Brooklyn Physical Therapy News- Evolve NY
Don’t jump through hoops to find a great basketball PT
Physical Therapy for Basketball Players; Playing Offense Against Injuries- Most basketball players are looking to gain a competitive edge and many hope to be able to play the game for years. Some even have aspirations of playing professionally. One important aspect of longevity in basketball is high quality injury rehabilitation and injury prevention programs.
Physical Therapy for Basketball Players
Playing Offense Against Injuries
Basketball is a popular sport amongst kids, teenagers and adults. A great way to socialize with friends and teammates, stoke the competitive fire and get some exercise, playing basketball has many benefits. Most players are looking to gain a competitive edge and many hope to be able to play the game for years. Some even have aspirations of playing professionally. One important aspect of longevity in basketball is high quality injury rehabilitation and prevention programs. To get the most out of these programs, working with a sports or orthopedic physical therapist familiar with the sport of basketball is a smart choice.
SUCCESS IN BASKETBALL
You don’t get to be Kobe Bryant or Michael Jordan without thousands of hours practicing basketball drills and skills on top of time spent in the fitness room. No matter what level you participate in a sport, preparing your body physically for the demands of that sport is an important way to minimize injury risk, promote longevity and improve performance. Physical therapists use their understanding of the unique physiological and anatomical demands of a sport like basketball to train and rehabilitate their athletes. Let’s take a look at the components of fitness and movement that are important for basketball players to maximize performance and decrease injury risk:
Strength: Muscle strength refers to the amount of force a muscle can develop, the amount of force or pressure it can withstand or the amount it can move. Whole body strength is important for basketball players who need to run, jump, change directions and shoot a ball.
Power: Power is a component of muscle performance in which strength or muscle force is developed rapidly in order to perform ballistic movements like passing a ball to another player or taking a jump shot. A player that is strong but slow will be at a disadvantage in many situations.
Flexibility: Appropriate muscle flexibility is essential for players to move through their full ranges of motion without straining muscles.
Joint Mobility: Joint mobility is important for the execution of movements requiring more extreme ranges of motion like shooting a ball overhead.
Joint Stability: The ability to control joint position while rapidly changing directions or while landing from a jump, for example, is important to help prevent sprains and strains.
Proprioception and Coordination: Joint proprioception and neuromuscular coordination are important components of the skills required to be a great player.
Muscle Endurance: Strong muscles with poor endurance will have difficulty performing at a high level for the duration of practice or game play and injury risk increases as muscles fatigue.
HOW PHYSICAL THERAPISTS CAN HELP
Having a great physical therapist on your team is a huge benefit. PT’s have two main roles when it comes to athlete management. First, they use their knowledge of components of movement and fitness that were outlined above to screen athletes and identify impairments that increase their risk for injuries and may be compromising performance. This type of athlete screen allows for a proactive approach to injury prevention and athlete development. Some of the components of a screen that your physical therapist may select to use are isolated muscle strength, length and power assessments, joint range of motion measurements, muscle coordination and control tests and functional movement screens.
You may feel confident about the training and work you are doing on certain body segments like your legs, but physical therapists know that the body is connected from head to toe and are able to identify impairments throughout the body that can have a negative impact on your performance. Once they have identified these impairments your physical therapist can prescribe a series of treatments and exercises that you can implement in off-season, pre-season and/or during the regular season to support performance and minimize injury risk. By taking this proactive step you can get ahead of potential injuries and you may even see your performance improve.
The second role that physical therapists play in the management of basketball players is injury rehabilitation. Despite a good training program and injury prevention program, injuries can still occur and proper rehabilitation can make the difference between returning to sport at full capacity and sitting on the bench. If you play regularly or competitively, finding a good physical therapist that you trust before you get injured gives you the opportunity to get support as soon as a problem arises. For example, it is common to ignore small, recurring aches and pains until they become a bigger problem. When you are working with a physical therapist, you should alert them to these symptoms right away so they can advise you on how to address them before they become season-interrupting injuries.
When an injury strikes, the steps you take early on are just as important as the steps you take later in the recovery process. Knowing when to rest completely, when to modify activity and when to continue playing is an important skill that physical therapists have developed based on their education and practice. Basketball-related injuries can occur during practice, during games and even in the training room. Some examples of injuries that physical therapists often treat in basketball players are as follows:
Achilles tendon tears
Achilles tendinopathy
Muscle contusions
Concussions
Calf injuries
Each of these injuries has a unique timeline for recovery and protocol for rehabilitation and working with a physical therapist that understands basketball will help them tailor your rehabilitation plan of care to support return to sport. Injuries are never fun and sometimes taking a break from sport is necessary to allow for optimal healing, but teaming up with a physical therapist you trust will help make the recovery process that much easier.
CHOOSE EVOLVE PHYSICAL THERAPY
At Evolve PT we want to get you strong and healthy so that you can get back to playing the game you love. We apply an individualized approach to athlete assessment and rehabilitation and our goals are to help you become the best player you can be. If you are a basketball player recovering from an injury or wondering if there are steps you can take to prevent one in the future, call Evolve PT today.
Click here to find out more information about physical therapy for basketball players
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Baseball Players
Whether playing baseball in a recreational league, for the big leagues or even in little league, players can benefit from having a good physical therapist on the roster. Baseball is a fun sport but even recreational play can stress a players’ bones, joints, tendons, ligaments and muscles as they run the bases, throw the ball and slide into bases.
Baseball Physical Therapy
Hitting Home Runs with PT!
Whether playing baseball in a recreational league, for the big leagues or even in little league, players can benefit from having a good physical therapist on the roster. Baseball is a fun sport but even recreational play can stress a players’ bones, joints, tendons, ligaments and muscles as they run the bases, throw the ball and slide into bases.
Understanding the demands a player’s body undergoes during training, practice and play as well as learning about injuries common in baseball players, is an important aspect of a long career in baseball. Whether looking to rehabilitate from an injury or simply prevent one in the first place, working with a sports or orthopedic physical therapist can be a great way to play your best each game.
PREPARING THE BODY FOR BASEBALL
Baseball, like most sports, demands a lot of the body. Understanding the components of movement and exercise necessary to be a successful player and minimize injury risk is important. Each position on the field requires different skills, motions and types of muscle performance. Below is a list of components of fitness and movement that are important for baseball players to develop as a strategy to maximize performance and decrease injury risk:
Strength: Muscle strength refers to the amount of force a muscle can develop, the amount of force or pressure it can withstand or the amount it can move. Whole body strength is important for a baseball player in that it helps with throwing, running, jumping and more.
Power: Power is a component of muscle performance in which strength or muscle force is developed rapidly in order to perform ballistic movements like throwing a ball across the field or sprinting to catch a fly ball. A player that is strong but slow will be at a disadvantage in many situations.
Flexibility: Baseball players move their limbs through large ranges of motion when extending a leg to reach the base, throwing a ball, etc. Appropriate muscle flexibility is essential for players to move through their full ranges of motion without straining muscles.
Joint Mobility: Joint mobility is important for the execution of movements requiring more extreme ranges of motion like externally rotating the shoulder to prepare for a pitch or for a catcher squatting low to the ground.
Proprioception and Coordination: Joint proprioception and neuromuscular coordination are important components of the skills required to be a great ball player.
Muscle Endurance: Strong muscles with poor endurance will have difficulty performing at a high level for the duration of practice or game play and injury risk increases as muscles fatigue.
SCREENING BASEBALL PLAYERS FOR INJURY RISK
Now that you understand how many different components of fitness, movement and muscle performance baseball players need, you may be wondering how to identify impairments that may compromise your success as a player or put you at risk for injury. One role that physical therapists play in the care of baseball players is injury prevention and prehabilitation. Waiting for an injury to occur before you begin looking for potential weak links in the kinetic chain is not the best approach. Good news, however, because physical therapists are movement experts with tools to identify areas you should address if you want to prevent injuries and improve performance.
As part of a comprehensive assessment or screening process, a physical therapist can assess joint range of motion, muscle strength, power and endurance, speed, stability, neuromuscular control, coordination, flexibility and joint mobility and compare your results with values deemed ideal or beneficial for baseball players.
With this information your physical therapist can prescribe a series of treatments and exercises that you can implement in off-season, pre-season and/or during the regular season to support performance and minimize injury risk. By taking this proactive step you can get ahead of potential injuries and you may even see your performance improve.
