Work Out? How A PT Can Enhance Your Training

How Physical Therapy Can Take Your Workout to the Next Level-

There is no denying that exercise and working out produce a long list of benefits for your physical and emotional well-being. Reducing risk factors for developing chronic diseases, preventing injury, improving brain health, strengthening bones and muscles, managing your weight, improving ability to do functional activities, reducing stress, anxiety and depression are only a few of the benefits you will receive by participating in regular physical activity. 

Whether you love running or biking, olympic weight lifting or crossfit, yoga or hiking, at some point in time you may start thinking about how you can enhance your performance in these activities. Most of us think about personal trainers or coaches as the primary resource for learning how to optimize your performance and progress in your ability but today we are going to talk about how physical therapists can play an important role in enhancing your training. 

WHAT MAKES A PT QUALIFIED TO HELP YOU IN THIS AREA?

Physical therapists help people live healthy and active lives. The American Physical Therapy Association defines physical therapists as movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education. Many people think about physical therapists as professionals who help people recover from injury, which is certainly true, but physical therapists also work with people who just want to become healthier, perform their sport or activities better, and prevent injuries before they happen. 

While some seasoned physical therapists may have a bachelor’s degree in physical therapy, the majority of practicing physical therapists have a master’s or doctorate level education in movement and exercise. They go through rigorous education on anatomy, physiology, and biomechanics to understand how the body should work. They also undergo extensive education on exercise physiology, disease, injury, and dysfunction of the body as a platform on which they build their skills as rehabilitation professionals who work to restore optimal movement and prevent recurring injury. 

While other exercise professionals and coaches have a great depth of knowledge in exercise principles and training for different sports, a physical therapist has a great depth of knowledge in exercise principles and training specifically for you, as an individual whose body may have capabilities and injuries that necessitate a more individualized training plan.

IS A PHYSICAL THERAPIST THE RIGHT RESOURCE FOR ME?

If you’ve been reading this article and wondering if a physical therapist is the right resource to help you enhance your training keep reading below to see if you fit into one of these categories.

I have an injury or am experiencing pain/discomfort: No matter the type of workout you are engaged in you may find yourself experiencing pain or discomfort during or after you exercise. There are many potential causes to injury, pain, or discomfort during a workout but without understanding the cause it’s hard to fix the problem. A physical therapist can help you with this in many ways:

• They will perform physical assessments and special tests to examine the area of pain or discomfort to better understand it’s origin.

• They will perform physical assessments of related areas and movement analyses of your specific workout components to see if deficiencies in strength, flexibility, stability, or motor control may be causing extra stress and strain on the area of pain or discomfort.

• They will create a treatment plan to help rehabilitate the injury or reduce pain and discomfort while staying active and getting stronger and more injury-proof.

• They can advise you on how to modify either temporarily or permanently the workouts and exercises you love to increase your ability to perform them pain and injury-free.

• They will educate you on how to self-monitor your own positions and performance during your workouts so you will feel confident in your ability to return to full activity after discharge from physical therapy while limiting the chance for re-injury.

I want to start training more, differently or at a higher intensity or become more competitive but I don’t want to injure myself: You have been working out for some time but are ready to take it to the next level. This may mean entering races or competitions, lifting heavier weights, trying new compound moves, or going longer distances. Whenever you increase any component of training such as time, speed, or intensity, you may experience an increased risk for injury if your body is not prepared to handle the new load. Here are several ways consulting a physical therapist with special knowledge in your sport or workout can help:

• PT’s are movement experts and a PT with extensive knowledge in your sport or workout will understand what optimal movement or mechanics look like for each component of your workout.

• Since they know what is needed to enhance your performance of a particular skill they will next examine your body and your movement performance to see how your strength, flexibility, power, agility, etc. line up with the demands of the skill.

• If areas of deficiency are noted in your performance then your PT can create a plan to fix them.

• They can also advise you in proper warm up and cool down routines as well as any cross-training that would both reduce your injury risk and improve your performance on your favorite workout.

I have a history of disease, surgery, or injury and I could use some guidance on how to safely enhance my training and workouts: As long as you have been cleared to exercise by your physician, finding ways for you to workout more or differently is something PT’s love to do. Because physical therapists have a strong background in injury, disease, and differential diagnosis they are specially positioned to help those who may be unsure or intimidated by working out, get more comfortable.

• A PT will get a thorough medical and surgical history and work with your doctors to understand if there are any precautions or contraindications for exercise.

•  They will find out what kind of exercise and workouts excite you and what concerns you have about starting or progressing these workouts.

• They can teach you safe and effective modifications to activities when needed to help you perform your workouts safely and effectively.

• They can monitor things like heart rate, blood pressure, or oxygen saturation while you exercise to keep you safe and help you monitor your body’s response to the workout.

• They can provide you with a program of exercises and activities to supplement your favorite workouts to manage pain or discomfort and reduce injury risk.

So as you can see, physical therapists can help you optimize and enhance your workouts whether you are fighting off an injury or wanting to prevent one. With a unique combination of knowledge in disease, injury, and movement dysfunction with expertise in movement and exercise PTs want to help you take your workout to the next level. 

Click here for more information about sports physical therapy for athletes

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Brooklyn Locations!

1-718-258-3300

https://EvolveNY.com 

Addressing Ankle Pain with Physical Therapy

What a Pain in the Ankle!

Looking for Answers to Ankle Pain?

Ankle pain, whether new or chronic, can seriously interfere with being on your feet. If sitting down all day isn’t an option, physical therapy is a great choice for identifying the cause of your ankle pain and taking steps to getting a handle on your symptoms.

LET’S EXAMINE THE ANKLE CLOSER

The ankle is a hinge joint where the primary motion is to lift and point the foot. If we look at an image of the ankle joint you will see the larger inner bone of the lower leg leg called the tibia and the thinner outer bone called the fibula articulate with a bone called the talus in the posterior part of the foot. Beneath the talus lies the calcaneus or heel bone. Many ligaments, muscles. and tendons travel between the bones of the lower leg and foot, crossing the ankle joint. 

Because of the complex anatomy in the ankle area, there are many potential sources of ankle pain or discomfort. In this article we will take a look at some of the more common causes of pain and how physical therapy can treat these conditions. 

COMMON CAUSES OF ANKLE PAIN

Posterior Ankle Pain 

• Posterior Ankle Impingement: symptoms of this condition include posterior ankle pain with forced plantarflexion (pointing of the toe or pushing off of the toe). It results from compression of the soft or bony tissue between the tibia and the calcaneus. Some people have a small extra bone in their ankle called an O’s Trigonum which can increase the compression. On occasion a large amount of force through the ankle joint can cause small fragments of bone to fracture and become compressed when the toe is pointed. Inflammation and swelling in this area leads to pain.

• Achilles tendinopathy or rupture: pain felt behind the heel and up the back of the ankle may indicate an irritation of the achilles tendon, the long tendon that connects the calf muscles to the bottom of the foot. This irritation may be a result of an acute or sudden trauma or from repetitive microtrauma and can cause discomfort when walking, running, jumping, or climbing stairs. Tenderness when pressing the achilles tendon, stiffness and pain especially during first steps, and swelling in the back of the ankle are characteristic of this condition. In the case of a tendon rupture or tearing of the tendon, calf weakness, bruising, swelling, and pain result. A full rupture can typically be identified by squeezing the calf muscle with your hand and observing a lack of toe pointing indicating the connection between the calf muscle and foot has been disrupted. 

Lateral Ankle Pain

• Ankle sprain: rolling your ankle outward, can cause an acute ankle inversion sprain. There are three ligaments on the outside of the ankle that can be injured when stretched beyond their normal capacity. These ligaments are the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL) and the posterior talofibular ligament (PTFL). Tenderness over the involved ligament is common. Depending on the severity of the sprain you may notice bruising, swelling, stiffness, and if the sprain is severe, laxity or instability of the ankle.

• Peroneal tendon injury: Two peroneal muscles run along the outer lower leg and their tendons travel behind the ankle bone (known as the lateral malleolus) and attach at the outer midfoot and beneath the foot. These muscles are tasked with stabilizing the foot and helping to prevent sprains and injuries. Symptoms of peroneal tendon injury can come on suddenly or over time and include pain or tenderness along the lateral lower leg or ankle. Warmth or swelling may be noticed in the lateral ankle and a pop may be heard with a sudden injury. Increases in activities such as running, jumping or walking, a sudden trauma to the ankle, having high arches and wearing inappropriate footwear can contribute to this type of injury

• Sinus Tarsi Syndrome: this clinical syndrome is characterized by pain in the lateral foot just below the ankle in an area called the sinus tarsi. It is thought to be caused by inflammation and scar tissue formation possibly brought on by abnormal mechanics in the joint between the talus and calcaneus. Recurrent ankle sprains causing instability may be a predisposing factor.

Medial Ankle Pain

• Ankle sprain:  rolling the ankle inward so that the outer edge of the foot lifts up is called an eversion sprain. The primary ligament involved in this type of sprain is called the deltoid ligament, a strong, flat, triangular band composed of four separate ligaments. Tenderness over the deltoid ligament is common with this type of injury. Depending on the severity of the sprain you may notice bruising, swelling, stiffness, and if the sprain is severe, laxity or instability of the ankle.

• Medial ankle stress fracture: a stress fracture refers to a weakening of one area of bone caused by repetitive breakdown of bone without sufficient rebuilding. It is considered an overuse injury and seen most commonly in track and field athletes and military recruits who walk long distances with heavy packs. In the ankle, pain and tenderness along the inner ankle bone called the medial malleolus may indicate a tibial stress fracture. Initially the pain is present during activity and will improve with rest but over time it may become more constant and be accompanied by tenderness to touch over the area and swelling or bruising. 

• Posterior tibial tendonitis: The tibialis posterior muscle runs along the inside of the calf muscle and its tendon travels behind the medial ankle bone and attaches under the arch of the foot. Pain or swelling along the inner ankle or arch of the foot especially with standing or walking and increased pronation or flattening of the arch are common with this condition. Overuse or sudden trauma can trigger this condition

• Tarsal Tunnel Syndrome: Running parallel to the tendon of the posterior tibialis, the tarsal tunnel is a dense band of fibrous tissue that creates a tunnel through which the tibial nerve, several tendons, and the blood vessels traveling to the foot, course. Similar to carpal tunnel in the wrist, compression of the tibial nerve as it passes through the tarsal tunnel can cause burning, tingling, electrical shock pain, and numbness in the inner ankle and/or bottom of the foot

Anterior Ankle Pain

• High ankle sprain: In contrast to the much more common lateral ankle sprain, the high ankle sprain involves injury to the ligaments that connect the tibia bone to the fibula bone just above the ankle. This ligamentous connection helps stabilize the ankle joint and typically has very minimal movement so a large force is needed to disrupt and injure this area. It is important to correctly diagnose this injury as it typically requires longer times to heal and can result in more chronic ankle instability than other ankle sprains.

• Anterior Ankle Impingement: Ankle instability, bone spurs, and repeated stress at end range positions of squatting, jumping, or descending stairs can cause this condition that leads to pain in the anterior aspect of the ankle. A history of repeated ankle sprains may predispose one to this condition as scarred ligaments take up more room in the joint space leading to compression and inflammation. 

PHYSICAL THERAPY FOR ANKLE PAIN

Identifying the cause of your pain is the first order of business when a physical therapist assesses your ankle. If your physical therapist suspects a more serious injury such as a tibial stress fracture or high grade ankle sprain they may refer you back to your doctor for imaging to determine if surgery, modifications to weight bearing, bracing, or casting are needed. 

If you are being treated for an acute injury such as a tendon injury or sprain, your physical therapist will educate you on how to protect these newly healing tissues. Treatment may include compression or bracing, offloading the injured area through crutches, modalities such as ice, ultrasound or electrical stimulation to reduce pain and swelling, and activity modification. 

In the case of well-healed tissues, chronic injuries like tendinopathy or ankle impingement, or a well-healed stress fracture your physical therapy program will focus not only on reducing or eliminating localized symptoms but on addressing factors that contributed to the onset of the symptoms. Often chronic injuries or pain in the ankle are caused by repeating faulty movement patterns or having an imbalance of muscle strength and length to carry out a task such as walking, running,or jumping. Optimizing muscle strength and flexibility and improving motor control and mechanics of the lower limb is important for returning to prior activities and reducing the likelihood of the injury recurring. 

While some ankle injuries may require intervention by a doctor or surgeon, a physical therapist should always be a primary member of your care team. A physical therapist at Evolve can help you get on the road to recovery. Our therapists do not just treat symptoms, but we get to the root of the cause. We strive to enable our patients to live pain free, and prevent the recurrence of related issues

Click here for more information about physical therapy for your ankles!

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Look out Gravesend, Evolve Physical Therapy is Coming Your Way

Evolve Physical Therapy is Growing to Gravesend!

And Gravesend Makes Four: Evolve Physical Therapy Opens a New Location in Brooklyn

Check it out, Brooklyn, Evolve Physical Therapy + Sports Rehabilitation is growing! We are very excited to announce a brand new flagship location in Gravesend on Avenue U. Construction is wrapping up as we speak and we are thrilled that we will have the opportunity to serve more of our community members. 

