even a rip that flaps when the ball is spun around. It is not uncommon for a shoulder dislocation or subluxation to be accompanied by a labral tear; chronic shoulder instability can also lead to labrum injury.

What Does a Labrum Do?
Because the “ball and socket” is so shallow, the shoulder joint is often described, quite accurately, like a “golf ball sitting on a tee.” To picture the shoulder labrum, imagine a ring around the outer edge of a golf tee, effectively deepening the overall bowl shape, almost suctioning the humerus into the space. The labrum helps stabilize the shoulder by making the “ball” more difficult to remove from the “tee.”

How Can I Prevent a Labrum Injury?
The best way to prevent a labral tear is to strengthen the musculature surrounding the shoulder joint. The best case scenario is all of the muscles are working together to keep the shoulder joint moving fluidly through its full range of motion. Important within this group of muscles are the muscle that control the shoulder blades. By strengthening the stabilizing muscles individually and functionally, it helps them stay balanced and strong with the other, stronger muscles (like the RTC). The other way to prevent a labrum tear is to avoid excessive contact, repetitive overhead motions, and falls.

This article about athletic injuries was provided by PT & Me physical therapy partner: The Center for Physical Rehabilitation. More information about the center and their locations throughout Grand Rapids, MI can be found on their website at www.pt-cpr.com

To see a shoulder strengthening program visit our Sports Medicine Tip Page by clicking here.

Common Causes of Knee Injuries

November 15, 2017 Teresa Stockton - Blog, Knee

While most of us take our knees for granted, injuries can occur quite easily and for a variety of reasons. Only when you suffer a knee injury, do you realize how much we rely on these joints on a day to day basis. Knee injuries cause discomfort and pain, but that’s not all. They can also be extremely debilitating and in serious cases, result in dramatically reduced mobility. So let’s take a look at some of the most common causes of knee injuries, and what to do in case you experience one.

What Are the Most Common Knee Injury Causes?

Well, there are a number of them – some more serious than others. Let’s take a look at some of the most common ones!

Fractures: Fractures are very common knee injuries and can affect the patella, which is the most commonly fractured bone around the knee. Fractures can also affect the ends of the tibia and femur in the area where they come together to form the knee joint. Incidents such as serious falls and road traffic accidents are common causes of fractures. And sometimes even the best knee brace for running or other sports won’t be able to prevent a fracture.
Dislocated knee: Knee dislocation is another common knee issue and it occurs when the knee bone is either partially or totally out of place. This could include the patella slipping or the femur and tibia sustaining injury that forces them out of alignment. Various different sports activities as well as falls and other high impact trauma can cause this injury.
Torn ligament: Tearing of the anterior cruciate ligament is also a common type of knee injury. This is more common among those that take part in athletics and sporting activities. Some of the common causes of this injury include a rapid change in direction when running or incorrectly landing from a jump. In many cases, this sort of injury also comes with additional injuries to the cartilage.
Torn tendons: This type of injury is more common among older people, particularly those who are active runners or do any sports that require a lot of running. The tendons of the patella can become stretched and then torn during this type of activity. Direct force to the front of the knees, falls, and incorrect landing following a jump are all common causes of a torn tendons.

There are many different causes of knee injuries, but usually they involve some sort of high impact trauma. This is why these types of injuries are often sustained by athletes as well as people who are keen on physical activities. Falls, incorrect landings following a jump, and the twisting of the knee can all cause various different knee injuries.

The knees are among the most easily injured joints in the human body, and also one of the most common reasons for people seeing their doctor. So in the event of a knee injury, no matter what the cause, it is important to seek medical advice because a knee injury can escalate from simple twisting of the knee to a dislocation or worse pretty quickly. Because the treatment for a knee injury varies based on the severity as well as the type and cause of the problem, ranging from medication and physical therapy to even surgery, consulting a medical professional is the first step to treating your knee successfully.

More information about common knee injuries can be found in the PTandMe injury center.

Most Common Hockey Upper Body Injuries

October 3, 2017 Teresa Stockton - Blog, Sports and Fitness

Hockey season is getting ready to start and the sport of hockey can be quite dangerous. It is important for players to know how to prevent and treat injuries that occur during games. Unfortunately, these injuries leave us with some questions with descriptions such as “lower-body” and “upper-body” injuries. These injuries are purposely vague to leave some question as to the exact nature of the injury.