INJURIES HAPPEN
Despite a good training program and attempts at minimizing the risk for injury, injuries still happen in baseball. Having a good sports and orthopedic physical therapist on hand that you can turn to quickly is an important step to beginning injury rehabilitation on the right foot. Knowing when to rest completely, when to modify activity and when to continue playing is an important skill that physical therapists have developed based on their education and practice. Making the right choices early after an injury can make a big difference in how you recover.
Baseball-related injuries can occur during practice, during games and even in the training room. Some examples of injuries that physical therapists often treat in baseball players are as follows:
Muscle contusions
Shoulder labral tears
Ulnar Collateral Ligament injuries (and post-Tommy John Surgery)
Shoulder instability
Knee and ankle ligament injuries
Wrist sprains or tendonitis
Each of these injuries has a unique timeline for recovery and protocol for rehabilitation and working with a physical therapist that understands baseball will help them tailor your rehabilitation plan of care to support return to sport. Injuries are never fun and sometimes taking a break from sport is necessary to allow for optimal healing, but teaming up with a physical therapist you trust will help make the recovery process that much easier.
CHOOSE EVOLVE PHYSICAL THERAPY
At Evolve PT we want to get you strong and healthy so that you can get back to playing the game you love. We apply an individualized approach to athlete assessment and rehabilitation and our goals are to help you become the best player you can be. If you are a baseball player recovering from an injury or wondering if there are steps you can take to prevent one in the future, call Evolve PT today.
Click here for more information about physical therapy for baseball players
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapists are a Football Player’s Friend
Physical Therapists are a Football Player’s Friend. Any athlete who wants to play at a competitive level can benefit from having a great physical therapist in their corner. Football players are no exception. Just like coaches and trainers, physical therapists play an important role in keeping players in top physical condition for practice and game day.
Football Physical Therapy
Intercept and Tackle Football Injuries
Any athlete who wants to play at a competitive level can benefit from having a great physical therapist in their corner. Football players are no exception. Just like coaches and trainers, physical therapists play an important role in keeping players in top physical condition for practice and game day. From injury recovery to injury prevention, you want a skilled physical therapist on the team.
Don’t Fumble Your Injury Recovery
The most well-known role that physical therapists play in the world of football is helping with injury recovery. Though football is often thought to be associated with high rates of injury, the majority of youth level players will not experience an injury that restricts their participation. Injuries tend to become more common and more severe as athletes age and the forces they are able to create become larger. The majority of football-related injuries affect the musculoskeletal system and occur to the legs including the hips, knees and ankles. The most common types of injuries include:
Ligament sprains/tears (ankle sprains, ACL/MCL tears, etc,)
Muscle contusions
Concussions
Ligament sprains, contusions and concussions are three of the most common football-related injuries. Concussions are an injury that has garnered a lot more attention in the media as of late, due to the concern for long-term repercussions associated with repeated concussions. Football remains near the top as far as concussion rates among high school athletics. The NFL has been tracking the rate of concussions among players during preseason and regular season play since 2015, with the total number of concussions ranging from 172 to 281 concussions per year.
Injuries can happen when two players contact each other such as during a tackle. Noncontact injuries can also occur such as when a player plants his foot in the grass and tries to pivot, injuring a ligament or rolling their ankle. Some injuries may take just a day or two to recover from but any injury that forces a player to modify how they are walking or how they normally move should be evaluated by a physical therapist. This includes concussions.
STAGES OF RECOVERY
The ultimate goal of physical therapy following a football-related injury is to ensure that the injured tissues are ready to undergo the forces experienced during a high impact sport like football. In the case of concussions, sustaining another concussion before the brain has healed from the first one, a condition called second-impact syndrome, can have devastating consequences. In some cases modifying practice or training for a short period of time is enough to allow for full healing and other times full rest from practice and play is needed. It can be difficult at times to know which is the right choice, which is why you have a knowledgeable physical therapist who is trained to help you make these calls. When it comes to recovering from an injury, your PT will help guide you through the stages of healing. Doing too much too soon can impede and prolong the healing process while doing too little at the right time can also under-prepare the injured area for return to play.
When an injury is new, the primary goal is to protect the newly-healing tissue. In this very early phase your physical therapy treatment will focus on reducing inflammation and pain, and maintaining strength in unaffected areas above and below the injury. To achieve these goals your physical therapy treatment may consist of the application of ice or light soft tissue work to mobilize any edema. Modalities such as electrical stimulation or ultrasound physical therapy may be applied to increase circulation, decrease inflammation and control pain. You may need to briefly use a brace, crutches or a sling. In the case of a concussion it often includes full rest from play along with a reduction in screen time, noise and even some schoolwork.
As the healing tissues become stronger, inflammation subsides and pain is reduced, it is time to move on to the next phase of rehab. If your injury is in one of the joints of the leg, ankle or foot, it is important that you are able to walk with a normal gait pattern without any assistive devices before you start adding too much stress to the area. Your PT will help you know when you have reached these milestones and you may begin to perform gentle pain-free stretching and range of motion exercises to restore mobility to the injured area. It is also important in this phase to start performing light resistance training to the muscles around the affected ligament to start activating muscles and restoring neuromuscular control.
Finally, in the later stages of healing your physical therapy treatment will focus on exercises and activities that prepare the injured area to withstand the stress and strain of football practice, play and training. In this stage you may begin more sport-specific exercises and activities to restore power, agility and speed. Optimizing biomechanics and muscle strength and motor control is essential to support the previously-injured joint and reduce the likelihood of experiencing an injury in the future.
Most players will heal from a concussion within a few weeks if an appropriate return-to-play protocol is followed. In the case of protracted recovery, a condition called postconcussion syndrome, working with a physical therapist knowledgeable in concussion rehab is very important to facilitate full recovery in a timely fashion.
IDENTIFY THE CAUSE OF AN INJURY
Some injuries are unavoidable but whenever there is a chance to increase injury resilience in a player, it is worthwhile to do so. Physical therapists are interested in identifying the factors that may have predisposed a player to the injury in the first place, so they can make a plan to address them. Some of the factors that a PT will look for are imbalances in muscle strength, power, endurance and neuromuscular control as well as limitations in muscle and joint flexibility/mobility. They will consider sleep and nutrition habits, a player’s training schedule, their history of prior injury and the physical demands of their role on the team.
These considerations will be a part of an injury rehabilitation program but a player does not need to wait until they are injured to consult with a PT about injury prevention. Off-season training, preseason training and regular season training are all appropriate times to consult a physical therapist about injury prevention and they can help you implement a training protocol to address these risk factors.
DON’T WAIT TO MEET YOUR PT
If you are going to be playing football it is important to have a good PT on your roster. Our team of therapists at Evolve are here to help you recover from injury and be the best player you can be. If you are recovering from an injury or looking for ways to prevent one, call Evolve today to schedule an evaluation.
Click here for more information about football 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 Brooklyn Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Athletes
Enhance Sport Performance with PT- Whether you are a weekend warrior or a pro-level athlete, working with a good physical therapist can enhance your performance and reduce your risk of injury. In 2021, 3.2 million people were treated in emergency departments for injuries involving sports and recreational equipment.
Elevate Your Game with a Great Physical therapist
Enhance Sport Performance with PT
Whether you are a weekend warrior or a pro-level athlete, working with a good physical therapist can enhance your performance and reduce your risk of injury. In 2021, 3.2 million people were treated in emergency departments for injuries involving sports and recreational equipment. The activities most frequently associated with injuries are exercise, cycling, and basketball. Amongst the roughly 30 million teens and children who participate in some kind of organized sport here in the United States, more than 3.5 million injuries occur each year which lead to some loss of time participating in the sport.
If you are an athlete or the parent of an athlete, you likely understand the roles of coaches and trainers in sport performance, but do you know how physical therapists can support an athlete?
IT STARTS BEFORE THE INJURY
Most people are familiar with the important role that physical therapists play in injury rehabilitation, but in many cases an athlete can work with a PT well before an injury happens. Here is why you should consider this:
Identification of injury risk factors: working with a physical therapist familiar with your sport can allow you to identify potential injury risk factors well before the injury. This can give you the opportunity to address them. Risk factors that a physical therapist will look for may include imbalances in muscle strength or flexibility, movement coordination, biomechanics, endurance, soft tissue mobility and so forth.