Since our first location opened its doors in 2010, Evolve Physical Therapy + Sports Rehabilitation has been providing physical therapy, post-operative care and pain relief to the people of Brooklyn. After hearing so many experiences of unsuccessful physical therapy treatment we knew it was time to get to work. We have always believed that long term health and recovery is achievable through physical therapy and we set forth to build a model of care that is holistic, patient-centered and focuses on addressing the root cause of pain and injury, and the dysfunction they are causing. 

If you’ve been to our Marine Park, Mill Basin, or Park Slope locations already then you know how much detail and attention we put into designing our clinic spaces. Our new Gravesend location is no exception and we can assure you this place will look good. But more importantly you will feel great after working with one of our skilled therapists who will provide you with the one on one attention that quality physical therapy care necessitates. 

From pediatrics to post-surgical care, neurologic rehab to sports injury recovery, we’ve got a team member ready to get you on the road to recovery. Let us show you what high quality physical therapy care looks like when provided by a team of therapists passionate about their profession and the impact they can make on the people of New York.  

Follow us on social media @Evolvefit4life to get a sneak peak at our progress and be the first to know when it’s time for the official grand reveal! Click here to find out more information about our new HQ location- https://evolveny.com/locations/gravesend-physical-therapy-brooklyn

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Help! My Jaw is Killing Me

TMJ PT or TMJ Doctor?

Should You Call the PT or the MD for Jaw Pain?

If you’ve ever suffered from tightness, popping, or pain in your jaw joint known as the temporomandibular joint (TMJ), then you may be familiar with a condition called temporomandibular joint dysfunction (TMD). According to the American Academy of Family Physicians, up to 15% of adults experience TMD with peak incidence occurring between the ages of 20 and 40 years old. In this article we will examine this condition further and discuss how to determine if seeing a TMJ physical therapy practitioner is appropriate or if a visit to a physician is needed.

WHAT AND WHERE IS THE TMJ?

The temporomandibular joint is located in front of the ear on each side of the face. It is the connection between the mandible or jaw bone and the temporal bone of the skull. It works a little like a hinge and a little like a ball-and-socket joint.  The two joint surfaces are separated by an articular disc and surrounded by fibrocartilage. Several ligaments stretch between the skull and the jaw bone to stabilize the TMJ. Muscles of the face and neck allow you to protrude and retract your jaw and elevate and depress it to open and close the mouth. 

WHAT DOES TMD FEEL LIKE?

Dysfunction of the TMJ can be caused by problems both within and outside the joint. Common symptoms include facial pain, jaw pain or soreness, jaw fatigue, earache or ringing in the ears. Additionally headache, popping of the joint, locking of the jaw, teeth sensitivity without dental issues, limited mouth motions, and changes in the way the teeth fit together can occur. Often these symptoms are more pronounced upon waking up and in the late afternoon. 

WHAT IS THE CAUSE OF TMD?

The cause of TMD is often thought to be multifactorial. Biological, environmental, emotional, social, and cognitive triggers for TMD exist. The incidence is higher in persons diagnosed with other conditions such as autoimmune conditions, sleep apnea, mental illness, or fibromyalgia. TMD can be the result of arthritis in the TMJ or from displacement of the articular disc. Jaw or facial fractures and surgery of the face or jaw may lead to TMD in some persons. Also problems with teeth alignment (malocclusion) and frequent jaw clenching (bruxism) can trigger TMD. Even poor posture habits can lead to TMD if repeated frequently.

SHOULD I GO STRAIGHT TO MY PHYSICAL THERAPIST?

Many physical therapists are trained in the assessment and treatment of TMD. Physical therapy has been shown to be effective in reducing pain and restoring motion to the jaw in many cases. It also has the benefit of teaching you how to manage the symptoms on your own if it recurs in the future. In some states you can schedule an evaluation with a physical therapist without a referral from a physician. Outside of those states you will need to see your physician first for a referral. 

Since physical therapy is a great option for managing your TMD, let’s take a look at some of the treatments offered by physical therapy to manage TMD symptoms:

Postural re-education: Poor posture including a forward head position and rounded shoulders can contribute to increased stress on the muscles around the jaw and on the TMJ. PT will assess for any postural abnormalities and teach you how to be aware of them and begin to correct them.

Manual Therapy to improve jaw mobility: Restoring the normal motions and mobility of the TMJ and jaw can be done through gentle hands on techniques either outside of the mouth or sometimes from inside the mouth. 

Strengthening Exercises: Exercises to strengthen the muscles around the jaw and neck can be very helpful in reducing symptoms of TMD, improving jaw range of motion, and reducing the likelihood of recurrence.

Dry needling, ultrasound, electrical stimulation: Your therapist may choose to apply these modalities to manage your pain and inflammation 

WHEN DO I NEED TO SEE MY DOCTOR?

If these symptoms are new to you it is always a good idea to visit your primary care physician or dentist and update them on how you are feeling. While we know that TMD is fairly common, it is not the only condition that can cause jaw pain or discomfort. Here are some other conditions that may mimic TMD but need evaluation and treatment by a physician or dentist:

Cluster headaches: one of the most painful types of headaches, a cluster headache often causes pain around or behind one eye but it can also radiate pain into the jaw.

Sinus infection: infected sinuses can cause pressure on the jaw joint causing discomfort and pain. Unlike TMD, however, sinus infections are often accompanied by congestion, facial pressure or pain, runny nose, throat irritation, fever, or tenderness over the sinuses.

Tooth Pain: Dental abscesses in a nearby tooth can cause pain to radiate into the TMJ and jaw. Sensitivity to chewing or biting, tenderness of the lymph nodes in the neck or jaw, and fever are other symptoms of a tooth abscess. 

Trigeminal Neuralgia: pressure or compression on the trigeminal nerve that is responsible for sensation in the upper and lower jaw area can mimic TMD to some degree. Numbness or tingling on one side of the face, pain in front of the ear, one-sided tooth pain, and electric-like shooting pain on one side of the face or jaw is common with this condition.

Heart Attack: The most serious and emergent condition listed here, some people will experience sudden-onset jaw pain during a heart attack. If you are experiencing jaw pain along with other symptoms such as chest pressure or pain, shortness of breath, lightheadedness, cold sweats, nausea or vomiting, or a sense of impending doom, call 911 immediately.  

Certain treatments may be prescribed by a physician or dentist that cannot be provided by a physical therapist to treat TMD symptoms. These may be necessary if you are experiencing severe symptoms interfering with eating or physical therapy treatments have not been successful.  Here are some examples of these types of treatments:

Medications: anti-inflammatories, muscle relaxants, or low-dose tricyclic antidepressants may be prescribed for pain management

Imaging: Imaging such as X-rays, CT Scans, or MRI may be recommended if a more in depth look at the TMJ is recommended 

Oral splints or mouth guards: These devices are typically worn at night to minimize teeth grinding and bruxism which may be causing increased muscle tension and jaw pain.

Surgical intervention: Various surgical options exist to address different causes of TMD. These may be recommended if conservative care has failed to successfully treat your symptoms.

Corticosteroid joint injections: used to reduce local inflammation

THERE IS HELP OUT THERE FOR YOU

After reading this article we hope you have a better understanding of how doctors, dentists, and physical therapists can treat your TMD symptoms. If you haven’t had the opportunity to try physical therapy, it is a great option to improve your symptoms and educate you on how you can manage your TMD symptoms in the future. If you have been suffering with symptoms of TMD, the physical therapists at Evolve are ready to help restore better jaw movement, provide symptom relief, and give you something to smile about. 

Click here for more information about TMJ/TMD treatments or if you are in need of immediate need of physical therapy for TMJ/TMD

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com 

Birth-Proofing Your Body with Prenatal PT

Prenatal PT: Pushing back against pain and preparing for childbirth

Taking Care of Aches and Pains with Prenatal PT 

Carrying a growing fetus, adapting to changing body proportions during pregnancy, and giving birth vaginally or by cesarean section is nothing short of a miracle, but there is no denying it is also one heck of a workout! Just as you probably wouldn’t choose to enter a marathon race without training or pick up the heaviest dumbbells on the rack during your first day at the gym, it’s wise to take steps to prepare the body physically for the demands of pregnancy and childbirth.

Physical therapists with training in prenatal care are an excellent resource to guide you through this preparation and to help address any aches and pains that may develop along the way. This article will address both how physical therapy can improve symptoms of pain or discomfort that might develop during pregnancy and how physical therapists can create an exercise plan to keep you comfortable and prepare your body for childbirth. 

IS EXERCISE SAFE DURING PREGNANCY?

Because every woman and every pregnancy is different, it is important to talk with your obstetrician to get the green light before beginning an exercise program. Generally, however, exercise that includes aerobic activity and specific strength and flexibility training is thought to improve the ease of pregnancy and birth and help with postpartum recovery. 

One study published in 2016 by Di Mascio et al. in the Journal of Obstetrics and Gynecology gathered data from several randomized controlled trials during which women with uncomplicated, singleton pregnancies performed aerobic exercise for 35-90 minutes, 3-4 times per week. Compared to those that did no aerobic training, the aerobic exercise group experienced a significantly higher incidence of vaginal delivery and lower incidence of delivery via cesarean section. They also had significantly lower rates of gestational diabetes and hypertensive episodes while the incidence of pre-term labor did not differ significantly between exercisers and non-exercisers. 

ADDRESSING PRENATAL PAIN

Pain and discomfort in muscles and joints is not uncommon during pregnancy, especially as it progresses. Before, during, and after childbirth a woman’s hormones are fluctuating significantly. Hormones such as progesterone and relaxin cause increased ligament laxity during pregnancy. This has the effect of allowing the pelvis to expand during the birth but also causes laxity in other joints such as the lower spine and hips. Because the ligamentous laxity tends to reach its height during the second trimester as a woman’s uterus is expanding, her belly is getting larger, and her posture is changing, low back, hip, and pelvic pain may develop. 

It is also possible to develop pain or discomfort outside of the lower back and pelvis. Prior lower extremity injuries may be exacerbated by changes in body proportions and aches and pains can even develop in the neck or upper body in response to repetitive activities or moving in new ways. If you are experiencing pain or discomfort, a physical therapist trained in antepartum (before childbirth) physical therapy can assess your symptoms and develop an individualized treatment plan. Also, they can advise you on which exercises are safest and most beneficial to perform during the first, second, and third trimesters. 

WHAT CAN I EXPECT DURING PRENATAL PT?

Prenatal physical therapy should always be individualized to each woman to address her specific needs. Here are some of the treatment techniques a physical therapist may prescribe:

Stretching, mobility and flexibility exercises:  Muscle shortness or tightness can cause discomfort and lead to pain during pregnancy. Flexibility and mobility limitations that may not have bothered you much before pregnancy should be addressed early to limit issues with pain and discomfort. Whether you are seeing your PT because you are already having pain or looking for ways to prevent its onset, your PT can help identify these issues and teach you targeted stretches and mobility exercises. 

Strengthening exercises: Strengthening exercises are key to managing joint or muscle pain during pregnancy and to help prepare the body for childbirth while shortening recovery times. If you are having pain in a certain area, your PT will progress you through a strengthening program targeted to the area of injury. If you are simply looking to develop a program of exercises to prepare your body for giving birth, then you can expect that your program will include exercises to strengthen the abdominals, the back, the pelvic floor and even the legs. 

Pelvic Floor Training: The pelvic floor muscles and tissues are undergoing changes throughout pregnancy and experience trauma during the birthing process. A pelvic health physical therapist can advise you on exercises to strengthen and prepare your pelvic floor for giving birth. There is much more to pelvic floor PT than kegals. These PTs can help address issues of pain, discomfort, or incontinence that might develop during pregnancy and teach you strategies for minimizing these issues after childbirth.  

Soft Tissue Mobilization: Increased muscle tension and decreased soft tissue mobility can exacerbate pain and discomfort during pregnancy. Your PT may choose to apply gentle soft tissue mobilization techniques to address pain and impaired tissue mobility.   

Diastasis rectus abdominus prevention: A diastasis rectus abdominus is a separation of the left and right outermost abdominal muscles known as the rectus abdominus. It most commonly occurs as a result of pregnancy. As the fetus grows, increased pressure is placed on the connective tissue between the two sides of abdominal muscles causing separation. It commonly develops during the second or third trimester and often will resolve on its own in the first few postpartum months. Sometimes, however, it will persist and can cause discomfort, feelings of weakness in the abdominals, low back, hip, or pelvic pain, and feelings of “flabbiness” in the abdominals. 

Physical therapy during the prenatal months can help decrease the likelihood of developing a diastasis rectus abdominus that does not heal quickly on its own. A program of specific abdominal and pelvic floor strength and stabilization exercises performed throughout pregnancy has been shown to be highly effective. 

Just as eating the right foods, getting enough sleep, and managing your stress can help with a healthy pregnancy and delivery, keeping a strong and flexible body should also be a priority. Physical therapy is a great resource for supporting your physical health and reducing pain and discomfort. Whether this is your first pregnancy or fourth, Evolve PT would love to be a part of your journey through a healthy pregnancy and delivery. 

Click here for more information about physical therapy for pregnancy

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Get Movin’: The Undeniable Benefits of Exercise

Got Exercise? How Exercise Keeps You Healthy, Feeling Young, and Disease Free…

Live Longer, Happier, and Healthier with Regular Exercise!