The accompanying infographic gives players an assist by listing off some common “upper body injuries.” It features tips and tricks to remain healthy both on and off the ice. The following should ease the minds of players who want to play the game as safely as they possibly can.

Click arrows in the bottom right corner to expand full screen

Upper Body Injuries by Pro Stock Hockey, an online resource for authentic pro stock hockey equipment (https://www.prostockhockey.com/)

Age Appropriate Strength and Performance Training

August 17, 2017 Teresa Stockton - Blog, Pediatrics, Sports and Fitness

In recent years there has been discussion on training for our adolescent athletes and what is appropriate, whether it be how much, how soon, how specialized? Here are some answers to common strength training questions we hear:

When Can My Athlete Start Lifting Weights?
The NSCA’s position statement states pre-adolescence (7-8 y/o) is a safe age to begin resistance training with graduated modalities and loads. Basically, if the athlete is ready for organized sports, they are ready for some kind of resistance training.

Why Can’t I Just Buy a Blu-Ray Workout for My Adolescent to Train By?
No athlete is the same, and doing a cookie-cutter workout without properly screening for potential injury risk would be negligent. The risk is too great to potentially hurt an athlete by trying to perform exercises their bodies cannot physically handle.

What Should I Look for with Overtraining?
Ongoing decreased performance on field. Often injured or sick. Disengagement from sport and school. Mood swings. Physically tired all the time. Sleep issues. Overreactive emotional response to failure. Depression. Nutrition issues.

A strength training and conditioning specialist can screen each athlete’s movements in order to determine a baseline level of movement and strength. They then develop exercises and drills that will enhance the good movement qualities while addressing any bad motor patterns that may exist. Main components that are often noticed by trained professionals are mobility(flexibility) and stability (strength) issues.

For more on strength & conditioning or to inquire about training with the Center for Physical Rehabilitation at the Academy for Sports & Wellness, please visit: www.pt-cpr.com/academy

Guidelines to Prevent Throwing Injuries

July 13, 2017 Teresa Stockton - Blog, Elbow, Shoulder, Sports and Fitness

In this monthly series, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.

WRIST EXTENSION
Start with the arm supported on a table and your wrist facing toward the ground. Hold the weight off the edge of the table and bring the back of your hand toward the ceiling.

WRIST FLEXION
Start with the arm supported on a table and your wrist facing toward the ceiling. Hold the weight off the edge of the table and bring your palm toward the ceiling.

ASMI GUIDELINES TO HELP PROTECT PITCHERS FROM SHOULDER & ELBOW THROWING INJURIES:

Don’t throw too much:
Daily, weekly and annual overuse is the greatest risk to a pitcher’s arm health. Numerous studies have shown that pitchers who throw more pitches per game and those who do not adequately rest between appearances are at an elevated risk of injury. While medical research does not identify optimal pitch counts, pitch count programs have been shown to reduce the risk of shoulder and elbow injury in Little League Baseball by as much as 50% (Little League, 2011). The most important thing is to set limits for a pitcher and stick with them throughout the season.

Don’t pitch through arm fatigue:
Individuals are 36 times more likely to develop shoulder and elbow injuries when routinely pitching with arm fatigue.

Don’t pitch more than 100 innings per year:
If an athlete throws over 100 innings they are 3.5 times more likely to be injured than those who did not exceed 100 innings pitched.

Don’t throw more than 8 months per year:
Athletes who throw > 8 months per year are 5 times as likely to suffer an injury requiring surgery of the elbow or shoulder. Pitchers should refrain from throwing for at least 2-3 months per year and avoid competitive pitching for at least 4 months per year.

Don’t pitch on consecutive days:
Pitchers who pitch on consecutive days have more than 2.5 times greater risk of experiencing arm pain.

Don’t play catcher following pitching:
If the player catches following pitching they are 2.7 times more likely to suffer a major arm injury.

Don’t play on multiple teams at the same time:
There is increased risk of injury due to the difficulty in monitoring pitch limits and rest time. If the player is on multiple teams, make meticulous efforts to keep track of the amount of pitches thrown to allow adequate rest.

Don’t forget the shoulder in strength and conditioning programs:
Numerous studies have shown that deficits in upper extremity strength and mobility are strongly correlated to serious arm injuries. Shoulder and forearm strengthening exercises can build strength, endurance and motor control which can prevent injury.