Examine your training plan: While a trainer or coach will likely set up a training plan for an athlete, physical therapists can examine your training plan within the context of your history of past injury, your unique body morphology and any impairments that you currently have. With this information they may make suggestions on what to modify or incorporate into your training to reduce injury and enhance performance. Here are some additional suggestions your PT might make:
Warm-up routine: just like workouts, an individualized warm-up routine will help prepare your body for the forces involved in playing your sport
Cool down routine: cooling down is just as important as warming up and while it can be tempting to skip this part, your PT will help you create a cool down routine that helps you recover faster
Recovery strategies: Stretching, foam rolling, mobility routines are just some of the examples of recovery routines that may help you prevent injury and recover for your next big event
Cross-training: while some people’s bodies can handle high volume of the same activity with minimal injury, other people need to incorporate more cross-training into their training cycle.
Optimize movement patterns: Physical therapists are movement experts and a sport-oriented physical therapist can help you optimize your movement patterns during both training exercises and actual sport performance in order to derive both a performance benefit and an injury-prevention effect. Evaluating run form on a treadmill or jumping mechanics are two examples of how PTs assess movement quality.
Address the niggles right away: Many athletes wait until they have a full-blown injury before working with a physical therapist but there is a great deal of benefit to consulting a PT when they are experiencing the small aches, pains or niggles that usually develop first. Any symptom that is persisting during your training needs to be addressed–the earlier, the better.
Now that you understand many of the benefits to working with physical therapy aside from rehabilitating injuries, you may be wondering when is the best time to consult a PT? The true answer is anytime, but depending on your training cycle and sport seasons throughout the year, a PT may play different roles at different times. An athlete that has a competitive season will also have an off-season.
If you are running races or playing games multiple times a month or even a week, your focus is going to be on maintaining fitness, perfecting sport-specific skills and recovery. During this time a PT can intervene to address minor injuries or niggles, advise you on how to maximize recovery and help optimize movement patterns. During the off-season, athletes should focus on strength, power, speed, and endurance development when accumulated stress and fatigue do not increase the risk for injury or decrease your performance during a game or competition. This is an optimal time to work with a PT on all of the factors listed above so that as you build toward your competitive season or event, you are in the best place possible.
INJURIES DO HAPPEN
Despite best-laid plans, injuries in athletes still occur and working with a physical therapist to heal the injury and minimize the risk for recurrence is a good idea. The goal of injury rehabilitation is to ensure that the injured tissues are ready to withstand the stresses of your sport. These tissues undergo three stages of healing from an acute phase to a chronic phase with each phase having important physiologic processes for healing. Doing too much too soon can re-injure healing tissues and prolong recovery. On the other hand, doing too little at the right time during recovery can also hinder recovery and may predispose the tissues to another injury. It can be tough for an athlete to know how to support an injury through this process but that is why physical therapists exist!
Our team of physical therapists at Evolve will help guide you through the injury recovery process from the earliest moments where protecting the injury is the number one goal, to the late stages where you are performing sport-specific drills and getting back into your prior activity levels. Don’t leave injury rehabilitation and prevention up to chance, let the experts at Evolve help you be a healthier and more resilient athlete!
Click here for more information about 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 Physical Therapy Locations!
https://EvolveNY.com
You’re Too Busy to Feel Dizzy!
The Many Faces of Vestibular Dysfunction- While all humans have a vestibular system, most will never know it is there unless they develop a vestibular system disorder. The vestibular system, like most of our body systems, typically hums along in the background doing its job without much notice and no active participation from its owner.
Vestibular Physical Therapy
The Many Faces of Vestibular Dysfunction
While all humans have a vestibular system, most will never know it is there unless they develop a vestibular system disorder. The vestibular system, like most of our body systems, typically hums along in the background doing its job without much notice and no active participation from its owner. This system does play a very important role in normal human movement, however, and when it is not operating optimally can cause significant symptoms like dizziness and imbalance. Physical therapists are healthcare providers that can help treat the symptoms of a vestibular disorder and improve overall patient function.
THE WHO, WHAT AND WHERE OF THE VESTIBULAR SYSTEM
Deep inside the inner ear lie what are called the vestibular organs. These organs are part of the vestibular system that gathers sensory information about the position and movement of the head and plays an important role in balance and gaze stability. Inside each inner ear lie 5 small organs–3 semicircular canals that provide information about angular acceleration (head rotation) and 2 otolith organs that are sensitive to linear (straight line) acceleration.
When the head and body move, these organs send information via the vestibular nerve into the brain to update the nervous system about how the body is moving so it can fire the proper muscles to keep you balanced and stable. Typically, the signals in each ear balance one another. Certain medical conditions can cause a sudden imbalance in vestibular input between the ears or a reduction in function in both ears. When this system is not functioning optimally symptoms like vertigo, dizziness, and unsteadiness result.
THE MANY FACES OF VESTIBULAR DYSFUNCTION
Dysfunction and disorder of the vestibular system comes in many forms. Sometimes our patients will come to the clinic with a diagnosis of a vestibular condition and other times they come to the clinic with symptoms of a vestibular disorder but no diagnosis. In either case, physical therapy can often help to identify the cause (when needed) and treat the symptoms. Symptoms that can indicate a vestibular disorder include:
Feeling off balance or unsteady when you turn your head, change position, walk or are in a space with a lot of visual stimuli like a grocery store or busy airport
Feeling like the environment around you or words on a page are bouncing up and down or oscillating back and forth
Room-spinning vertigo that occurs in response to a position change such as rolling over in bed or bending down to clean out the dishwasher
Feeling of unsteadiness in low light conditions or on uneven terrain
Dizziness when turning your head or changing position
Dizziness or vertigo when bearing down
Nystagmus (abnormal movements of the eye)
Some common vestibular disorders encountered by physical therapists include:
Meniere’s Disease
Vestibular Neuritis
Vestibular hypofunction
Concussion
Labyrinthitis
Cervicogenic Dizziness
Persistent Postural Perceptual Dizziness
Vestibular migraine
In addition to symptoms like imbalance or dizziness, vestibular disorders can be accompanied by other symptoms such as neck pain or stiffness, loss of or changes in hearing, tinnitus, nausea/vomiting and hearing your own heartbeat or footsteps more loudly than usual. Symptoms can develop following a concussion or brain injury or a recent upper respiratory, gastrointestinal or other viral infection.
It is important to recognize that many of these symptoms can overlap with other serious medical conditions and seeking treatment from a medical provider is always recommended. If you are experiencing symptoms of a vestibular problem along with any of these other symptoms it is essential to seek urgent medical care:
Weakness, especially on one side of the body or face
Loss of coordination
Changes in vision
Severe headache
Changes in sensation
Abnormal eye movements
Confusion
Changes in speech
Vomiting
Chest pain or pressure
Unrelenting vertigo or dizziness
At the onset of new symptoms your doctor may recommend imaging studies such as MRIs or CT scans to rule out some of these more serious causes of dizziness and imbalance. In some cases you may be referred to an ENT or audiologist for specialized testing of the vestibular system. Some medications can also be damaging to the vestibular nerve or vestibular organs so it is important to discuss your medications with your doctors as well.
VESTIBULAR EVALUATION
The vestibular evaluation is intended to identify an underlying cause for your symptoms, determine if physical therapy is indicated and if a referral to another provider like an ENT or Neurologist is needed. During this evaluation your physical therapist will be looking closely at how your eyes move as they are closely linked to the vestibular system through several reflexes. In some cases they may ask you to wear a set of special goggles called Frenzel lenses that allow the therapist to see your eyes magnified on a screen, watch a playback of eye movements and even briefly occlude your vision with a goggle screen cover. They will observe your eyes under several conditions such as:
Following a moving object
Looking back and forth between two points
Following an object as it approaches your nose
Maintaining gaze on a stable target while turning your head back and forth
Gazing in different directions
Moving your head quickly one direction or another while looking at a fixed point
Changing positions
Your therapist will be observing for things like gaze stabilization, nystagmus, convergence of the eyes, and so forth while asking you about the presence of symptoms like double vision, blurry vision, dizziness, vertigo, nausea, imbalance, etc. The vestibular evaluation also often includes an assessment of balance, gait, strength and coordination and possibly other assessments depending on the exam findings.