Did you know that exercise is one of the best things we can do to stay healthy, live longer, and manage disease? The Centers for Disease Control and Prevention report that one in two adults are living with one or more chronic diseases and that only 50% of adults get the physical activity they need to reduce and prevent chronic diseases. In total this results in around $117 billion in annual healthcare costs associated with inadequate physical activity. Depending on your access to health insurance you may be footing a hefty portion of that bill.

Whether you love to exercise, hate to exercise, or don’t mind exercising, the truth is humans are physiologically designed for physical activity. Before comfy couches, work from home, and access to modern amenities, our ancestors were hunter gatherers roaming large swaths of land to survive, moving with the seasons, and needing a body that was capable of sustaining them through heavy loads of physical activity. Despite the conveniences of modern life, our DNA still carries the blueprint of that active lifestyle and failing to move our bodies in a way that stresses it appropriately has serious consequences. 

BUT I DON’T ENJOY EXERCISE

If you aren’t naturally inclined to participate in regular exercise for enjoyment, let’s take a look at some of the health benefits of exercise that might provide a different source of motivation.

Most children are naturally active but certain circumstances such as living in an unsafe neighborhood, too much screen time, lack of access to sports or physical education classes in their homes and communities can encourage too much sedentary time. It is important, however, to find ways to encourage physical activity in children as it has been shown to reduce their risk for depression, improve bone health and favorable body composition, and even improve attention and some measures of academic performance (with school physical activity programs).

As we move through adulthood, the importance of physical activity continues and the benefits expand. Adults who participate in regular physical activity have lowered risk for high blood pressure and stroke, have improved mental health and cognitive function, lower risk for weight gain, and reduced arthritis symptoms. In older adults regular physical activity can even improve their sleep, extend years of quality, active life, improve their balance and joint mobility, and reduce their risk for falling. 

Additionally, research shows that regular exercise could prevent:

• 1 in 8 cases of breast cancer

• 1 in 8 cases of colorectal cancer

• 1 in 12 cases of diabetes

• 1 in 15 cases of heart disease 

HOW MUCH PHYSICAL ACTIVITY IS ENOUGH?

The 2nd Edition of the Physical Activity Guidelines for Americans outlines science-based recommendations for physical activity for all ages. Here are some of their findings:

• Children ages 6-17 should do 1 hour (60 minutes) or more of moderate to vigorous physical activity daily. If they aren’t getting this in school, it is important to find ways to encourage physical activity at home and in the community. The sixty minutes of activity should include aerobic activities like running or bike riding, muscle strengthening activities, and bone strengthening activities.

• Adults should aim to move more and sit less throughout the day. Substantial health benefits are gleaned from doing at least 150 minutes (2 hrs, 30 min) to 300 minutes (5 hours) a week of moderate-intensity or 75 minutes ( 1 hour, 15 min) to 150 min (2 hrs, 30 min) of vigorous intensity (or a combination) aerobic activity spread out throughout the week. They should also perform muscle-strengthening activities for major muscle groups of moderate or greater intensity on 2 or more days per week. 

• Older adults also gain substantial benefits from participating in physical activity and should participate in aerobic, muscle strengthening, and balance training weekly. If they have chronic conditions they should understand how their condition affects their ability to do regular physical activity and aim to get as close to the 150 minute recommendation for aerobic activity as they can, safely.

• For adults, there are some health benefits to doing any amount of moderate to vigorous physical activity even if they aren’t able to consistently meet the recommended amount.

• For adults with chronic health conditions or disabilities, it is recommended to meet the same physical activity recommendations outlined above for adults. When it is not possible to meet the above guidelines, they should avoid inactivity and engage in as much regular physical activity as possible.

• Adults with chronic conditions or symptoms should be under the care of a healthcare provider and consult a physical activity specialist or healthcare provider about the types and amounts of physical activity appropriate for their abilities and chronic conditions.

HOW CAN I INCREASE MY PHYSICAL ACTIVITY?

Now that you have learned all the amazing benefits of physical exercise and have an understanding of how much is recommended each week, it's time to make a game plan for your increasing activity throughout the week. Here are some suggestions for ways to meet these activity guidelines:

• Join a gym or local community center that has fitness classes

• Use sites like YouTube to find free exercise videos that require little to no equipment

• Clear out a space in your home to create a home gym 

• Take your children out on bike rides or walks after school or on weekends

• Join a community rec league for a sport that interests you

• Schedule your exercise time into your weekly calendar like you would an appointment

• Invite friends or family to exercise with you to make it more enjoyable

• Try different ways of exercising to find ones that are enjoyable for you

IS EXERCISE SAFE FOR ME?

Before you begin an exercise program you should consult your doctor to understand how any acute or chronic conditions may affect your ability to exercise. With this understanding, some people may still feel apprehensive about physical exercise if they are experiencing regular pain or living with chronic conditions that affect their movement and mobility. The physical therapists at Evolve are a great resource for addressing pain, movement, and mobility difficulties and helping you establish a safe and individualized exercise program. 

Don’t let these concerns stop you from engaging in physical activity. In most cases, the benefits of exercise far outweigh the risks when guided by knowledgeable exercise professionals. Physical therapy can help you start and progress your exercise journey so you can live longer in better health. No matter your age, physical activity can improve your life in many ways, it’s never too late to start! You may even find you enjoy it!

Click here to find out more information about our specific services for personalized workout routines, running and gait, and sports physical therapy

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Say Hi to Your SI (Joint)

What is the SI Joint?

The Lowdown on Your SI Joint…

The sacroiliac joint, ever heard of it? Maybe you’ve heard the term “SI joint.” Whether you’ve heard of it or not, if you are a human with a spine and a pelvis then you have a sacroiliac joint. In fact, you have two. 

The sacroiliac joints are the connections between the sacrum at the base of the spine and the ilium bones of the pelvis. If you take both of your hands and place them on the narrowest part of your waist then slide them downward until they are resting on top of the large crest of bones that wrap from back to front, you have found your ilium bones. The pelvis which connects the spine and the legs is formed by two halves, each made up of three bones–the flat and broad ilium that form the crest at the top, the pubis which is the lowest bone and connects with the opposite side and the ischium which is near the lower and posterior aspect of the pelvis and forms what we often call the “sit bones”. The three bones come together to form the socket of the hip joint. 

The sacrum itself is a flat, spade shaped structure near the base of the spine. It is positioned below the lumbar spine and above the coccyx. Just as the other areas of the spine above it–the cervical spine (neck), the thoracic spine (mid back), and the lumbar spine (low back) are made up of individual vertebrae stacked on top of one another, the sacrum is composed of five individual vertebrae. Unlike the segments of the spine above it, however, the sacral vertebrae eventually fuse into a solid mass of bone beginning in the 2nd- 3rd decades of life. On occasion some people are born with six sacral vertebrae or only four. Many muscles cross from the bony sacrum to the pelvis and the femur bone of the thigh.

As noted above, where the flat sacral bone meets the ilium on either side is called the sacroiliac joint. The articulation is enclosed by a fibrous joint capsule and filled with a lubricating fluid called synovial fluid. Several ligaments span between the sacrum and the ilium further stabilizing the bony connections. 

WHY IS THIS JOINT SO IMPORTANT?

Aside from acting as the only bony connection between the spine and pelvis, the SI joint’s main job is to stabilize this bony connection and to attenuate (reduce the effect of) forces traveling up the legs. While the joint is quite stable, it is capable of moving very small amounts as it absorbs the forces that travel up the legs toward the spine. 

WHY DO PHYSICAL THERAPISTS WORK WITH THE SI JOINT?

Sacroiliac joint pain and dysfunction can occur for a number of reasons. Pain that is felt at the base of the spine, near the buttocks, especially on one side (though both sides can be affected) may be SI joint pain. Walking, climbing stairs, or crossing your legs may provoke this pain. Pain radiating down into the buttocks is not uncommon. Often an inciting incident can be pinpointed though not always. 

Trauma such as a slip and fall, a car accident, or even repetitive trauma from sports or heavy weight lifting can cause irritation or injury to the ligaments of the joint causing inflammation and pain. Hypermobility conditions such as Ehlers Danlos Syndrome and the hormonal changes that occur in pregnancy can cause reduced tautness of the joint capsule and ligaments leading to instability and irritation. Arthritis and an inflammatory condition such as sacroiliitis can also cause SI joint pain and dysfunction. 

Because low back pain and SI joint pain can be confused for one another, physical therapists often perform a series of tests and assessments to differentiate between the two. Once SI joint dysfunction has been identified, a physical therapist can prescribe a rehabilitation program to restore normal mobility to the joint, stabilize it, reduce irritation, help the client return to their regular activities, and reduce the likelihood of the pain recurring. 

WHEN SHOULD I CALL A PT?

If you are experiencing pain or discomfort that sounds like it may be coming from your SI joint, the physical therapists at Evolve are ready to help. Not only can they identify the location of your pain, help you understand the condition, and begin to address your symptoms, but they will empower you with the knowledge and understanding to stay symptom free moving forward. If you are having pain, call for an evaluation today and get on the road to recovery. 

Click here for more information about physical therapy for back pain

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com 

Rotoscoliosis: A Twisted Tale of the Spine

Are You Living With Rotoscoliosis?

The human skeleton is designed to be balanced and aligned so that our muscles, tendons, ligaments, and organs can work optimally. But variation still exists within the bones and joints of individual skeletons. In some cases these variations go unnoticed unless picked up incidentally on imaging. In other cases they are visible to the naked eye and can affect the functioning of the body in small and large ways. In this article we will be discussing a condition of the spine that can have large implications on movement and daily functioning called rotoscoliosis.

LET’S TAKE A LOOK AT THE SPINE ITSELF

Balance between stability and mobility allows the spine to keep you standing tall but allows you the flexibility to bend, twist, and arch your back. Whether you are reaching down to pick your child up from the floor or hitting a hole-in-one on the golf course, appropriate spinal alignment and flexibility are essential. Let’s take a closer look at the anatomy of the spine. 

The spine is made up of five distinct segments. The seven vertebrae that make up the neck, known as the cervical spine, the 12 vertebrae that make up the mid back, or thoracic spine, and the 5 vertebrae that make up the lower back, or lumbar spine, create a long canal that houses the spinal cord. The broad and flat sacral bones sit beneath the last lumbar vertebrae and act as connectors between the pelvic bones and the spine. Beneath that, lies the coccyx or tailbone.

If you look at a model of a typical, healthy spine from the back or front it appears to be a straight column of vertebrae stacked on top of one another.  When you view the spine from the side, however, you will see that the spine is actually curved in several places. In the neck the spine curves toward the front creating a small arch or “lordosis” in the neck. It then switches directions and a gentle backwards curve or “kyphosis” can be seen in the thoracic spine followed by another reversal and lordosis in the lumbar spine. Even the sacrum and coccyx are slightly curved. This normal alignment of the spine allows for all of the movement we expect from the spine, proper shock absorption capabilities, and good alignment from the head to the feet. 

WHAT IS ROTOSCOLIOSIS?

Scoliosis is an abnormal curvature of the spine. It affects about 2% of women and 0.5% of men and can begin in infancy, childhood, adolescence, or adulthood. While a certain amount of curvature in the spine from front to back is normal, curvature that goes from left to right is characteristic of scoliosis. Several subsets of scoliosis exist based on the location of the abnormal curvature and its characteristics. Rotoscoliosis is used to define one of the most severe forms of scoliosis. The name comes from the word “rotation”. In this type of scoliosis the vertebral column is both curved toward the side and rotated. All scoliosis has a degree of rotation or twisting of the spine but in rotoscoliosis it is severe. 

Scoliosis can be congenital, meaning it is present before birth (usually caused by abnormal formation of spinal bones)--or idiopathic, in which case it develops after birth. The cause of a scoliosis can typically be identified as one or more of three causes. A functional scoliosis develops in response to a skeletal or movement abnormality elsewhere in the body. For example, a discrepancy in length between the legs could cause a functional scoliosis to develop because the hips are not even. A scoliosis can also be neuromuscular in origin meaning it is associated with a condition that affects the nerves or the muscles. Finally degeneration of the vertebral bodies and weakening of their supporting ligaments can cause scoliosis to develop in adults.

HOW IS THIS CONDITION IDENTIFIED?

If scoliosis is mild it may be hard to identify without an X-ray, CT, or MRI of the spine. If moderate or severe, the following are visible signs that may indicate scoliosis:

    -One shoulder is higher than the other

    -One hip is higher than the other

    -A “rib hump” can be seen on one side of the back as the person bends forward

    -One shoulder blade is more prominent than the other

    -The spine appears twisted

    -Clothing appears to hang unevenly

Radiologists use certain measurement techniques to quantify the degree of curvature of a rotoscoliosis. This allows them to monitor progression over time and to guide treatment decisions.

HOW DOES IT FEEL?

A mild rotoscoliosis may not cause any symptoms. As the rotation and sidebending of the spine increase, discomfort or pain in the back or rib cage may develop. A person may notice changes in their walking gait or in their ability to perform daily tasks like reaching, bending, or even sleeping. If the degrees of curvature and rotation are severe enough, the heart and lungs can even be affected. With the changes in rib cage position, taking a full breath may become restricted.

WHAT CAN BE DONE?

Observation: In young children with a mild scoliosis observation may be the first course of treatment. If a child has a mobility impairment it can be helpful to use proper positioning equipment to make sure their spine is aligned optimally, for example while they are sitting to help limit curvature and rotational progression. 