Be cautious with throwing curve balls and sliders:
While existing research has not consistently shown a strong connection between the curveball and injuries, Yang et al., found that amateur pitchers who threw curveballs were 1.6 times more likely to experience arm pain while pitching and Lyman et al, found that youth pitchers who throw sliders are 86% more likely to experience elbow pain.

Be cautious with the radar gun:
Radar guns do not directly cause harm to a pitcher, however, the gun may cause the pitcher to over throw beyond their normal comfort level. This could possibly create arm strain.

Following these guidelines may keep the throwing athlete safe from the debilitating shoulder and elbow throwing injuries seen on a regular basis in physical therapy clinics.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. They specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Their staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

What We Know About Concussions is Changing

June 29, 2017 Teresa Stockton - Blog, Pediatrics, Sports and Fitness

As concussion research continues we’ve learned that a few of the things we have held as truth isn’t entirely accurate. Including the fact that a person with a concussion shouldn’t be allowed to sleep for long periods of time. So let’s take a look at how concussion treatment is evolving from what was… to what it is now.

Old School vs. New School Concussion Treatment
The first step to treating a concussion is to seek medical help. Your health care provider is knowledgeable and can help you or your child return to work or sport safely.

Old School Concussion Rehabilitation

It’s just a “Mild, Grade-1” concussion.
They didn’t have loss of consciousness, it’s not a concussion.
Should we have a CT scan or MRI?
An athlete needs to be hit on the head to sustain a concussion
Injury to the brain only occurs at the initial impact of the concussion.
Should I wake them up every couple of hours?
Male athletes have a higher chance of sustaining a concussion than females.
He’s young, he’ll bounce back quick.
Protective equipment will prevent concussion if the newest modelis used.

New School Concussion Rehabilitation

Medical professionals with “up-to-date” education on concussions will not use the historic grading scale. The grading scale has been abandoned in favor
of a symptom-based, multi-faceted approach to concussion management that emphasizes the use of objective assessment tools aimed at capturing the spectrum of clinical signs and symptoms,cognitive dysfunction and physical deficits, and a symptom-limited, graduated exercise protocol leading to a return to play.
Approximately 90% of concussions are NOT accompanied with loss of consciousness.
Conventional CT or MRI scans will not diagnose a concussion and are not needed or recommended for the vast majority of sport related concussions. While these types of neuroimaging are crucial in the diagnosis of intercranial hemorrhaging and detecting brain lesions, approximately 78% of concussions will have normal scans.
Concussions can occur with any movement or jostling of the head as in whiplash injuries or rotational force, causing injury to the brain.
Traumatic brain injury is an evolving process at the microscopic level of thebrain. Chemical and metabolic changes occur for days, weeks to months after impact. That is why it is important to prevent any additional concussions andavoid a second impact syndrome during this time period.
Encourage plenty of rest with uninterrupted sleep. Since fatigue and drowsiness are common symptoms associated with concussions, sufficient sleep will allow the brain to heal and is necessary for recovery.
Studies show a higher probability in female vs. male athletes. This is likely due to their genetic make up and the fact that women are more likely to self report symptoms vs their male counterparts.
Due to their continued brain development at these ages, children and adolescents actually recover more slowly.
Evidence shows that protective equipment such as helmets, mouth guards and other protective devices may lower risk but no equipment eliminates the risk of concussion

This article about concussions was provided by PTandMe physical therapy partner: The Center for Physical Rehabilitation. More information about the Center and their locations throughout Grand Rapids, MI can be found on their website at www.pt-cpr.com

Additional articles from PTandMe about concussions can be found here:

Guidelines to Prevent Throwing Injuries

June 15, 2017 Teresa Stockton - Blog, Shoulder, Sports and Fitness

In this monthly series about how to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.

PRONE ROW
Lay on your stomach with your arm hanging off the edge toward the ground. Squeeze your shoulder blade and bring your elbow toward the ceiling while keeping your forearm perpendicular to the ground.

PRONE ROW WITH EXTERNAL ROTATION
Lay on your stomach with your arm hanging off the edge toward the ground. Turn your wrist so your palm is toward your feet. Squeeze your shoulder blade and bring your elbow toward the ceiling while keeping your forearm perpendicular to the ground. Once your arm is parallel with the ground rotate the back of your hand toward the ceiling while keeping the elbow bent.

PRONE T (HORIZONTAL ABDUCTION)
Lay on your stomach with your arm hanging off the edge toward the ground. Lift your arm straight out to your side and squeeze your shoulder blade with the palm continuing to face toward the ground.