VESTIBULAR PHYSICAL THERAPY CAN HELP
While vestibular physical therapy is not indicated for every single vestibular condition, in many cases it can be very helpful to reduce and sometimes eliminate symptoms and improve overall function. How do physical therapists treat the vestibular system? Well, it depends on the cause of the symptoms. In the case of BPPV the use of canalith repositioning maneuvers like the Epley Maneuver are used to remove calcium carbonate crystals from the semicircular canals. In the case of other vestibular conditions, vestibular therapy often focuses on facilitating adaptation of the vestibular system or helping the body compensate for a loss of vestibular function. Reducing motion sensitivity, addressing any neck-related conditions, improving balance and walking ability are all aspects of vestibular physical therapy that can help patients immensely. Educating patients on how to manage their conditions is another important role of physical therapy.
As you can see there are many ways that physical therapists can help individuals experiencing vestibular-related symptoms and it starts with scheduling an initial evaluation. Call Evolve Physical Therapy today to schedule an appointment with one of our vestibular physical therapists today.
Click here to find out more about vestibular 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 Brooklyn Locations!
https://EvolveNY.com
Physical Therapy for Tennis Elbow
Tennis Elbow? If you are experiencing pain on the outer elbow or forearm with wrist, hand or elbow movements, you may have a condition called tennis elbow. Known formally as lateral epicondylitis, tennis elbow is a condition in which the tendons on the outside of the elbow become inflamed, irritated, and painful resulting in the symptoms noted above. Not a tennis player? While this condition…
Physical Therapy for Tennis Elbow
We’ve Got No Love for Tennis Elbow
If you are experiencing pain on the outer elbow or forearm with wrist, hand or elbow movements, you may have a condition called tennis elbow. Known formally as lateral epicondylitis, tennis elbow is a condition in which the tendons on the outside of the elbow become inflamed, irritated, and painful resulting in the symptoms noted above. Not a tennis player? While this condition was named due to the stressing of these tendons during an improper tennis swing, this condition is not limited only to tennis players.
Let’s dive deeper into this condition and how physical therapy can be used to treat it.
ANATOMY OF TENNIS ELBOW
If you lay your forearm out on the table in front of you, palm up, the bony area on the outside of the elbow is known as the lateral epicondyle. A sheath housing several tendons attaches to the bone here and acts as an anchor point for muscles that extend the wrist and hand. Repetition of these movements can stress the tendons at their attachment points under certain conditions. When this happens, the irritated or inflamed tendons cause pain, burning or aching at the lateral (outside) of the elbow and sometimes extending down toward the wrist.
Symptoms may initially be present only during activities requiring repetitive wrist extension such as during a game of tennis, but can eventually become symptomatic even at rest. In more severe cases you may experience stiffness in the elbow and even weakness in the forearm and hand with gripping can occur over time. Pain may occur at night.
WHAT CAUSES THIS CONDITION?
Tendons are built to withstand a lot of force but repetitive stress which exceeds the tolerance of the tendon can lead to injury. The overloading of the tendon may be caused by ramping up the volume of a new activity too quickly, due to muscle strength or length impairments, movement pattern inefficiencies or biomechanical errors in and around the wrist and elbow.
While this condition is termed “tennis elbow” due to its prevalence among racket sport athletes such as tennis and racquetball players, any activity that requires repeated wrist extension can lead to tennis elbow. Painters, plumbers and carpenters, for example, are prone to developing this condition because of the tools they use and the movements they perform for their jobs. Butchers, cooks and workers in the automobile industry are similarly at risk.
Initially, the symptoms of pain and soreness may be caused by localized inflammation–known as tendonitis ( “itis” = inflammation ). In this case anti-inflammatory medications and other treatments aimed at reducing inflammation are often effective as long as the tendon is allowed to rest.
Oftentimes, however, ongoing symptoms are not caused by persisting inflammation which is why anti-inflammatory medications and ice, for example, may lose effectiveness over time. In this case the tendon is likely not inflamed but has undergone some degeneration leading to chronic symptoms. This is called tendinopathy and likely accounts for ongoing symptoms in many chronic tendon injuries. Why does this matter? This matters because while rest may be helpful for an inflamed tendon, it is not the best treatment for tendinopathy. In fact, it may have the opposite effect.
PHYSICAL THERAPY CAN HELP
Tennis elbow can often be diagnosed through a careful history and examination. During an initial evaluation, your physical therapist will ask you about when the symptoms started and if you started any new activities or increased the time or intensity of these activities before the symptoms began. They may also ask you about how long your symptoms take to resolve and what you can do, if anything, to help reduce them.
Examining the arm will help your physical therapist to determine the most likely cause of your symptoms and to identify contributing factors such as strength asymmetries, range of motion deficits, tissue mobility problems or biomechanical errors in the arm. This will help your therapist to develop a comprehensive elbow physical therapy treatment plan.
If your therapist suspects your symptoms are caused by tendonitis, you can expect your treatment may initially include modalities such as ice, ultrasound physical therapy, or electrical stimulation to manage pain and swelling, and education on your injury including any necessary activity modifications. They may also apply gentle manual techniques such as passive range of motion and possibly taping or bracing to protect the injured area and allow the body’s healing process to proceed.
If your therapist suspects your symptoms are no longer inflammation-based and more likely a tendinopathy, there will likely be less emphasis on passive modalities that would normally be used to calm inflammation, and more emphasis on interventions that will help remodel the structure of the tendon. The goal of treatment for tendinopathy is to apply graded stress to the tendon and increase its stiffness so that it becomes more resilient to the repetitive forces of your work tasks and favorite sports. Resting the tendon will not contribute to this process and will predispose you to experience recurrence of these symptoms when you resume your previous level of activities. To do this correctly, your PT will guide you on appropriate dosing of specific activities and may also utilize tools such as ASTYM or Graston to encourage collagen production and remodeling.
Whether your physical therapy program will emphasize calming inflammation or remodeling the tendons you can be sure that addressing other contributing factors such as muscle weakness, flexibility impairments and poor biomechanics is also important to prevent injury recurrence. This is another example of how working with a physical therapist can get you faster and more long-lasting results. With their expertise they can individualize your program to treat the factors that are causing your specific case of tennis elbow.
So if you have been experiencing pain or tenderness along the outside of your elbow and forearm, grip weakness or elbow stiffness, call and set up an appointment with a physical therapist at Evolve. Our therapists do not just treat symptoms, but we get to the root of the problem. We strive to enable our patients to live pain free, continue doing the activities they love, and prevent the recurrence of related issues.
Click here for more information about physical therapy for tennis elbow
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 Physical Therapy Office Locations!
Rehabbing Not Resting Painful Tendons
IT’S NOT ALL ABOUT THE MUSCLES: Muscles get most of the attention when it comes to strength and conditioning. We work hard to build those muscles up so that we can lift heavier objects, run faster, jump higher, and look good while doing it. But while our muscles display all of our hard work, our tendons are in the background working just as diligently with little of the glory.
Physical Therapy for Tendonitis
Tackling Tendon Pain Once and For all
Muscles get most of the attention when it comes to strength and conditioning. We work hard to build those muscles up so that we can lift heavier objects, run faster, jump higher, and look good while doing it. But while our muscles display all of our hard work, our tendons are in the background working just as diligently with little of the glory. Tendons are a type of fibrous connective tissue that connect muscles to bones. Far from simply fasteners of muscle to bone, tendons play a pivotal role in the effects that muscles have on the skeleton. First, tendons help to move our bones and amplify the effect of muscle contractions . Second, they play an important role in attenuating and absorbing shock that is transmitted from bone into muscle.
Tendons are strong but they are not designed to stretch or deform easily. They can also become weaker or stronger/stiffer in response to a training stimulus. Depending on the training and the activity, a tendon can become more prone to or more resilient against injury. Tendons are built to withstand a lot of force but repetitive stress which exceeds the tolerance of the tendon can lead to injury. The overloading of the tendon may be caused by ramping up the volume of a new activity too quickly, or due to muscle strength or length impairments, movement pattern inefficiencies and biomechanical errors in and around the involved tendon.