Physical Therapy and Exercise: Advances in conservative treatment for scoliosis have come a long way. Exercise and physical therapy are important tools to help manage a condition like rotoscoliosis. At Evolve, we utilize the Schroth Method, a physical therapy technique that can help stop the progression of scoliosis and has been proven to reduce pain.

Bracing: Bracing is often helpful in stopping the progression of skeletal maturity in those with moderate scoliosis who have not yet reached skeletal maturity. Bracing is customized to fit the individual’s body and needs to be regularly reassessed to ensure proper fit. They may need to be worn for 16-23 hours a day until skeletal maturity is reached.

Surgery: Surgical intervention to straighten and stabilize the spine may be recommended in children with severe curvature and adults with severe curvature who are also experiencing signs of nerve damage or compression such as leg weakness and bowel or bladder issues. 

The appropriate treatment measures for your rotoscoliosis should be decided upon by you and your physicians. Whether observation, bracing, or surgery is the route you are taking, physical therapy can be an important treatment strategy to improve your pain, slow the progression of rotoscoliosis, and help maximize your ability to participate in all the activities of daily life. 

Click here to find out more information about scoliosis treatments in Brooklyn

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Pediatric Sports PT; Just What the Coach Ordered

Sprinting Away from Pediatric Sports Injuries

Sports and athletics can be one of the most fun and rewarding aspects of a young child or teenager’s life. Through sports, children and adolescents learn how to set goals, how to manage their time, how to work as a team, and strategies for improving their performance. They also develop their fitness, coordination, balance and agility. One aspect of sports and athletics for kids and teenagers that cannot be ignored, however, is the risk of injury. According to sports injury statistics through Stanford University, more than 3.5 million children ages 14 and younger get hurt annually while participating in sports or recreational activities.

While avoiding all injuries might not be possible, having the right rehab professionals in your corner makes all the difference. Is your athlete injured? Schedule an appointment with a local physical therapist right away to jumpstart the recovery process. Looking to dodge those injuries before they happen? You should also schedule an appointment with a physical therapist because PTs don’t just treat injuries after they happen but they treat athletes before they are injured! 

IS MY CHILD AT RISK FOR INJURY?

While anyone participating in sports and athletics is susceptible to an injury, certain things about young athletes' bodies may make them more prone to injury than their adult counterparts. First, their bodies are growing and maturing. Bones, tendons, and ligaments are still developing and when combined with still-evolving coordination, stamina, and strength, are more susceptible to injury.  Additionally, while severe injury is less common in young children, individual teenage athletes may be at differing phases of growth and development and are capable of moving at much faster speeds and generating high levels of contact force which may increase their risk for injuries.  

In recent years, guidelines and limitations on length, duration, intensity and frequency of practices and competitions have changed as professionals recognize that the bodies of young athletes cannot withstand the stresses of intense, frequent practices in the same way that an adult can. There is a lot that can be done, however, to make their bodies as resilient and prepared as possible for the demands of their favorite sports and activities.

WHAT PEDIATRIC SPORTS INJURIES DO PHYSICAL THERAPISTS TREAT?

Sports injuries in young athletes fall into two main categories. Acute injuries occur suddenly in response to a force, stretch, or strain that is too great for the body’s tissues to handle. A fall while diving for home base results in a fractured wrist. A poorly aimed kick to the thigh instead of the soccer ball causes a hematoma. A rolled ankle after a jump shot leads to a sprained ankle. In each of these cases pain, inflammation, bruising, and difficulty moving or using the injured body part sets in immediately or shortly after the injury. Protecting the joint, helping the injured tissues begin to heal, preventing loss of flexibility and strength to the greatest degree possible, and eventually restoring normal strength, coordination, flexibility, power, and neuromuscular control are the primary goals of physical therapy in this case. 

Outside of acute injuries, young athletes may be dealing with chronic conditions or overuse injuries. In this case an area of the body experiences minor injury or irritation but does not fully recover between bouts of use or exercise which causes symptoms to recur and persist. Chronic and overuse injuries often happen when athletes are performing repetitive activities like pitching in baseball or running in track but their tissues are not strong or resilient enough to handle the load that the high volume demands. They can also occur when poor movement patterns or biomechanical errors repeatedly overload parts of the body incorrectly. Tendinopathies such as achilles tendinopathy, patellar tendinopathy, or tendinopathies in the elbow are examples of overuse injuries. Stress fractures and plantar fasciitis are other examples. 

INJURY REHAB STARTS ON DAY ONE

Whether the young athlete is trying to recover from an acute injury or has been dealing with these symptoms for some time, pain, inflammation, weakness, and difficulty or inability to participate in their sport can occur. While reduction or modification to training is often important to allow injuries to heal, stopping activity altogether and resting completely is often not the best course of action. It is important, however, to seek the guidance of a trained professional like a pediatric sports physical therapist who understands the process of tissue healing and how to maximize the rate of healing and return to sport while minimizing the time you are sitting on the sidelines.

If you are being treated for an acute injury such as a sprain or strain,  fracture or muscle contusion,your physical therapist will educate you on how to protect these newly healing tissues. Treatment may include compression or bracing, offloading the injured area through crutches, modalities such as ice, ultrasound, or electrical stimulation to reduce pain and swelling, and activity modification. 

In well-healed tissues or in chronic or overuse injuries, your physical therapy program will focus not only on continuing to reduce pain, irritation, or instability but also on addressing areas of weakness, tightness, and impaired neuromotor control both at the site of injury and in surrounding areas. Because physical therapists are movement experts, they will individualize the rehabilitation plan to match the demands that the young athlete’s sport or activity places on the body to prepare for return to full sport and decrease the likelihood of injury recurrence. 

AN OUNCE OF PREVENTION

Because of the dynamic nature of sports, we can expect that bones, ligaments, muscles, and tendons that aren’t prepared for the dynamic forces of athletics are more likely to be injured. There is no reason to wait for an injury to occur, however, before implementing a plan to fix muscular imbalances, improve coordination, and enhance technique. Areas of weakness, areas that lack flexibility, and errors in movement control can be identified by a physical therapist through careful assessment. By evaluating a young athlete before they are injured, there is an opportunity to address individual risk factors through exercise and training and educate the athlete, their parents, and their coaches on how to properly warm up and to avoid playing when very tired or already in pain. 

Staying injury-free is one way to promote lifelong participation in sports and recreational activities. Work with a pediatric physical therapist at the first sign of injury to help get the young athlete back on the field. But also take advantage of their expertise to individualize a training program for aerobic, resistance, and mobility training that will keep young athletes healthy and happy in their favorite sports for years to come. A physical therapist at Evolve is ready to get your young athlete optimized for injury prevention and sports performance.

Click here for more information about pediatric sports physical therapy

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com 

Treat Pregnancy and Postpartum Pain with Physical Therapy

Prepare Your Body for Pregnancy and New Mom Life with Physical Therapy

Pregnancy Doesn’t Have to Hurt! Physical Therapy Can Help

Pregnancy is often a time of great joy and anticipation but there is no denying that a woman’s body undergoes many changes before, during, and after childbirth. Emotional, physical, and hormonal changes are all a part of the process of pregnancy, childbirth, and postpartum life for new moms. If you are pregnant or thinking of becoming pregnant, you may have heard other women discuss the changes their body has undergone before and after pregnancy. While some of these changes are out of your control and simply a necessary part of the process, others may be prevented, controlled or relieved with the help of a knowledgeable physical therapist!

It's true, physical therapists can undergo specialty training in the care of antepartum (before childbirth) and postpartum (after childbirth) women. While you may have heard that low back pain during pregnancy, incontinence after childbirth and new muscle and joint pain from caring for a newborn are all to be expected, the truth is, there is a lot that a physical therapist can do to help treat, alleviate and prevent many of these problems! As is the case with all medical conditions, it is important to check with your doctor before starting any new physical activity while pregnant, but this article will give you an introduction to how physical therapists help their clients before and after pregnancy.

WHAT IS THE CAUSE OF PREGNANCY-RELATED PAIN?

Before, during, and after childbirth your hormones are fluctuating significantly. Hormones such as progesterone and relaxin cause increased ligament laxity during pregnancy. This has the effect of allowing the pelvis to expand during the birth but also causes laxity in other joints such as the lower spine. Because the ligamentous laxity tends to reach its height during the second trimester as a woman’s uterus is expanding, her belly is getting larger, and her posture is changing, low back and pelvic pain may develop. 

Other causes of musculoskeletal pain or discomfort are the new physical demands of caring for a newborn. Bending down repeatedly to pick up an infant out of a crib or off the floor, holding a baby in one arm for prolonged periods, or even holding a bottle for an extended time can cause stress and strain on the muscles, joints, and nerves. Neck, shoulder, wrist, hip, or leg pain may develop but can often be addressed with a good physical therapy program. 

Finally, pregnancy and childbirth place a high physical demand on the pelvic organs and pelvic floor. Constipation, urinary and/or bowel incontinence, painful sex, and pelvic pain can result. Many women may find these issues embarrassing or assume they are just a “normal part of having a baby” and don’t know that a pelvic floor physical therapist can educate them on these symptoms and create a treatment plan for them. 

HOW CAN PHYSICAL THERAPY HELP?

Prevention, prevention, prevention! Because we know that pregnancy will put a certain amount of strain on your musculoskeletal system, preparing the body to handle that stress is one of the best ways you can decrease your risk of developing pain or discomfort before or after childbirth. In most cases, exercise is safe during pregnancy and if your doctor has given you the green light to exercise, you might be wondering what is and isn’t safe for you to do while pregnant. A physical therapist with training in the assessment and treatment of pre- and postpartum clients is an excellent resource for developing an exercise plan to prepare your body for the process of nurturing a growing fetus, giving birth and starting new routines of caring for your child.

During an evaluation, physical therapists will perform an individualized assessment of your muscle strength, flexibility, movement patterns, prior history of injury, and level of activity. After assessing these areas, they can prescribe a series of stretches, movements, and exercises to help keep you strong, flexible, healthy, and as pain-free as possible throughout your pregnancy. Because of their area of expertise, you can feel confident that your physical therapist understands the special considerations for pregnancy and exercise so that your program will be both safe and effective.

What if you are already having pain? Not to worry, if you are feeling pain or discomfort associated with pregnancy or after giving birth, there is a lot that can be done to help. One of the most important roles your physical therapist will play is as an educator. Understanding how to move your body and care for your baby in the most biomechanically sound way possible can help to relieve some of the excess stress on your nerves, joints, and muscles. 

If you have an old injury that is flaring up or new pain or discomfort that has developed, a physical therapist will be able to assess the area of discomfort to determine how best to address the issue. They can advise you on safe application of heat or ice to reduce pain and teach you appropriate stretches, strength and stabilization exercises to help reduce or eliminate your symptoms.

Finally, if you have already given birth, whether vaginally or by cesarean section, your body has been through quite a lot of physical trauma. Many women don’t know that a postpartum evaluation by a physical therapist can help address pelvic floor and musculoskeletal issues like a diastasis recti (separation of the abdominal muscles) or pelvic floor muscle dysfunction, early. A good PT program will help you recover from childbirth and pregnancy so you can enjoy taking care of your baby and getting back to the activities you love to do.

Let’s not forget about the pelvic floor. The pelvic floor and pelvic organs are star players in pregnancy and childbirth. They are asked to work harder than normal during this time and often need extra care. Issues of bladder or bowel leakage, incontinence, pelvic organ prolapse, or pain during sexual intercourse can occur during pregnancy and after childbirth and it is important that women know there is help out there for these conditions. A specially-trained pelvic floor physical therapist can teach you strategies, good habits, and exercises to decrease the likelihood of developing these conditions and when necessary, can help to treat them after they’ve developed. 

So no matter where you are on your pregnancy journey, it is a great idea to involve a physical therapist. Addressing problems early on and preventing new ones from developing can help you to have an enjoyable pregnancy and recovery after childbirth. Specially-trained PTs at Evolve are waiting to join you on this journey!

Click here for more information about physical therapy for pregnancy

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

New Pilates Class in Brooklyn Starting May 1st at Evolve Physical Therapy

Pilates!

〰️

Pilates! 〰️

Take Your Fitness to the (Pilates) Mat at Evolve NY in Brooklyn!

Evolve NY physical therapy clinic in Brooklyn is excited to announce the addition of Pilates classes to our list of health and wellness services. If you are looking to take your practice to the next level, are interested in starting Pilates for the first time, or are hoping someone can help you modify your practice to accommodate for injury or health conditions, keep reading to learn how Evolve NY is the perfect place to practice.

While you may be new to Pilates, Pilates is not new to the fitness scene. In fact, Pilates was developed in 1920 by fitness instructors Joseph and Clara Pilates when they opened their Body Conditioning Gym in New York City. Joseph developed many of his techniques while working to rehabilitate patients who could not walk. Since then it has continued to hold an influential space in the fitness industry attracting those looking for a way to strengthen body and mind and rehabilitate from injuries. 

At Evolve NY we are offering traditional mat Pilates which may involve the use of other equipment to promote strength, stability, and flexibility. Pilates exercises develop the body through muscular effort that stems from the core, which helps to improve general  fitness and overall well-being. In keeping with the tradition of Pilates, classes will incorporate the 6 Principles of Pilates:

• Breath

• Flow

• Concentration

• Centering

• Control

• Precision

WHAT ARE THE BENEFITS OF PILATES?