PRONE Y (SCAPTION)
Lay on your stomach with your arm hanging off the edge toward the ground. Lift your arm at a 45 degree angle over your head with your thumb facing toward the ceiling. Squeeze your shoulder blade down and toward your spine.

See the entire Guidelines to Prevent Throwing Injuries series here:

PT News

May 23, 2017 Teresa Stockton - Blog, PT News

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

1. Decreasing Cartilage Loss in Osteoarthritis
Written by the Therapy Team at The Jackson Clinics Physical Therapy – Northern Virginia

Although some over-the-counter nutritional supplements have been advertised as capable of rebuilding cartilage in arthritic joints, the claims most often do not stand up under scientific scrutiny. Read more

2. Treating Degenerative Meniscus Tears
Written by the Therapy Team at The Jackson Clinics Physical Therapy – Northern Virginia

During the aging process, the fibrous cartilage between the thighbone (femur) and the shinbone (tibia) within the knee can degenerate and become prone to tearing. Read more

3. Five Stretching Tips Before You Workout
Written by the Therapy Team at Momentum Physical Therapy – San Antonio, TX

As temperatures start to warm up, many of you will start to hit the streets, trails, and parks to exercise outdoors. Read more

Guidelines to Prevent Throwing Injuries

May 18, 2017 Teresa Stockton - Arm, Blog, Elbow, Shoulder, Sports and Fitness

In this third intallment of our series to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.

INTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high up on a doorway and face away from door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the ceiling. Rotate from your shoulder bringing your hand forward while keeping your arm parallel to the floor and your elbow bent to 90 degrees.

EXTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high on a doorway and face toward the door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the door. Rotate from your shoulder bringing your hand away from the door while keeping your arm parallel to the floor and your elbow bent to 90 degrees.

SHOULDER INTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising closest to the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand toward your stomach while keeping the elbow bent to 90 degrees.

SHOULDER EXTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising furthest from the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand away from your stomach while keeping the elbow bent to 90 degrees.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

Want to be a Physical Therapist?

May 9, 2017 Teresa Stockton - Blog, General Information

PHYSICAL THERAPIST
WHAT DO THEY DO?
PTs are health care professionals who provide rehabilitation for musculoskeletal issues.
Rehabilitation includes programs focused on:

Strengthening
Range of motion
Balance training
Functional training
Gait training
Return to work programs
Pain reduction

Physical therapist’s goal is to return patients to a normal life, that is pain free.

HOW TO BECOME A LICENSED PHYSICAL THERAPIST?
1.) Bachelor’s degree, that includes required Prerequisites for PT schools of your choice.
2.) Doctorate degree from credited school which includes a number of hands on clinical experiences.
3.) Apply & sit for licensure exam in state, you choose to work.

PHYSICAL THERAPIST ASSISTANT
WHAT DO THEY DO?
Work as part of the Rehabilitative team to provide physical therapy services under the direction and supervision of the physical therapist.
PTAs implement:

Selected components of patient/client interventions (treatment)
Obtain data related to the interventions provided
Make modifications in selected interventions either to progress the patient/client as directed by the physical therapist

HOW TO BECOME A PTA?
1.) Attend CAPTE – accredited associated program
2.) Apply & sit for licensure exam

JOB SETTINGS: Any setting in which a PTA can work

CERTIFIED ATHLETIC TRAINER
WHAT DO THEY DO?
Certified Athletic Trainers (ATCs) are health care professionals who work alongside physicians to provide:

Preventative services
Emergency care
Clinical diagnosis
Therapeutic intervention
Rehabilitation of injuries and medical conditions

Certified Athletic Trainers can help you avoid unnecessary medical treatment and disruption of normal daily life.

HOW DO I BECOME A CERTIFIED ATHLETIC TRAINER (ATC)?
1.) Graduate from a bachelors or master’s degree program accredited by the Commission on Accreditation of Athletic Training Education (CAATE).
2.) Pass the certification examination conducted by the Board of Certification (BOC).
3.) Once certified, he/she must meet ongoing continuing education requirements in order to remain certified.
4.) Athletic trainers must also work under the direction of a physician and within their state practice act.

JOB SETTINGS

Colleges & Universities
Hospital & Clinical
Occupational Health
Military
Performing Arts
Physician Extender
Professional Sports
Public Safety

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy practice with locations in Georgia and Florida, that focuses on providing the highest quality rehabilitation services. For more information click here.