One type of tendon injury that can affect tendons throughout the body is tendonitis. This condition is commonly treated by physical therapists. While other joint conditions can mimic tendonitis, signs and symptoms suggestive of tendonitis include:
Pain over the involved tendon when the muscle is contracted
Pain over the involved tendon when the muscle/tendon is stretched
Swelling or inflammation over the injured tendon
Stiffness when moving the joint near the involved tendon
A feeling of weakness when contracting the involved muscle
Technically any tendon in the body could experience tendonitis, however, certain tendons seem to be more susceptible to this condition than others. Common types of tendonitis include:
Patellar tendonitis (aka jumper’s knee)
Rotator cuff tendonitis
Lateral epicondylitis (aka tennis elbow)
Medial epicondylitis (aka golfer’s elbow)
Achilles tendonitis
Thumb tendonitis (aka De Quervain's tenosynovitis)
Hip flexor tendonitis
Posterior tibialis tendonitis
Hamstring tendonitis
A CASE OF MISTAKEN IDENTITY?
The term “tendonitis” is commonly used to describe pain and irritation of a tendon, but are we using this term incorrectly? It turns out, in many cases, yes. The suffix “itis” denotes the presence of inflammation. In the case of tendonitis, the term suggests the tendon is inflamed, and in the early stages of tendon injury, inflammation is likely present. Except in mild cases of tendonitis which heal quickly, however, the symptoms of a chronic or prolonged case of tendonitis likely have little to do with inflammation and more to do with degeneration that can develop in an injured tendon. This is why it is often more appropriate to refer to a case of persistent tendonitis as a tendinopathy which means “disease or disorder of the tendon.”
Are we splitting hairs here? It may seem that way but understanding what is happening at the level of the injured tissue helps us to select the appropriate treatment interventions. A tendon that is inflamed benefits from treatments aimed at reducing inflammation. A tendon that is degenerating needs a different type of treatment. This is why a tendon that is allowed to rest and treated with ice or anti-inflammatories may recover quickly if caught early. These treatments, however, become less effective over time, and a case of persistent tendinopathy is much more responsive to treatments that improve the stiffness and strength of the tendon rather than simply trying to manage symptoms by reducing inflammation. Similarly, reducing the offending activity can be a good choice early on to allow inflammation to subside and the body’s natural healing process to take over, but prolonged rest may do more harm than good.
Hopefully by now you understand a bit more about the pathophysiology of tendonitis/tendinopathy but you may be wondering how you would know which treatment approach to take. The good news is, you don’t have to figure that out on your own. Physical therapists are experts at musculoskeletal injuries like the one we are describing and are there to tell you which type of treatment or exercise you need. If they believe your tendon injury is in the inflammatory stage they will teach you how to rest and protect the tendon while applying interventions to minimize pain and inflammation. When the tendon has moved beyond the inflammatory stage, your therapist will prescribe treatments and exercises to help increase the stiffness of the tendon so that it becomes more resilient to the repetitive forces of your work tasks and favorite sports. Resting the tendon will not contribute to this process and will predispose you to experience recurrence of these symptoms when you resume your previous level of activities. There is a right way and a wrong way to go about this process of applying graded stress to the tendon and it is a good idea to work with a PT who can help you progress without setbacks.
Tendonitis can seem like a big hurdle to overcome, but with the right treatment plan and the keen eye of a skilled physical therapist, you can get long lasting results that will allow you to return to the activities you love and need to do without worrying that your symptoms will come back as soon as you do. If you are experiencing tendonitis or tendinopathy, let our team of physical therapists at Evolve show you how to recover more quickly and completely.
Click here for more information about physical therapy for tendonitis
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 Physical Therapy Locations!
https://EvolveNY.com
Don’t Run Away from Shin Splints
Get Help Healing from Shin Splints for Good- If you are running, jumping and sprinting at high volumes and begin to experience pain along the inside of the shin bone, you may be developing shin splints. While it is tempting to ignore the discomfort and push through your training, shin splints is a condition to be taken seriously and a physical therapist trained in sports and orthopedic injuries can help you recover fully.
Shin Splint Physical Therapy
If you are running, jumping and sprinting at high volumes and begin to experience pain along the inside of the shin bone, you may be developing shin splints. While it is tempting to ignore the discomfort and push through your training, shin splints is a condition to be taken seriously and a physical therapist trained in sports and orthopedic injuries can help you recover fully. Read on to learn more about this condition and why you want a physical therapist in your treatment corner.
MEDIAL TIBIAL STRESS SYNDROME
The medical term for shin splints is medial tibial stress syndrome. This longer name helps explain exactly what is happening when shin splints develop. “Medial tibial” refers to the inner side or medial side of the tibia/lower leg bone which is often referred to as the shin bone. The muscles and tendons involved in shin splints attach along the middle or lower part of the inside of the tibial bone. The term “stress syndrome” denotes that shin splints are an overuse syndrome caused by repeated stress to the tendons and bone in that area.
Shin splints are not the only cause of pain along the inside of the lower leg but should be considered by healthcare providers when a patient presents with complaints of pain along the middle or bottom third of the inside of the tibia. Sharp pain may be felt when their PT or doctor presses along the affected area and a deep ache in that area may be experienced during activity. In the early stages of shin splints the discomfort is present at the beginning of exercise and usually lessens or disappears as an athlete warms up. As it progresses though, symptoms will persist during activity and eventually can become bothersome even at rest.
Unlike a traumatic injury to the tibia like falling and breaking or hitting the bone, medial tibial stress syndrome is considered an overuse injury that usually develops in athletes, military personnel or active persons who run, jump, or sprint at high volumes. Dancers, runners, tennis players and basketball players are some of the athletes at highest risk for developing shin splints. They may notice the onset of these symptoms after increasing the volume or time spent performing these activities.
SHIN SPLINTS ARE MORE THAN A MUSCLE PROBLEM
So what is happening to the lower leg in the case of shin splints? Shin splints are the result of microdamage that accumulates along the attachment point of several lower leg muscles. Repeated contractions of these muscles, such as that which occurs in a runner training for a marathon or a dancer rehearsing for a show, pull on the outer layer of the tibial bone causing microdamage and inflammation of the bone. Without sufficient time for the bone to recover between bouts of activity, this microdamage can accumulate leading to the development of medial tibial stress syndrome or shin splints. Most commonly the posterior tibialis, soleus and flexor digitorum longus muscles are implicated in this condition.
Many athletes will try to push through the discomfort of injuries and conditions like shin splints but we want to help you understand why you should take treating this condition seriously. Unlike other muscle or tendon conditions like a muscle strain or tendonitis, medial tibial stress syndrome is considered to be an early bone stress syndrome. The repetitive pulling of the muscles involved in shin splints along their attachments to the medial tibia bone can begin to cause a stress reaction in the bone. This means that without appropriate modification to activity or technique, shin splints can progress to a bone stress injury or stress fracture.
Bone stress injuries occur in response to repetitive submaximal loading without sufficient recovery time. This repetitive stress to the medial tibia exceeds the bone’s elastic resistance causing structural fatigue and eventually what we know as a stress fracture. Early stress fracture symptoms mimic early shin splint symptoms quite well and it can be extremely difficult to tell how seriously the bone is affected with shin splints. If left untreated, a bone stress injury will worsen and become a significant disruption to your life. Casting or splinting, modified weight bearing and even surgery may be required to promote healing of a stress fracture.
IT’S TIME TO TURN TO YOUR PHYSICAL THERAPIST
Long term healing from shin splints can be tough if you don’t understand what caused the condition to develop in the first place. A physical therapist experienced in orthopedic injuries, however, is a great resource to help you recover from this condition and prevent its return later on. Resting from activity can help reduce the likelihood of shin splints progressing into a full blown bone stress injury but it does nothing to ameliorate the likelihood of symptoms recurring once you return to your previous level of activity.
A physical therapist will ask you about your symptoms, your injury history, your activities and your training schedule to try and identify aspects of your lifestyle or training that may be predisposing you to developing shin splints. They will also perform a physical examination to identify impairments that may be contributing to this condition. For example, the presence of a flattened arch or excessive hip motion during activity can predispose someone to developing shin splints. Limited range of motion in the hip and ankle can also contribute as does the presence of a higher BMI in athletes.