One of the great things about Pilates is that no no matter your fitness or experience level, Pilates will challenge your body. Aside from the general health benefits that participating in any regular exercise program will give you, Pilates provides many specific benefits including:

• Improving your posture

• Strengthening your core

• Improving your flexibility

• Helping to reduce aches and pains

• Improving your body awareness and breath control 

MEET YOUR INSTRUCTOR

Donna Cicchesi is a Doctor of Physical Therapy with experience treating  patients of all ages from pediatric to geriatric. She received her BA in dance from Hofstra University and her DPT from SUNY Downstate. Donna's  pilates classes draw on both the science of Physical Therapy and the art of dance and movement. Her goal is to make sure that clients understand  that pilates is accessible to virtually anyone, no matter their  physical capabilities.

A HAPPY MARRIAGE BETWEEN PHYSICAL THERAPY AND PILATES

No matter your experience with Pilates, working with an instructor like Dr. Cicchesi provides benefits that you won’t find at a traditional Pilates studio. As a Doctor of Physical Therapy, Dr. Cicchesi is a movement expert with years of formal instruction, continuing education and practice in the evaluation and treatment of injury and injury prevention, anatomy and physiology.

While you will not be undergoing physical therapy while participating in Pilates classes at Evolve NY, Dr. Cicchesi’s experience creates an environment in which anyone, no matter your age or physical ability, can benefit from the practice of Pilates. If you have an injury or condition that may make exercising difficult, Dr. Cicchesi is able to modify your practice to ensure you can safely participate in the class and reap the benefits of regular practice. 

Don’t Miss Out on Evolve Physical therapy’s New Pilates Classes in Brooklyn! 

To learn more about Pilates classes at Evolve, check out our website where you can learn about Evolve and sign up for your first pilates class in Brooklyn! 

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Gout Got You Down?

Physical Therapy for Gout 

Are you suffering from gout? Physical Therapy Can Help

Gout–many people have heard of it but for the more than 8 million people in the U.S. suffering from gout, it is a painful reality they’d love to prevent. While medical care from a physician is an important part of managing gout, many people do not know that a physical therapist can help address the symptoms and risk factors associated with gout. 

WHAT IS GOUT?

So what is gout? Gout is a complex form of arthritis characterized by sudden, severe bouts of joint swelling, pain, warmth, redness, and tenderness. Accumulation of needle-like urate crystals in the joint causes the inflammation and pain characteristic of gout. 

Urate crystals form when either too much uric acid is produced by the body or too little is excreted by the kidneys. Uric acid is produced normally by the body when it breaks down what are called purines. Purines are substrates found commonly in food we eat such as red meat, organ meat and some seafood like tuna, anchovies, and mussels. Eating these foods in high amounts can cause elevated uric acid as can drinking certain alcohols such as beer or sugary cocktails.

Men tend to be at higher risk for developing gout than women, though post-menopausal women are at a higher risk than their pre-menopausal counterparts. Certain medications such as low dose aspirin, ACE inhibitors and anti-rejection medications for post-organ transplant patients may increase levels of uric acid in the body. Finally, a family history of gout and a personal history of certain medical conditions such as obesity, uncontrolled high blood pressure, diabetes, metabolic syndrome, or heart and kidney disease increase one’s risk of developing gout.

Gout attacks are most common in the joint at the base of the big toe but can actually occur in any joint. Ankles, knees, fingers, wrists and elbows may be affected by gout as well. An attack of gout typically occurs suddenly. You may awake in the middle of the night with pain, heat, and redness in a joint so severe that even the bedsheet touching the area is unbearable. 

It is important to call your doctor if you develop these symptoms. Firstly it is important to rule out other causes of joint pain, redness and swelling such as an infection or acute injury. Secondly, untreated gout can lead to joint erosion and prolonged pain. 

HOW IS GOUT TREATED?

During an acute gout attack your physician may prescribe medications to reduce inflammation and manage pain. They may also recommend medications to prevent the build-up of uric acid and improve its removal from the body to decrease your risk of future gout attacks. 

While your physician is an important and necessary first point of contact for treating gout, a physical therapist should be another important member of your care team. 

WHAT IS A PHYSICAL THERAPIST’S ROLE IN TREATING GOUT?

Once the gout attack is under control, physical therapy is a great option to help restore normal joint movement and function and also to address lifestyle modifications that will lower your risk for future gout attacks. 

Lifestyle modifications: If you go back and review the list of risk factors for gout outlined above, you will notice that many of them can be addressed with modifications to one’s lifestyle. It should feel empowering to know that medication is not the only way you can decrease the likelihood of another gout attack and of developing long term joint damage. 

Participation in a regular exercise program consisting of moderate to high intensity cardiovascular and strength training can improve risk factors for diabetes, heart disease, high blood pressure, and metabolic syndrome, all conditions associated with an elevated risk for gout. 

For many people, lack of familiarity with exercise and concerns about injury or worsening pre-existing conditions such as joint pain or heart disease is a barrier to entry for exercise. Luckily, physical therapists are experts in prescribing exercises that are individualized to not only prevent worsening of your pre-existing medical concerns but to actually help improve them! When you work with a physical therapist they can advise you on how to safely begin an exercise program. Your physical therapist will take the time to get to know your medical history, your current abilities, your concerns, and your motivating factors and help tailor a program to meet your needs. 

Physical therapy treatment: Physical therapy for gout will focus on managing pain symptoms and improving function. Modalities such as cryotherapy (cold/ice) have been shown to improve inflammation and pain during a gout attack. Your physical therapist may advise you on splinting, or bracing the involved joint or on assistive devices such as a cane or crutches when pain is severe enough to impair walking. 

As the acute attack wanes or in the case of chronic joint damage from gout, restoring normal joint motion is an important part of restoring your function. Your PT may apply gentle hands-on techniques such as passive range of motion, soft tissue therapy or joint mobilization, myofascial release techniques, or taping to improve the mobility and health of the joint and soft tissues that are affected. 

In the case of chronic gout, while the surfaces of the joint may no longer be pristine, how the joint moves and how much stress is applied across a joint can play a large role in how much pain you experience and how much you have to limit your activities. Proper strength and flexibility in the muscles surrounding the joint can optimize the movement of the joint and may reduce some of the rubbing that occurs between uneven joint surfaces. Your physical therapist will test your muscles to identify areas that need work and can guide you through a progressive program of exercises to address these issues.

 As muscles get stronger and tissues regain their proper length and flexibility, learning to activate muscles at the right time and in the right order during a specific activity is essential. Even if your muscles are strong, the motor control of these muscles may not be adequate to properly perform a movement without putting excessive stress across a certain joint. As you learn to control and fire your muscles while performing motions such as going up stairs or running, you will experience less pain.

The ultimate goal of a physical therapy program is to help you get back to the activities you love and need to do throughout your life. While you may not be able to prevent every gout attack, you can help prevent long-term disability associated with joint injury and inactivity. Don’t let gout get in your way of a happier, healthier, and more active life. Schedule an appointment with a physical therapist at Evolve where they will empower you to make lifestyle changes to reduce your risk for another gout attack and help you get back to activities in the safest, most effective and quickest way possible. 

Click here for more information about physical therapy for Gout

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Are Your Fingers Tingling? It May Be Carpal Tunnel Syndrome

Physical Therapy for Carpal Tunnel Syndrome

Getting Control of Your Carpal Tunnel Syndrome with Physical Therapy…

WHAT IS CARPAL TUNNEL SYNDROME?

Have you been experiencing numbness, tingling, or burning in your palm, thumb, index or middle fingers? In the beginning maybe you would wake up with these symptoms and be able to relieve them quickly but now they are occurring more often during the day, especially after you’ve been using your hands for a while. The numbness might linger and eventually you start noticing some weakness in your hands. If this sounds familiar, you might be experiencing carpal tunnel syndrome (CTS). 

Carpal tunnel syndrome refers to a group of symptoms that are caused by pressure on the median nerve as it passes through the carpal tunnel of the wrist. The carpal tunnel is a narrow passageway on the palm side of the wrist created by a ligament called the transverse carpal ligament that crosses from left to right between several wrist bones. The median nerve and several tendons travel through and are protected by the carpal tunnel. 

The median nerve arises from the neck region of the spinal cord and travels through the muscles and tissues of the upper arm and forearm, through the carpal tunnel and it’s branches travel into the hand. The median nerve supplies motor impulses to several forearm and hand muscles and transmits sensory information between the thumb, index, middle, and half the ring fingers, their corresponding palm areas, and the brain. 

You can see why pressure on the median nerve as it travels through the carpal tunnel would cause numbness, tingling or burning in the first 3 (and sometimes part of the 4th) fingers. In fact many people find themselves shaking their hands out frequently to relieve these sensations. If the compression is prolonged or severe, it can interfere with the nerve’s ability to transmit motor signals to corresponding muscles and a person can notice weakness in their hands and grasp and more difficulty performing fine motor tasks such as typing, writing, or handling small objects. 

WHO IS AT RISK FOR DEVELOPING CTS?

While nerves are pretty resilient against occasional pressure and compression, prolonged pressure can cause the types of symptoms we see with CTS. Because of the nature of this condition, repetitive forceful finger use, prolonged vibration through the hands, and extreme wrist positions can raise your risk of developing CTS. Data shows that women are more than three times more likely to develop CTS and that certain professionals such as assembly line workers, manufacturing, sewing, cleaning, and meatpacking workers develop CTS at higher rates. Even repetitive typing and keyboarding, if the wrists are angled less than optimally, can cause CTS. 

CTS is also associated with certain health conditions in some people:

• Trauma or injury to the wrist that causes inflammation such as a fracture or sprain

• Diabetes

• Overactive pituitary gland

• Underactive thyroid gland

• Rheumatoid arthritis or gout

• Fluid retention during pregnancy or menopause

• Hand or wrist deformities

HOW IS THIS CONDITION DIAGNOSED?

A thorough subjective exam is often adequate to diagnose CTS. Your physical therapist will ask you about the duration and nature of your symptoms and what kinds of activities you do in your job, for recreation and in your daily tasks. This information gives the physical therapist insight into potential underlying causes and helps rule out other conditions that may cause symptoms in the hand and fingers. 

Once they have interviewed you, you can expect to undergo a physical exam to evaluate your strength, sensation and coordination of your affected hand and forearm. Your PT will likely also examine your neck and shoulder as the median nerve originates in the neck and at times conditions of the neck can mimic symptoms of CTS. They may also perform certain special tests to detect compression and irritation of the median nerve:

• Phalen’s test: gently pressing the backs of your hands together to flex both wrists for one minute. Tingling or numbness in the fingers that occurs within 60s is suggestive of CTS

• Tinel sign: your physical therapist may tap over the median nerve where it passes through the wrist. Tingling that results in the thumb, middle or index finger may indicate CTS

If you see a specialist physician such as a Neurologist, they may recommend specialized electrical and nerve function testing such as an electromyogram (EMG) to determine how well motor impulses are traveling through the nerve. A nerve conduction velocity test may also be utilized to assess how well the median nerve transmits sensory information. These tests can identify and assess severity of CTS. In some cases an x-ray or MRI may be ordered to assess for possible trauma or deformity in that area. 

HOW CAN PHYSICAL THERAPY IMPROVE MY SYMPTOMS?

Physical therapy can be helpful in improving symptoms as a form of conservative care or as part of a post-surgical rehabilitation plan. Non-surgical treatments are typically recommended first and may include physical therapy, corticosteroid injections or non-steroidal anti-inflammatory medications prescribed by a physician, and splinting. If the condition is severe or does not respond to conservative treatment then surgical intervention may be recommended to create more space within the carpal tunnel to relieve the pressure on the median nerve. 

A physical therapist will always create an individualized plan to meet your specific needs but generally aims to reduce your pain and help prevent surgery, increase your ability to be functional and active, and help you resume your normal work, home and leisure activities. If PT is recommended after CTS surgery then additional goals will include minimizing scar formation and restoring normal strength and range of motion. 

Due to the nature of CTS, you can expect that education and activity modifications will be an important part of your custom physical therapy program. Understanding what specific activities and hand/wrist positions may have caused your symptoms to develop in the first place is an important step in improving symptoms and reducing the likelihood of recurrence. Modifying the tools you use, taking breaks, adjusting your workspace to allow for a more neutral wrist position and reducing the force that you put repetitively through your wrist and hands are just a few of the suggestions your PT may make to help prevent return or worsening of CTS.

If you start to notice any of these symptoms developing it is important to seek treatment early, however, much can still be done even if you’ve had these symptoms for a while. A physical therapist at Evolve is trained to help identity signs and symptoms of CTS and can recommend modifications you can make immediately to start improving your symptoms but perhaps more importantly, can prescribe a plan of treatments to help you recover the strength and sensation you have lost, reduce your pain and get you back to your regular activities with the confidence in knowing how to prevent carpal tunnel syndrome from returning. 

Click here for more information about physical therapy for carpal tunnel syndrome

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com 

Give Osteophytes the One Two Punch!

Physical Therapy for Bone Spurs

Feeling Bad About Bone Spurs? PT Can Help!

Have you been experiencing pain in your joints or tendons, loss of joint flexibility, numbness or weakness in the legs or arms? Your symptoms may be caused by bone spurs, known as osteophytes, that develop over long periods of time usually in or near joints. Though the name suggests a ragged or sharp outgrowth of bone, bone spurs are usually smooth and depending on their location may or may not cause symptoms. If you suspect you may have a bone spur or have been told by your doctor that you do, this article will help you better understand where they come from and how physical therapy can help treat your symptoms. 

WHAT CAUSES BONE SPURS?

Bone spurs are most common in adults over the age of sixty and usually grow in areas where osteoarthritis–breakdown of the cartilage from wear and tear–has formed in a joint. Other conditions such as Ankylosing Spondylitis which affects the spine can also put someone at risk for bone spur formation. Bone spurs can grow from any bone but are most common in the foot (especially the heel, big toe and ankle), the hands and fingers, hips, neck and spine, knees and shoulders. 

The body most commonly develops bone spurs in an attempt to repair or address an injury. It does so by producing excess bone where there has been trauma to the joint, repeated tendonitis, breakdown of the cartilage or repeated overuse of a joint. Does anyone else in your family have bone spurs? Research suggests it may also have a genetic cause.

WHAT ARE SYMPTOMS OF A BONE SPUR?

Most bone spurs are asymptomatic if they are not in a place to rub or irritate any other tissues. In this case you may not even know you have them unless they are identified on imaging such as an X-ray. In some cases, however, bone spurs can cause pain and loss of joint flexibility if their location restricts joint movement or causes rubbing on soft tissue structures such as tendons or ligaments. 

Bone spurs in the heel can be especially painful secondary to the pressure you put on your foot each time you walk. Bony nodules, stiffness and pain may be noticeable when bone spurs develop in the hands or fingers whereas pain and loss of flexibility is more common in joints like the hip and knee. Bone spur formation in the spine can be especially bothersome if its location causes a narrowing of the spinal canal where your spinal cord travels or of the space where the nerve roots exit. In this case the pressure on the delicate nerves of the spinal cord or nerve roots can cause radiating pain, weakness, numbness or tingling in the arms or legs. 

CAN PHYSICAL THERAPY TREAT MY BONE SPURS?

It is important to understand that not all bone spurs require treatment. If you are experiencing pain or discomfort in a particular area and imaging reveals there is a bone spur nearby, a physical therapist can help determine the impact that the bone spur has on your symptoms. Pain, weakness, loss of flexibility, swelling and discomfort can all have multifactorial causes and the presence of a bone spur may play a large role, a small role or no role at all in those symptoms. 

Reduce Pain and Swelling: Your physical therapist can provide treatment to manage pain and inflammation. Modalities such as heat and ice, ultrasound, and electrical stimulation may be applied to improve these symptoms. Hands-on treatments such as gentle soft tissue mobilization may also be used to improve the mobility of the tissues surrounding the bone spur. In some cases, special orthotics or shoe inserts may be recommended to reduce pain and irritation from bone spurs in the foot or toe. 

Improve Joint Motion: Improving motion of the involved joint and the tissues that surround it can improve both pain and function. A program of stretching and mobility exercises can help to improve the flexibility of a joint so you can more easily and comfortably perform your daily activities. Your PT may also gently mobilize the involved joints to help restore motion.

Improve Quality of Movement: Improving the quality of movement around an area with a bone spur can help reduce excessive stress across the joint and may reduce the irritation and rubbing of a bone spur on surrounding tissues. Also, as mentioned above, the presence of a bone spur may be only one factor causing your pain or discomfort so treating muscle strength and neuromuscular control issues around the involved area is also very important to ensure all contributing factors are addressed.

While in some cases surgery may be necessary to remove bone spurs, a physical therapist at Evolve can help you to reduce pain and swelling, improve your joint mobility and optimize your movement patterns. You may be wondering how you can continue with your favorite activities when you are dealing with a bone spur, but remember, bone spurs are often only one factor that can be targeted to improve your symptoms. Your physical therapist can advise you on how to modify your activities when needed and develop a program to help you to get back to your normal routines whenever possible while preventing recurrence of these symptoms in the future. 

Click here for more information about physical therapy for bone spurs in Brooklyn.

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Physical Therapy for ACL Injury: Getting Started on the Right Foot

Did you Injure Your ACL? PT Can Help!

If you are an avid sports fan or an athlete yourself, it is likely you’ve heard of athletes injuring their ACL. The anterior cruciate ligament (ACL) is part of a team of ligaments that stabilize the knee joint. This ligament runs through the center of the knee joint between the two bones that make up the knee–the femur (thigh bone) and the tibia (lower leg bone). The ACL’s primary role is to restrain anterior translation of the tibia on the femur but aids in stabilizing against excess movement in other planes as well.

HOW DO ACL INJURIES OCCUR?

Most ACL injuries occur during athletics, however, a poorly executed everyday task can also result in an injury to this area. Younger athletes seem to be at higher risk than older athletes of tearing their ACL and women are at higher risk than men. Soccer, football, and skiing are three of the most common sports responsible for ACL injuries. 

Believe it or not, most ACL tears are what is called a non-contact injury meaning the injury occurs in the absence of another player, for example, crashing into the knee of the athlete (though this certainly can be the cause of an injury to the ACL). Because of the mechanics of the ACL, it is susceptible to tearing when excessive strain is placed across the knee. One common mechanism of injury is sudden hyperextension of the knee joint with internal rotation of the tibia bone such as when a basketball player lands after a jump. Deceleration injuries are common also such as when a soccer player plants their foot in the grass while pivoting their upper body to change direction. It is possible, however, to injure this ligament simply by taking a misstep off of a curb if the joint is stressed in just the right way.

When the ligament tears it often produces a sudden pop along with significant pain. Swelling often develops within the first 24 hours and may last for quite a while. A deep pain or ache felt in the knee that worsens with walking or stair climbing is typical and a feeling of instability or giving way at the knee may occur. Tenderness, bruising and difficulty straightening the knee fully are also common. In about 50% of cases other structures in the knee such as the cartilage lining the joint, the meniscus or another ligament are also injured when the ACL tears. 

HOW IS AN ACL TEAR DIAGNOSED?

Because of the ACL’s role in stabilizing the knee, there are several tests that can be performed by a physical therapist, athletic trainer or physician to help rule in or out a suspected ACL tear. The Lachman’s Test, Anterior Drawer Test and Pivot Shift Test are three examples that may be performed to assess the laxity of the ACL by gently attempting to translate the tibia forward. An intact ACL will resist this movement. A low grade ACL tear (Grade I) may present with pain but laxity will be minimal whereas a larger grade ACL tear (Grade II or III) will allow the examiner to pull the tibia forward more than expected. An MRI is often utilized to confirm the diagnosis and examine the surrounding ligaments, cartilage, and soft tissue for injury. An X-ray will help to identify any injuries to the bone.  

WHAT DOES TREATMENT LOOK LIKE FOR AN ACL INJURY?

The majority of people with an ACL injury will undergo surgery to help re-establish good stability and control at the joint. Some people will opt for nonsurgical management by modifying their activities to minimize excessive stress on the joint while a small number of people termed “copers” will return to athletics and be able to perform relatively well. 

Nonsurgical management of an ACL injury focuses on using secondary structures such as the surrounding muscles to compensate for ligamentous instability in the long run while managing pain, swelling, weakness and range of motion impairments immediately after injury. Your physical therapist will educate you on ways to modify your activities to reduce unwanted stress across the joint. If the ligament has not completely ruptured, healing of the tissues will occur over many weeks but may never heal completely. As pain and swelling improve your PT will teach you exercises to improve strength and motor control around the knee joint and help you slowly increase your activity level. If return to sport is in your future then running and agility tasks will begin later in your rehabilitation. 

Surgery for an ACL tear is the most common approach. Some surgeons will recommend a short course of physical therapy before surgery to help decrease swelling, improve knee range of motion, and strengthen the quadriceps muscles. Because repairing a ligament is nearly impossible, the torn ACL is typically removed and replaced with a graft from the patient’s patellar tendon or hamstring tendon. Sometimes a cadaver tendon graft will be used. 

Physical therapy is an essential component of recovery from ACL surgery and progresses through several stages:

Recovery from surgery: Many surgeons will prescribe a knee brace and weight bearing restrictions for a period of time after surgery. During the initial recovery stage after surgery your PT program will aim to control swelling through modalities such as ice, taping or electrical stimulation; improve quadriceps muscle firing, regain full passive extension of the knee and begin to improve knee flexion mobility. Your PT will make sure you know how to use any assistive devices such as crutches and educate you on how much weight you can put through your leg based on your surgeon’s instructions.

Strength and neuromuscular control: Regaining leg muscle strength and motor control is an essential component of the next phase of rehabilitation. Exercises to improve leg muscle strength will be prescribed. Activities to challenge single leg balance and control of joint angles during tasks like a single leg step down or single leg squat are important to help recover full function of that leg. 

Agility, running and landing: Once good neuromotor control, muscle strength and flexibility have been established on the surgical side it is time to begin applying more load and stress to the knee to prepare it for return to sport and recreation. Regaining full strength and balance is essential to this phase of physical rehab. Under the supervision and guidance of a physical therapist the athlete will progress through a graded jumping, running, and agility program to improve the ability of the muscles, tendons and ligaments to withstand and control acceleration, deceleration and rotation.

Return to sport: Your physical therapist will use a series of functional and sport-specific tests combined with subjective and symptom reports to guide you in returning to your sport. Re-injury of the ACL is the biggest concern when returning to sport and it is important that your knee is ready to accept the stresses that returning to sport will place on it. Sport specific drills and graded return to sport are important components of this phase of rehabilitation

Preventing future injury: Now that you’ve done the hard work of recovering from an ACL injury, it is important to continue a program that will minimize the risk of re-injury of the same knee or injury of the opposite knee. Your PT will individualize a series of balance, strengthening, and plyometric exercises to be performed more than once a week to reduce the likelihood of future injury. 

If you’ve sustained an injury to your ACL, recovery may seem overwhelming at first. With physical therapy you can start taking steps toward healing even before you’ve had surgery. Schedule an evaluation with a physical therapist at Evolve to help you get on the road to recovery and minimize the recurrence of re-injury.

Click here to find out more information about physical therapy for ACL injuries in Brooklyn

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Your Pelvic Floor Muscles Need PT Too

Can Pelvic Floor Physical Therapy Help You?

PHYSICAL THERAPY FOR PELVIC HEALTH

Did you know that your pelvic floor may need physical therapy too? Your pelvic floor refers to the muscles, ligaments and connective tissue that support pelvic organs (uterus, bowels and bladder) and assist with bowel, bladder and sexual functions. No matter your sex, gender identity, sexual orientation, or age, pelvic floor muscles (PFM) are a normal part of our anatomy. Just like the muscles in your shoulder or hips, the PFM can become injured or lose function and contribute to a whole host of issues including pelvic pain, pain with sex, low back and hip pain, bowel and bladder leakage, pelvic organ prolapse, postpartum issues and post-prostatectomy leakage.

Luckily, physical therapy can address most of these issues. Unfortunately, many health care practitioners and persons in the community are not aware of its existence or its wide application to patient care and wellness. Pelvic floor dysfunction affects a substantial portion of the population and due to the sensitive nature of these issues many are embarrassed to bring their concerns up with their doctors and therapists. This article aims to educate you further on the purpose and function of the PFM, what you might expect during a physical therapy treatment and what conditions a pelvic floor physical therapist can address.

LET’S GET TO KNOW THE PELVIC FLOOR BETTER

If you think of your pelvis as a bowl made up of the two large pelvic bones that wrap from back to front, the sacrum and the coccyx at the end of the spine, then the pelvic floor forms the inside of the bowl including a sling of muscles that stretch across the bottom. The PFMs are an important component of what we often call our “core.” Several important ligaments stretch between bony structures and connective tissue adds support throughout the pelvic floor. 

The PFMs perform five major functions. First is support for the pelvic organs. Second is stability of the hips, pelvis and low back in conjunction with the muscles of the trunk. Third is bowel and bladder control to allow comfortable bowel and bladder movements and prevent leakage. Fourth is to assist in sexual function including allowing for comfortable intercourse and assisting in arousal and orgasm. Finally, the PFMs help with circulation of blood and lymph in the pelvic area. 

WHAT CAN YOU EXPECT DURING YOUR EXAMINATION?

Physical therapists specializing in pelvic health have gone through extensive post-graduate training in the assessment, evaluation and treatment of pelvic floor dysfunction. While this is a sensitive area of the body, you can expect your physical therapist to approach these conditions respectfully and discuss with you how they approach the exam and treatment before they start. You should feel comfortable communicating with them which parts of the examination and treatment you are comfortable with and know that you can stop and change your mind at any time. 

Because many disorders of the pelvic muscles are due to changes in the strength, flexibility and coordination, the physical therapy examination will be assessing each of these areas. At times, a second person may be present during the examination--it may be a person you request to accompany you, another staff member or you may decline to have another person in the room. To begin, your therapist will have a conversation with you about your medical history, your symptoms and how they are affecting your day to day life including any previous treatments you may have undergone. 

Similar to assessments for other conditions, you may be asked to perform certain movements to check the strength and flexibility of hip, back or abdominal muscles and to evaluate your biomechanics and movement patterns. Because the tissues of the body are so interconnected, dysfunction in areas adjacent to the pelvic floor may be contributing to your symptoms.