Activity modification, meaning reduction in load bearing activities, is a very important part of allowing the microtrauma involved in shin splints to heal. Stopping all activity, however, is not necessary and may lengthen the time needed to return to full activity. Your PT can guide you through an exercise program to minimize losses in fitness and performance while allowing the bone and tendons to heal. They may utilize modalities like ultrasound or dry needling to promote local healing. While this area is healing your PT will create a treatment plan to improve strength, range or motion, motor control or coordination deficits that may be contributing to the extra stress on your tibia during activity and can recommend a return to activity program that will help you resume activity without reinjury. Dealing with shin splints can be frustrating but with the guidance of a great physical therapist you can feel confident you are taking the best course of action. Call to schedule an evaluation with one of our physical therapists today to learn how you can recover from shin splints for good.
Click here for more information about physical therapy for shin splints
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Rotator Cuff
Physical Therapists Tackle Rotator Cuff Tears- Over 2 million people a year in the United States will visit their doctor because of a rotator cuff tear, according to the American Academy of Orthopedic Surgeons. Injuries to the rotator cuff of the shoulder can affect your ability to perform daily tasks like washing your hair, picking up your kids and even sleeping comfortably.
Reviving the Rotator Cuff: Rehab for Rotator Cuff Injuries
Over 2 million people a year in the United States will visit their doctor because of a rotator cuff tear, according to the American Academy of Orthopedic Surgeons. Injuries to the rotator cuff of the shoulder can affect your ability to perform daily tasks like washing your hair, picking up your kids and even sleeping comfortably. The rotator cuff consists of four muscles that play an important role in the function of the shoulder and require different treatment depending on the severity of the tear. In many cases, conservative treatment like physical therapy can be very helpful in managing the symptoms of a rotator cuff tear. If you have a rotator cuff tear or think you may have one, read on to learn more about this injury and how physical therapy can help.
GET TO KNOW THE ROTATOR CUFF
The rotator cuff is a group of four muscles located at the shoulder. The shoulder joint consists of the humerus bone of the upper arm where it meets the glenoid cavity created by the scapula or shoulder blade. The shoulder, or glenohumeral joint as it is anatomically known, is a ball-and-socket joint that allows for a high degree of movement of the arm. The four muscles of the rotator cuff are the supraspinatus, the infraspinatus, the teres minor and the subscapularis. Let’s take a brief look at each muscle and the role that it plays in the shoulder joint.
The subscapularis muscle is located at the top of the shoulder joint. Its muscle belly originates in a hollow area at the top of the scapula or shoulder blade called the supraspinous fossa. Its tendon connects to the upper part of the humerus bone near the shoulder. This muscle aids in lifting the arm up at the side, a movement called “abduction”
Next is the infraspinatus who’s muscle belly lies just below that of the supraspinatus. Its tendon wraps around the outside of the humerus and aids in rotating the arm outward, a movement called “external rotation”.
Just below that muscle, on the scapula, lies the teres minor. This muscle follows the path of the infraspinatus and aids in rotating the arm outward, a movement called “external rotation”.
Finally, the subscapularis muscle actually lies on the underside of the scapula closest to the ribcage. The tendon of this muscle travels through the axilla or underarm to attach near the front of the humerus and aids in rotating the arm inward, a movement called “internal rotation”
As you can see, the muscles of the rotator cuff are essential to many of the movements performed by the shoulder. Not only a mover of the arm, however, the rotator cuff also provides stability to the shoulder joint by helping to keep the head of the humerus centered in the glenoid cavity throughout movement. This is necessary to generate the range of motion and force normally available at the shoulder.
WHEN THE ROTATOR CUFF TEARS
Rotator cuff tears or strains are not uncommon but can present differently depending on the severity of the injury and the location. Any of the four muscles can be injured. Oftentimes rotator cuff tears are the result of progressive wear of the muscle and tendon over time such as with repetitive overhead lifting or work, but it can also result from a single incident such as a fall or accident. A tear can range from minor to severe and may involve the muscle, the tendon or the musculotendinous junction. The presence of pain, swelling and weakness can indicate the severity of the injury. With rotator cuff injuries it is common to experience pain in the shoulder area and pain or weakness when trying to raise the arm to the side, rotate it inward or outward.
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 its 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.
In the case of a severe strain or tear, a surgical approach may be recommended to restore function to the muscle. Age, functional level and the presence of other surgical risk factors all play a role in the decision to repair a severely torn rotator cuff surgically. In many cases, conservative treatment like physical therapy is recommended to promote healing of injured tissues, reduce pain and inflammation and restore function to the shoulder.
WHAT DOES PHYSICAL THERAPY FOR A ROTATOR CUFF INJURY LOOK LIKE?
During the acute phase of healing which typically refers to the 5-7 days immediately post-injury, the goal of physical therapy will be to protect the site of injury. During this phase, the body will begin to repair the injured tissue but at this point those repairs are very delicate. Any stretching or strong contraction of the injured muscle could re-tear the healing tissue causing the healing process to regress or begin again.Splinting or bracing may be recommended to limit excessive movement or stretching of the muscle and help reduce pain. Application of ice or other modalities like ultrasound or electrical stimulation may be used to reduce pain and promote healing. Passive range of motion performed by your therapist may also be introduced during this time.
As the muscle tear begins to heal your PT may begin to apply very gentle stretching to help maintain tissue flexibility and later on more intensely to restore muscle length. You will begin to perform exercises to restore the motor control and coordination of the muscle initially and the strength and power of the muscle later on. Your physical therapist will help educate you on signs that your muscle is ready to progress to the next stage of rehab and signs that you have overstressed the tissues, such as increased swelling or prolonged pain, and advise you on how to care for it. In later stages of rehabilitation your treatment plan will focus on helping you return to the activities you need to do for life, sports and work.
If you had surgery to repair a severely torn muscle, your physical therapist will help to progress you through your post-surgical protocol with the same goals of managing pain, decreasing swelling, improving flexibility and restoring strength and coordination.
Whether you are an athlete wanting to get back out onto the field or an injured worker trying to get back to your job, working with a skilled physical therapist will help you heal more thoroughly. If you have injured your shoulder, call Evolve PT today to schedule an evaluation with one of our experienced physical therapists.
Click here to find out more information about rotator cuff 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 Brooklyn Physical Therapy Locations!
https://EvolveNY.com
Getting to the Bottom of Plantar Fasciitis
Could Your Heel Pain be Plantar Fasciitis? Plantar fasciitis is the most common cause of heel pain in an outpatient setting and can be difficult to treat without the help of a knowledgeable practitioner like a physical therapist.
Could Your Heel Pain be Plantar Fasciitis?
Plantar fasciitis is the most common cause of heel pain in an outpatient setting and can be difficult to treat without the help of a knowledgeable practitioner like a physical therapist. Developing plantar fasciitis can be a bit scary for those experiencing the pain and discomfort of this condition, but after reading this article, not only will you have a better understanding of what is happening when pain in the plantar fascia develops, but also how physical therapy can help you to heal.
GETTING TO KNOW YOUR PLANTAR FASCIA
While most people know about the bones that create the shape of their feet and the muscles that move them, they may be surprised to learn that a third structure, the fascia, plays a pivotal role in how their feet function. The term “plantar” refers to the underside of the foot. The term “fascia” is used to describe a layer of connective tissue made up of closely packed collagen fibers. Fascia is found throughout the body and it envelops muscles, muscle groups, blood vessels, organs and even nerves. Fascia is responsible for holding some structures together while in other places allows for structures to slide and glide along one another. It is flexible but incredibly strong, and can resist tensile forces placed upon it. It also is rich in sensory nerve endings and helps our body know how it is moving and where it is in space.
The plantar fascia originates near the heel on the bottom of the foot and extends all the way to the bones at the ball of the foot. The flexibility and tensile strength of this band of fascia helps to maintain the arch of the foot when you put weight through it. There are three parts to the plantar fascia. The medial component runs along the inside of the foot near the arch. The central component makes up the center of the fascial band and the lateral band runs along the outermost part. There are also some connections between the plantar fascia and the achilles tendon at the base of the calf muscle which also inserts at the heel.
During walking, the plantar fascia stretches some as weight is transferred into the foot. As the heel lifts and weight is transferred over the big toe, the plantar fascia tightens, a process called the windlass mechanism, which helps shorten the foot and possibly conserves energy for forward propulsion. It also acts as a shock absorber for the foot. As you can see, the plantar fascia plays an important role in normal walking mechanics and experiences a great deal of strain and load with each step you take. The role of the plantar fascia in foot mechanics makes it unsurprising that people who spend a lot of time on their feet are more susceptible to developing plantar fasciitis.