Because of the location of your pelvic floor muscles, examination may consist of an internal assessment of your pelvic floor muscles. After education on these structures, and with your consent, your physical therapist will often begin with an external exam by palpating (feeling) for areas of scar tissue, tenderness or tightness around the external structures then if you are comfortable, may insert a lubricated and gloved finger to examine the muscles, ligaments and tissues internal to the body. 

During the internal examination your therapist can assess the deeper layer of the pelvic muscles to determine which may be weak, lack flexibility or coordination so that they can tailor your plan of care to target those specific structures. If you are not comfortable undergoing an internal examination, your therapist may ask a more detailed set of questions to help identify which structures are contributing to your pelvic floor dysfunction.

HOW WILL A PHYSICAL THERAPIST TREAT MY SYMPTOMS?

Once the examination is complete and you and your therapist have agreed on a plan for your care, treatment will begin. Treatment may consist of internal treatments, external treatments, exercise and education.

External Treatments: Depending on your specific presentation this may consist of joint mobilizations, trigger point release, soft tissue mobilization, dry needling, or myofascial release

Internal Treatments: The deeper PFMs are able to be accessed transvaginally or transrectally. With your permission, your physical therapist may perform internal manual therapy techniques directly to the PFMs, or may incorporate biofeedback which utilizes a small internal sensor to help you retrain your pelvic floor muscles. 

Exercises: Your custom physical therapy treatment plan will likely include exercises you will do in the clinic or at home to improve the strength and coordination of your pelvic floor. You might also learn relaxation techniques.

Education: Perhaps one of the most important components of your treatment plan, you will learn not only about the anatomy of your pelvic floor but about techniques and habits you can utilize throughout your day to improve your PFM functions.

Many will go too long dealing with these conditions on their own or without proper support and treatment and will experience a significant impact on their quality of life. Though you may have been living with the discomfort and isolation of pelvic floor dysfunction for some time, you should feel hopeful that a physical therapist specializing in pelvic health at Evolve may be able to help you improve your symptoms and regain the comfort and confidence to take on the activities you love.

Click here for more information about pelvic floor physical therapy in Brooklyn

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com 

Healing Your Back May Be Easier Than You Think

Physical Therapy for Your Back

Is Your Back Bothering You? Call a Physical Therapist in Brooklyn Today!

Are you looking for a way to relieve pain in your back? Do your back muscles feel weak? Is your back tight after sitting, standing or lifting all day at work? If this sounds familiar, you may need physical therapy for your back. Believe it or not, every movement you make with your arms, your legs, or your head translates some kind of stress or strain to the joints of the spine.

If you are bending and squatting down to pick up boxes all day but your hips are tight and glute muscles are weak, you may notice an annoying ache in your back. When your upper back is stiff and the muscles in the front of your chest are shortened from spending all day on your computer, your neck may be killing you after a day spent studying for exams. Finally, if you accidentally stepped off of the curb while reading a text message your lower back muscles might be spasming in response.

Whether these symptoms are new or chronic, mildly annoying or completely disruptive to your normal routines, physical therapy can help! Physical therapists are specially trained to get to the bottom of your back symptoms and get you on a program that creates long lasting results. 

LET’S START BY LOOKING CLOSER AT YOUR BACK

When we talk about the back we are usually referring to the upper, middle and lower spine and the muscles on either side of it. The seven vertebrae that make up the neck, known as the cervical spine, the 12 vertebrae that make up the mid back, or thoracic spine, and the 5 vertebrae that make up the lower back, or lumbar spine, create a long canal that houses the spinal cord. The spinal cord is made up of a bundle of nerves that arise from the brainstem and leave through channels between the bones of the spine to innervate and carry movement and sensation information between the brain and the rest of the body. The broad and flat sacral bones sit beneath the last lumbar vertebrae and act as connectors between the pelvic bones and the spine. Beneath that, lies the coccyx or tailbone.

In between each vertebrae is an intervertebral disc. These discs transmit forces, act as shock absorbers and facilitate motion in the spine. Loss of fluid in the discs is responsible, in part, for why we tend to become shorter as we age. Sometimes the intervertebral discs can herniate, or rupture, and put pressure on the spinal cord or nerve roots causing localized or radiating pain, changes in strength and sensation in the arms or legs. 

There are also many muscles that criss-cross the back. Some muscles are more superficial--closer to the skin--and often help in moving or positioning the arms. Intermediate layers of muscles act on the ribcage to help with respiratory function and deep layers of muscles help move the spine. While not technically part of the back, the abdominal muscles are also worth mentioning here as they are intimately connected to the fascial layers of the back and work together to help stabilize the lower spine. 

GETTING TO THE ROOT OF YOUR BACK PROBLEMS 

Now that you have a better understanding of the structures that make up the back, it’s important to understand that any of these anatomical structures may be involved in back symptoms. Whether you call it tightness, pain, discomfort, weakness or irritation, most back symptoms can be helped with conservative treatments like physical therapy but it starts with identifying the underlying cause(s).

When you schedule an evaluation with a physical therapist, the purpose is to understand when your symptoms started, what makes them better or worse, what might be causing them and what your goals are for working with a PT.

In some cases, a specific anatomical structure may be primarily to blame for your symptoms, such as the herniation of an intervertebral disc or a strain of a specific muscle but often times the underlying cause is due to faulty movement patterns or lack of strength and flexibility in other areas of the body. For example, if you aren’t able to raise your arm all the way overhead but you spend hours a day stacking items on high shelves at the grocery store, there is a good chance you are extending or arching your back further than you should to try and reach a little higher. Over time, this causes excess strain in the joints and muscles of the back and can lead to discomfort or pain. 

Because back symptoms are often multifactorial, your physical therapist will be evaluating how you move your arms, legs and spine as much as he or she is examining the specific structures of the back. 

HOW CAN PHYSICAL THERAPY HELP YOUR BACK?

Once the underlying causes have been pinpointed, it’s time to get to work. Physical therapy aims to give you immediate relief of your symptoms whenever possible, but most importantly, aims to address the underlying causes to reduce the likelihood they will return in the future. Here are some ways PTs will address your symptoms when you come in for a physical therapy treatment:

Reduce pain, inflammation and irritation: While completely eliminating your symptoms may take time, making you more comfortable in the meantime is an important first step in your rehabilitation. Applying ice or heat, ultrasound or electrical stimulation to the affected area can often give you some relief. Soft tissue mobilization or gentle joint mobilization may also be employed by your physical therapist to reduce tissue irritation.

Improve flexibility: Each activity you perform throughout your day requires your joints to move through a certain range of motion. When a joint lacks the flexibility needed to perform the movement optimally, extra stress and strain is translated to other parts of the body. Your back PT program may include stretching, myofascial release techniques, joint mobilization and mobility exercises to improve flexibility in the back itself but also in other areas of the body such as the ankles, hips, and shoulders. 

Build up your strength: Now that we’ve improved your flexibility, it is important to strengthen the muscles around your spine and other joints. Just as lack of flexibility around joints of the arms and legs can lead to pain or tightness in the back, lack of strength and stability can too. You will learn exercises to help strengthen the muscles around the back and abdomen to properly stabilize the spine and also in the arms and legs to minimize excess strain transfer to the back. Having good strength throughout the body allows stress to be distributed across multiple joints and helps to prevent injury and irritation in the future. 

Optimize your movement: Reducing inflammation and pain and balancing strength and flexibility across the body are only the first steps to treating your back. Many of the tasks we do throughout the day require complex, multi joint movements. Just think about how many joints are moving and muscles are working when you reach down to lift a box off the floor or serve a tennis ball at the beginning of a point. Learning proper biomechanics and enhancing the neuromuscular control of joints and muscles is an essential component of healing and preventing back injuries. Physical therapists are movement experts and through analyzing your movements, can guide you in improving how you move and train your muscles to perform those movements in the safest and most effective way possible. 

While back symptoms can be disruptive to your daily life, conservative treatments such as physical therapy are often highly effective. Physical therapists can identify the myriad of factors contributing to your specific back symptoms and provide you with a rehabilitation program to improve them now and help prevent them in the future. A physical therapist at Evolve can help you get on the road to healing your back.  

Click here for more information about physical therapy for upper and lower back pain

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Are You Suffering From a Knee Injury?

Knee Physical Therapy Can Get You Back on Your Feet

The knee is a hinge joint that flexes and extends. While it has fairly simple mechanics, it is responsible for creating and absorbing forces that come from walking, running, jumping, going up and down stairs, getting on and off the floor and much more. Because it is involved in so many of the movements we perform throughout our day it is susceptible to injury and discomfort caused by long term accumulation of stress or a sudden uncontrolled force. Whether you are experiencing new knee pain or have been living with it for some time, a physical therapist can help get to the root cause and improve your knee symptoms.

LET’S EXAMINE THE KNEE MORE CLOSELY

The knee joint is where the cartilage-covered ends of the thigh bone (femur) and lower leg bone (tibia) meet. The patella, also known as the kneecap, sits at the front of the joint within the tendon of the large quadriceps muscle and acts as a fulcrum to increase the power of these large thigh muscles. Two moon-shaped menisci cushion the joint on the medial and lateral sides. 

Four main ligaments provide stability to this knee joint. The medial collateral ligament (MCL) runs up and down on the inside of the knee to prevent the knee from buckling inward. The lateral collateral ligament (LCL) runs up and down on the outside of the knee to prevent the joint from buckling outward. The anterior cruciate ligament (ACL) runs through the center of the joint from the tibia to the femur and primarily restrains anterior translation of either bone though acts to restrain excess movement in other planes as well. Finally, the posterior collateral ligament (PCL) similarly runs between the tibia and femur and primarily restrains posterior translation of either bone. 

The hamstring muscles and calf muscle in the back attach near either side of the knee joint to help flex the knee while the quadriceps muscles extend the joint and run across the front of the knee attaching below it. The adductor muscle group which attaches near the groin runs down the inside of the leg and attaches above and below the knee. 

WHAT KNEE CONDITIONS CAN PHYSICAL THERAPY TREAT?

Muscle Strain: When overstretched, overused or contracted against a sudden load, a muscle strain can occur as muscle fibers or the musculotendinous junction are torn or injured. A muscle strain in the hamstring or calf muscles in the back or the quadriceps muscles in the front can cause pain near the knee joint. Muscle strains can range from mild to severe depending on how much of the muscle is affected. You may experience pain, swelling, tenderness or bruising with pain during muscle contraction. 

Ligament Sprains/Tears: ligaments are bands of collagen tissue that support bones, joints and organs. As outlined above there are four main ligaments in the knee joint. Because the primary function of ligaments is to provide passive stabilization to the area, loss of stability can range from mild to severe with a ligament sprain depending on how many fibers are torn.

MCL Sprain/Tear: An injury to this ligament often occurs during sudden bending, twisting or direction changes or when the outside of the knee is hit such as during a football tackle. Initially pain and tenderness on the inside of the knee may be felt and swelling and stiffness may develop later on. If the sprain is severe enough the knee joint may eventually feel unstable.

LCL Sprain/Tear: Sharp turns with a planted foot, sudden hyperextension of the joint, or a hit on the inside of the knee can all cause a sprain to the LCL. Pain, swelling and tenderness on the outside of the knee are common. Depending on the severity you may also experience locking or catching and possibly giving way during movement.

ACL Sprain/Tear: This ligament can be injured from a direct hit to the knee such as during a soccer game or if the upper leg suddenly twists while the foot is planted. Sometimes landing on a hyperextended knee or stopping momentum suddenly can also injure the ACL. A sharp intense pain and an audible pop may occur at the moment of injury. You may be unable to support any weight through the joint immediately and swelling typically develops shortly after.

PCL Sprain/Tear: Injury to the PCL most often occurs when a sudden force shifts the lower leg bone backwards under the upper thigh bone. Knee injuries that damage the PCL often injure other ligaments or cartilage in the knee and sometimes a small fragment of bone can break free. Swelling and stiffness are common with this injury. Pain may be felt inside the knee joint or at the back of the knee and made worse with squatting, running, or climbing stairs.

Iliotibial (IT) Band Syndrome: The IT Band is a thick band of tissue that runs along the outside of the leg from the pelvis to the knee. Irritation and inflammation around this band can occur from repetitive straightening and bending during activities such as running and cycling. Stabbing or stinging pain felt along the outside of the knee is often felt when going from a sitting to a standing position or following continuous activities such as walking or stair climbing. 

Tendinopathies: Tendons are the thick, fibrous bands or cords that attach muscle fibers to bones. Pain felt outside of a joint at the end of a muscle which is exacerbated by movement may be tendonitis or tendinopathy. In the knee, this most commonly occurs at the hamstring tendons where they attach on either side of the knee posteriorly and in the patellar tendon below the patella. The most common cause of inflammation and irritation in the tendon is repetitive overuse. Often biomechanical or movement errors, muscle strength and length asymmetries or insufficiencies are an underlying cause. Pain is usually described as a dull ache that can interfere with your activities. Tenderness, mild swelling and general weakness may also be present. 

Patellofemoral Pain Syndrome: This condition refers to pain at the front of the knee felt under or around the patella. It is worse with activity and sometimes after sitting for long periods of time with a bent knee. It is a common cause of knee pain and often occurs in response to an increase in activity that occurs faster than the tissues of the knee can adapt. 

Osteoarthritis: Arthritis can occur in any joint. In the knee, osteoarthritis refers to breakdown of the cartilage that covers the ends of each bony surface and a loss of synovial fluid that lubricates the joint. This results in rubbing of bony surfaces together causing pain and stiffness. In severe cases a total knee arthroplasty (replacement) may be performed by a surgeon. While physical therapists cannot reverse the OA itself, physical therapy has proven to be an effective treatment modality for arthritis. Restoration of optimal joint movement, addressing biomechanics and movement pattern inefficiencies, maximizing muscle strength and education on possible activity modifications are all helpful.

Meniscal Tear: Tears of either meniscus can be “acute”, meaning it occurred as the result of a sudden injury or “degenerative”, meaning it occurred over time. Acute injury to these cartilaginous discs often occurs when the upper leg is twisted or turned while the knee is bent and the foot is planted. Symptoms of a meniscal tear include a sharp intense pain in the knee and difficulty walking or going up and down stairs. If this is an acute injury a pop or tearing sensation may occur and swelling typically develops within about 24 hours. Some meniscus tears can cause a locking or catching sensation that restricts fully bending or straightening the knee.

HOW WILL YOUR PHYSICAL THERAPIST TREAT YOUR LEG?

Initially your PT will assess your knee to determine the cause and contributing factors to your symptoms and then will begin a customized treatment plan to get you back on your feet. 

If you are being treated for an acute injury such as a tear or strain, your physical therapist will educate you on how to protect these newly healing tissues. Treatment may include compression or bracing, offloading the injured area through crutches, modalities such as ice, ultrasound or electrical stimulation to reduce pain and swelling and activity modification. 

In well-healed tissues, chronic injuries like tendinopathy or IT band syndrome, your physical therapy program will focus not only on reducing or eliminating localized symptoms but on addressing factors that contributed to the onset of the symptoms. Often injuries or pain in the knee are caused by repeating faulty movement patterns or having an imbalance of muscle strength and length to carry out a task such as walking, running, cutting, or jumping optimally and with good mechanics.

While some knee injuries may require intervention by a doctor or surgeon, a physical therapist should always be a primary member of your care team. A physical therapist at Evolve can help you get on the road to recovery. Our therapists do not just treat symptoms, but we get to the root of the cause. We strive to enable our patients to live pain free, and prevent the recurrence of related issues. Click here for more information about knee physical therapy .

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com 

Experiencing Discomfort in Your Legs?

What are some of the injuries of the leg that Physical Therapy can treat?

Sprains, strains, pulled muscles, broken bones, fractures and sciatica are just some of the reasons a person may visit a physical therapist for their leg. Sometimes it can be difficult to determine the cause of your pain or discomfort but a physical therapist is trained to evaluate the myriad contributing factors to identify the most likely causes and craft a plan of action to improve your symptoms.  

WHAT LEG CONDITIONS CAN A PHYSICAL THERAPIST TREAT?

Sciatica: Sciatica refers to pain, burning, tingling, cramping, numbness and sometimes weakness that often begins in the buttock and travels down the back of the leg. It is caused by compression or irritation of the sciatic nerve that originates in the low back and travels down the posterior leg. With severe or prolonged compression or irritation muscle weakness can also occur. Your physical therapist will be assessing for a number of causes including disc herniations, misalignment of the pelvis, tightness in the hip or buttock muscles, narrowing of the spine or biomechanical problems before they begin treating you. 

Muscle Strain: Muscles are made up of bundles of muscle fibers aligned in specific patterns. When these fibers contract they shorten the muscle and pull on the bones they attach to creating movement and strength. At either end of these fibers is a strong band of tissue called the tendon which connects the fibers to the bone. When overstretched, overused or contracted against a sudden load, a muscle strain can occur as muscle fibers or the musculotendinous junction are torn or injured. 

Grade I strain (mild): very few muscle fibers are injured. Pain typically occurs the next day but no swelling or bruising is observed. Pain may be felt when the affected muscle is strongly contracted or stretched at its end range.

Grade II strain (moderate): many (but not all) fibers are injured resulting in stiffness, loss of flexibility and loss of strength. Pain is felt both during contraction of the muscle and during stretching. Swelling and bruising over the injured area is common. 

Grade III strain (severe): all fibers of the muscle are completely torn or the muscle belly has detached from it’s tendon. Severe pain is often felt upon injury and heavy swelling and bruising will develop. Range of motion may be either significantly reduced due to pain or excessive because the muscle is no longer limiting it. This muscle will generally be unable to produce any force due to the severe disruption in the fibers. 

Ligament Sprains: ligaments are bands of collagen tissue that support bones, joints and organs. In the leg the most common ligament sprains occur at the knee and ankle. A sprain typically occurs when these inelastic fibers are stretched beyond their capacity such as when you twist your knee or roll your ankle. Because the primary function of ligaments is to provide passive stabilization to the area, loss of stability can range from mild to severe with a ligament sprain.

Grade I (mild): microscopic damage has occurred to the ligament but only mild local tenderness and minimal bruising/swelling is noted without compromising joint stability. Typically takes 2-3 weeks to heal.

Grade II (moderate): partial tear/rupture of the ligament. Obvious swelling and tenderness noted over the injured ligament but joint instability is either minimal or absent. May require up to 6 weeks to heal.

Grade III (severe): complete rupture of the ligament with severe swelling and tenderness. This injury may be difficult to distinguish from a fracture initially. Instability of the joint is noticeable due to the severity of the rupture. Prolonged time to heal is frequent and may require surgery to repair. 

Tendinopathy: Tendons are the thick, fibrous bands or cords that attach muscle fibers to bones. Pain felt outside of a joint at the end of a muscle which is exacerbated by movement may be tendonitis or tendinopathy. The most common cause of inflammation and irritation in the tendon is repetitive overuse. Often biomechanical or movement errors, muscle strength and length asymmetries or insufficiencies are an underlying cause. Pain is usually described as a dull ache that can interfere with your activities. Tenderness, mild swelling and general weakness may also be present. Patellar tendinopathy, achilles tendinopathy and hip flexor tendinopathy are examples of tendon irritation that may occur in the leg. 

Muscle contusion: muscle contusions (bruises) are a common cause of injury in contact sports. Minor contusions typically heal quickly with little disruption to sports or daily life. A direct or repeated blow to the muscle can cause a severe contusion, however, which causes deep tissue damage to the muscle fibers and connective tissue and can take a long time to heal. Swelling, stiffness, weakness, localized bruising and pain are common. Sometimes a pool of blood called a hematoma can form over the area. Severe muscle contusions should always be evaluated by a health professional as there is a right and a wrong way to treat these injuries. 

HOW WILL YOUR PHYSICAL THERAPIST TREAT YOUR LEG?

As you can see, leg injuries can vary widely and at times symptoms may even be referred from another area such as your back. Initially your PT will assess your leg to determine the cause and contributing factors to your symptoms and then will begin a customized treatment plan to get you back on your feet. 

If you are being treated for an acute injury such as a sprain or strain, your physical therapist will educate you on how to protect these newly healing tissues. Treatment may include compression or bracing, offloading the injured area through crutches, modalities such as ice, ultrasound or electrical stimulation to reduce pain and swelling and activity modification. 

In well-healed tissues, chronic injuries like tendinopathy or referred conditions like sciatica, your physical therapy program will focus not only on reducing or eliminating localized symptoms but on addressing factors that contributed to the onset of the symptoms. Often injuries or pain in the leg are caused by repeating faulty movement patterns or having an imbalance of muscle strength and length to carry out a task such as running, cutting, or jumping optimally and with good mechanics.

While some leg injuries may require intervention by a doctor or surgeon, a physical therapist should always be a primary member of your care team. A physical therapist at Evolve can help you get on the road to recovery. Our therapists do not just treat symptoms, but we get to the root of the cause. We strive to enable our patients to live pain free, and to prevent the recurrence of related issues.

Click here to find out more about leg physical therapy in Brooklyn.

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

HIP INJURY GETTING IN YOUR WAY?

Physical Therapy for the Hip

HIP PAIN AND INJURY GETTING IN YOUR WAY?

The hip joint is a ball and socket joint where the top of the femur meets the pelvis. The mechanics of this joint allow for a great deal of movement of the leg but requires the appropriate balance between mobility and stability to reduce likelihood of injuries. True hip joint pain is felt deep in the groin area but many other conditions involving muscles, tendons or nerves surrounding the hip may be felt above, below and to the side of this area. 

WHAT HIP CONDITIONS CAN A PHYSICAL THERAPIST TREAT?

Bursitis: Bursa are small sacks of fluid that act as cushions over a bony area. The most common area for bursitis in the hip is on the greater trochanter of the hip on the outside of the upper leg. Bursa can become inflamed or irritated with repetitive friction usually caused by activities such as long distance walking on uneven surfaces or on uneven legs, running up hills or even by a direct trauma such as falling on the hip. Bursitis can cause pain and irritation when lying on the hip, lifting the leg, climbing stairs or walking. Physical therapy can help reduce inflammation and pain and address contributing factors such as muscle weakness, leg length discrepancies or movement pattern errors to resolve symptoms and limit recurrence. 

Labral Tear: An injury to the band of cartilage that lines the outside of the hip joint is called a labral tear. A tear in this area can occur from a trauma such as a fall or car accident but is more often the result of repetitive stress and strain during activities such as deep squatting, cutting and twisting. It is more likely to occur in the presence of bony abnormalities in the hip joint (hip impingement). Typical symptoms include dull pain felt deep in the groin that can be sharp with low squatting, clicking or catching of the hip with movement, pain and stiffness that is worse after prolonged sitting or walking and stiffness or muscle weakness. This cartilaginous ring is not capable of healing on its own so some people may opt for surgery. Others can achieve a satisfactory level of symptom reduction and return to activity with physical therapy to optimize muscle strength and length and address movement patterns. 

Osteoarthritis: Arthritis can occur in any joint. In the hip, osteoarthritis refers to breakdown of the cartilage that covers the femoral head (ball of the hip) and lines the acetabulum (socket of the pelvis) and a loss of synovial fluid that lubricates the joint. This results in rubbing of bony surfaces together causing pain and stiffness. In severe cases a total hip arthroplasty (replacement) may be performed by a surgeon. While physical therapists cannot reverse the OA itself, arthrtitis physical therapy has proven an effective treatment modality for arthritis. Restoration of optimal joint movement, addressing biomechanics and movement pattern inefficiencies, maximizing muscle strength and education on possible activity modifications are all helpful. 

Muscle Strain: Muscles are made up of bundles of muscle fibers aligned in specific patterns. When these fibers contract they shorten the muscle and pull on the bones they attach to creating movement and strength. At either end of these fibers is a strong band of tissue called the tendon which connects the fibers to the bone. When overstretched, overused or contracted against a sudden load, a muscle strain can occur as muscle fibers or the musculotendinous junction are torn or injured. 

Grade I strain (mild): very few muscle fibers are injured. Pain typically occurs the next day but no swelling or bruising is observed. Pain may be felt when the affected muscle is strongly contracted or stretched at its end range.

Grade II strain (moderate): many (but not all) fibers are injured resulting in stiffness, loss of flexibility and loss of strength. Pain is felt both during contraction of the muscle and stretching. Swelling and bruising over the injured area is common. 

Grade III strain (severe): all fibers of the muscle are completely torn or the muscle belly has detached from it’s tendon. Severe pain is often felt upon injury and heavy swelling and bruising will develop. Range of motion may be either significantly reduced due to pain or excessive because the muscle is no longer limiting it. This muscle will generally be unable to produce any force due to the severe disruption in the fibers

Peripheral Nerve Entrapment: This condition refers to compression of a nerve as it passes through structures around the hip. Depending on the location and severity you may experience radiating pain or burning sensation, numbness or tingling or muscle weakness. Manual therapy techniques such as soft tissue mobilization or stretching may help reduce compression. Taping to offload the area may also help. Your physical therapist may also prescribe strengthening exercises to ensure surrounding musculature can support the affected area while minimizing compression. 

Tendinopathy: Tendons are the thick, fibrous bands or cords that attach muscle fibers to bones. Pain felt outside of a joint at the end of a muscle which is exacerbated by movement may be tendinopathy. The most common cause of inflammation and irritation in the tendon is repetitive overuse. Often biomechanical or movement errors, muscle strength and length asymmetries or insufficiencies are an underlying cause. Pain is usually described as a dull ache that can interfere with your activities. Tenderness, mild swelling and general weakness may also be present. Patellar tendinopathy, achilles tendinopathy and hip flexor tendinopathy are examples of tendon irritation that may occur in the leg. 

LET US HELP YOU GET ON THE ROAD TO HEALING 

While a physical therapist cannot repair the labrum or reverse osteoarthritic changes in the joint, physical therapy is an excellent treatment option for acute and chronic hip pain and injuries. Your body was meant to move and whether you are looking for help rehabilitating after surgery or conservative treatment for discomfort that is keeping you from participating in home, work or recreational activities, physical therapy should be at the top of your list. Through a thorough assessment and evaluation, a physical therapist at Evolve can get to the root of your problem and develop a plan of care that will not only treat your symptoms but enable you to stay active for as long as you like by preventing the recurrence of related issues. 

Click here for more information about hip physical therapy in Brooklyn

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com