PAIN IN THE PLANTAR FASCIA
Now that you know how hard the plantar fascia works to keep you walking, running and jumping, let’s explore what can happen when the plantar fascia becomes injured, a condition known as plantar fasciitis. The suffix “itis” is used to denote the presence of inflammation. Since the condition is called plantar fasciitis, it would be reasonable to think that inflammation of the plantar fascia is the underlying cause of this condition but it turns out inflammation is not the main culprit. Plantar fasciitis is considered to be a mechanical overuse syndrome. Rather than inflammation, the reason for the pain and discomfort experienced with this condition is actually repeated microtrauma or microtears of the fascial fibers. Remember, fascia is highly innervated with sensory receptors which means trauma to those fibers can be quite uncomfortable.
The area of the plantar fascia most susceptible to this microtrauma is near the heel bone which is why your therapist may suspect plantar fasciitis if you present to them with heel pain. Symptoms of plantar fasciitis include pain along the bottom of the heel that is worse in the morning or during the first steps after a prolonged rest. Initially the pain may improve as you warm up but overtime can persist throughout activities. Pain near the heel with prolonged standing or during high impact activities like running, jumping or climbing stairs is also an indicator of plantar fasciitis. It is also often felt while walking barefoot or in shoes with poor support and tenderness may be present along the medial heel.
Pain from plantar fasciitis can range from mild to severe and can impact one’s ability to walk and take part in work, exercise and recreational activities. While we can’t necessarily predict who will develop plantar fasciitis, certain factors can increase one’s risk of developing this condition. Anyone who takes part in prolonged impact activities like distance running or even prolonged standing are more likely to develop this condition than those who spend a lot of time sitting. The presence of certain foot conditions like a high arch (pes cavus) or fallen arch (pes planus) or excessive pronation during gait may also elevate one’s risk. Limitation in ankle or big toe joint dorsiflexion and tightness or weakness in the calf muscle can also be risk factors. Similarly, the presence of a subcalcaneal heel spur, higher BMI (in a nonathletic population) and the presence of Diabetes Mellitus may increase the likelihood of developing plantar fasciitis.
WHAT CAN BE DONE TO ADDRESS PLANTAR FASCIITIS
Like all conditions, getting to the root of the problem is an important step to healing from plantar fasciitis and the earlier you can seek treatment the better. Conservative measures including physical therapy are the first line treatment for plantar fasciitis and can be very effective. Reducing the offending weight bearing activity until symptoms improve is often an important step. Your doctor may recommend the use of NSAIDs or ice to alleviate some pain but your physical therapist will take a multimodal approach to improving your symptoms, allowing the plantar fascia to heal and reducing the likelihood of symptoms recurring. Physical therapy for plantar fasciitis often includes:
Stretching
Dry needling
Strengthening
Night splints or orthotics
Optimizing lower extremity biomechanics during activities like running, jumping and walking
Recommendations for footwear
Manual therapy to the plantar fascia, foot, and ankle
Other modalities to promote tissue healing
More invasive treatments like corticosteroid injections, platelet rich plasma (PRP) injections, and surgical interventions are saved as a last resort for cases that do not respond to conservative treatment. If you are experiencing heel pain or have been diagnosed with plantar fasciitis, you will want to start your recovery off on the right foot. Call Evolve Physical Therapy to schedule an evaluation with one of our experienced physical therapists today.
Click here for more information about physical therapy for plantar fasciitis
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Heel Pain
Get Help for Painful Heels! As many as 1 in 10 people will experience pain in their heel or heels at some point in their life. That is to say, heel pain is fairly common but that doesn’t mean you will welcome its presence. In fact, heel pain can range from mildly annoying to quite painful and given that many of us walk as our primary form of mobility, it can be quite disruptive to our lives.
Stop Tip-Toeing Around Heel Pain
Get Help for Painful Heels!
As many as 1 in 10 people will experience pain in their heel or heels at some point in their life. That is to say, heel pain is fairly common but that doesn’t mean you will welcome its presence. In fact, heel pain can range from mildly annoying to quite painful and given that many of us walk as our primary form of mobility, it can be quite disruptive to our lives. If you are dealing with heel pain you are probably wondering what may be the cause. Let’s look a little deeper at the heel itself and discuss some of the common causes of heel pain treated by physical therapists.
ANATOMY OF THE HEEL
The heel refers to the back part of the foot. From a bony standpoint it is composed of the calcaneus bone. The calcaneus sits below the talus, the bone that articulates with the two lower leg bones to form the ankle joint. In front of the calcaneus are the tarsal bones which then connect to the long bones in our foot. The calcaneus is a sturdy bone that supports the weight of our leg and body and plays an important role in walking or gait. It acts as a short lever for our calf muscles to point the foot and bend the knee during walking, running and jumping activities.
The calcaneus provides an insertion point for several muscles and ligaments as it is the largest and broadest of all the foot bones. As mentioned above, the calf muscles (gastrocnemius and soleus) insert along the posterior aspect of the calcaneus via the achilles tendon. Other muscles that attach there are the abductor hallucis (flexes and moves the big toe outward), flexor digitorum brevis (flexes the outer four toes), quadratus plantae (supports the arch and helps flex the toes), abductor digiti minimi (moves the little toe outward) and extensor digitorum and hallucis brevis (extend the toes upward).
Several ligaments that stabilize the foot and ankle attach to the calcaneus on either side and from beneath the foot. The plantar fascia, a thick fibrous band of tissue that runs longitudinally along the bottom of the foot from the base of the heel up toward the toes is also an important structure when it comes to heel pain. It plays an important role in the biomechanics of the foot during walking and standing and in shock absorption. As you can see, there are quite a few places where heel pain can develop.
AM I AT RISK FOR HEEL PAIN?
While heel pain is a fairly common complaint many people will never experience this condition. Certain factors and activities, though, can increase one’s risk for developing heel pain. Lifestyle factors like participating in activities that involve a lot of running or jumping may increase the chance of heel pain or discomfort developing. Similarly, spending a lot of time on your feet, especially on concrete floors or while wearing unsupportive or uncushioned footwear may increase the risk. Finally, intrinsic risk factors like being overweight or having foot arthritis or flat feet may also increase the risk for heel pain. Having any one or several of these factors does not guarantee you will develop heel pain but identifying the risk factors can help provide targets for treatment or prevention.
WHAT MIGHT BE CAUSING YOUR HEEL PAIN?
While there are many potential sources of heel pain, here are some of the more common causes:
Heel spurs: Heel spurs are bone spurs or osteophytes that form on the calcaneal (heel) bone of the foot. These areas of excess bone can cause pain, inflammation, tenderness and joint stiffness in the area.
Sever’s Disease: The most common cause of heel pain in growing children, Sever’s Disease occurs when the growth plate at the back of the heel becomes inflamed and painful.
Plantar fasciitis: When inflamed or irritated pain can be felt in the bottom of the heel, along the arch or at the ball of the foot.
Achilles tendinitis: Achilles tendinitis is one of the most common causes of heel pain felt along the back of the heel. Injury or irritation at the attachment site or distal end of the achilles tendon which connects the calf muscle to the calcaneus is a hallmark sign.
Tarsal Tunnel Syndrome: Entrapment of the tibial nerve where it runs beneath a band of ligaments along the inner ankle can cause pain, numbness, tingling or burning along the sole of the foot, including the heel.
Stress fracture: Calcaneal stress fractures can occur in persons participating in high volumes of weight bearing activities like running or marching.
IDENTIFYING THE CAUSE OF HEEL PAIN
Identifying the cause of heel pain is helpful in developing an effective treatment plan. There are several tools that physical therapists and other medical professionals use to pinpoint the possible causes of heel pain. Some of these tools include:
Subjective interview: Don’t underestimate the importance of describing your symptoms to your healthcare provider. Providing information like where the pain is located, when it started, what provokes and relieves the pain and the characteristics of the pain can be very helpful to healthcare professionals in developing a list of possible causes.
Movement analysis: Watching the way your foot, ankle, knee and hip move while you stand, walk, jump and run can give clues as to what may be provoking your pain. Problems with form and biomechanics during repetitive movements can lead to pain or discomfort in areas that are experiencing higher levels of stress or strain than normal.
Palpation: Gently palpating or pressing along the heel can help your provider locate the exact location of your pain. By identifying the location they can more easily identify the anatomical structures that may be involved in your symptoms.
Imaging: When necessary, imaging studies such as X-rays, MRIs or CT scans may be warranted to look for structural issues and injuries like bone spurs, fractures, ligament tears, tendon inflammation and so forth. It is important to know that while imaging can sometimes be very helpful in locating the source of your pain, other times imaging may reveal what we would consider to be “abnormal” findings that don’t actually cause any symptoms at all. They may be a red herring, so to speak.
While living with heel pain can be quite frustrating, you don’t have to figure it out on your own. Our physical therapists can help you identify the underlying cause of your pain and develop a plan to reduce your discomfort and minimize the risk of recurrence in the future.
Click here for more information about physical therapy for heel 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 Brooklyn Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Heel Spurs
Physical Therapy for Heel Spurs- If you have been dealing with pain, inflammation or warmth over your heel, you could have a condition called a heel spur. This condition affects up to 1 in 10 adults though many individuals may not even realize they have a heel spur.. The likelihood of finding them on imaging increases with age. For those experiencing discomfort due to the presence of a heel spur, let’s learn more about the condition and how PT can help.
Save the Heel Spurs for Cowboys!
Get Help for Painful Heel Spurs!
If you have been dealing with pain, inflammation or warmth over your heel, you could have a condition called a heel spur. This condition affects up to 1 in 10 adults though many individuals may not even realize they have a heel spur.. The likelihood of finding them on imaging increases with age. For those experiencing discomfort due to the presence of a heel spur, let’s learn more about the condition and how PT can help.
TWO TYPES OF HEEL SPURS
Heel spurs are a type of bone spur named for their location along the calcaneus or heel bone.
They can develop in two different locations along the calcaneal bone. When a bone spur forms along the bottom of the heel on the sole of the foot, it is called bone spur syndrome. Alternatively, a bone spur that forms on the back of the calcaneus where the achilles tendon inserts is called insertional achilles tendonitis. In some cases a bony protuberance can be felt under the skin in these areas.
The medical term for bone spur is osteophyte. The prefix “osteo” means related to bones while the suffix “phyte” refers to pathologic outgrowth. Taken together, the term osteophyte refers to an outgrowth of bone. The body most commonly develops bone spurs in an attempt to repair or address an injury. It does so by producing excess bone and calcium 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
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. 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. In the heel, repeated stretching of the plantar fascia or tearing of the membrane that covers the heel bone can lead to heel spur formation. Runners that run on hard surfaces, those wearing improper or unsupportive footwear when on their feet for long periods and those who are overweight or obese are also at a higher risk for developing heel spurs.
NOT ALL HEEL SPURS CAUSE SYMPTOMS
Oftentimes the presence of a heel spur is an incidental finding when looking for something else. It is important to rule out other causes for foot or heel pain as the presence of a heel spur is not necessarily associated with having symptoms. In the case of heel spur syndrome it is important to differentiate between a case of plantar fasciitis and a symptomatic heel spur. So while some heel spurs are asymptomatic, bone spurs located in an area that can irritate tissue or impede range of motion can cause symptoms. If you are experiencing any of the following symptoms, you may have a heel spur:
Sharp pain or intense ache in the heel that is often worse first thing in the morning or after a longer period of rest
Inflammation or swelling over the heel
Tenderness when touching or applying pressure to the area
Warmth over the area
A palpable bony protrusion in the heel
CONSERVATIVE MANAGEMENT CAN HELP MANAGE HEEL SPURS
Conservative, non-surgical management like physical therapy results in symptom improvement in the majority of patients. By making some of these changes you can help improve the long-term success of your rehabilitation program:
Avoid long periods of time on your feet. Take breaks regularly, especially in the beginning of your treatment when you are more symptomatic
Wear well-fitting shoes with proper arch support when you will be standing or walking for extended periods
Wear slippers or cushioned shoes for walking on tile or hardwood floors at home
Run or walk on softer surfaces outdoors like grass rather than only on hard surfaces like concrete or asphalt.
Heel pads or shoe inserts may be beneficial to help distribute pressure more evenly across the heel
Physical therapy can be a great tool for managing symptomatic heel spurs. While it is true that physical therapy will not eliminate the heel spur, it can help reduce the irritation and inflammation around the spur that is causing your symptoms. As mentioned earlier, many people have heel spurs without any symptoms and we’d like you to be one of those people. Physical therapy aims to reduce inflammation, improve foot and ankle motion, address muscle and soft tissue impairments and improve the quality of movement to minimize heel spur symptoms.
Let's take a look at some exercises that can help manage the symptoms of a heel spur that your PT may prescribe. Please note, it is important to check with your doctor before starting a new exercise plan. Also, these exercises are meant to be only examples of what you may encounter while working with your physical therapist. Your PT will provide you with a customized physical therapy exercise program to treat your heel pain.
Calf stretching: Stand with your hands against the wall in a lunge position. With the back foot pointed straight ahead and knee straight, lunge forward over the front foot until you feel a moderate stretch in the back calf muscle. Hold for 20-30s and perform 2-3 repetitions to help stretch the calf muscle.
Big toe stretch: While seated, grasp your big toe on the symptomatic side and gently pull it back toward you until a gentle stretch is felt along the bottom of your foot. Hold this for 20-30s and perform 2-3 repetitions at a time to help mobilize the big toe and stretch the plantar fascia.
Massage: If your heel spur is on the sole of the heel, massaging the plantar fascia and bottom of the foot may help. Place a massage ball or frozen water bottle under your foot and roll your foot back and forth across the ball or bottle spending extra time in spots that feel tender.
Arch strengthening: Start by sitting with your feet flat on the floor. Place a pen under the arch of your affected foot. Without raising the foot off the ground, use your intrinsic foot muscles to try and lift the arch up and off the pen, holding for a few seconds at the top before lowering back down. Perform 15-20 reps for 1-2 sets to help re-educate and strengthen the muscles that support the arch. Progress to standing when you are ready for a greater challenge.
While in some cases surgery may be necessary to remove heel spurs, a physical therapist at Evolve can help you to reduce pain and swelling, improve your joint mobility and optimize your movement patterns. Give us a call today to schedule an evaluation and learn more about how we can help you manage the symptoms of a heel spur. Call: 1-718-258-3300
Click here for more information about physical therapy for heel spurs
About EvolveNY-
Brooklyn's Premier 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 Physical Therapy Locations!
https://EvolveNY.com
Breaking Through Bad Bursitis
Bursitis 101: Bursitis is a condition many are unfamiliar with until they begin to experience the telltale signs. Because bursae are located throughout the body, bursitis is not relegated to only one limb or joint but can occur in many different places. When pain is occurring near or around a joint, bursitis is one condition that should be included in the differential.
Physical Therapy for Bursitis
Bursitis 101
Bursitis is a condition many are unfamiliar with until they begin to experience the telltale signs. Because bursae are located throughout the body, bursitis is not relegated to only one limb or joint but can occur in many different places. When pain is occurring near or around a joint, bursitis is one condition that should be included in the differential. Let’s take a deeper look at bursitis and how this condition can present in different parts of the body.
SO MANY BURSAE…
Bursae (plural of bursa) are small fluid-filled sacs found near joints. Healthy bursae are very thin. They consist of a synovial outer membrane filled with slippery synovial fluid. These slippery sacs help the tendons, ligaments, muscles and skin glide smoothly over the bony surfaces of the joints. Though they contain only a small amount of fluid, they provide some cushioning to the area. These bursae play such an important role that there are actually more than 150 of them in the body.
Bursae are located throughout the body. The major bursae commonly affected by bursitis are located near the joints of the shoulders, elbow, hips and knees, though technically bursae anywhere can become inflamed. Because of the bursae’s location beneath and between tendons, ligaments, muscles and skin, repeated movement over a bursa or prolonged pressure or positioning can result in inflammation of the bursa known as bursitis. As inflammation sets in, more synovial fluid is produced causing the normally thin sac to swell and take up even more space than they usually do. When this happens, many of the common symptoms of bursitis can develop.
Common symptoms of bursitis include pain and tenderness in the area of the inflamed bursa. It may be difficult to lie on the area of the body with bursitis due to the discomfort it causes. Joint mobility may be limited in the area around the inflamed bursa. If the bursa is located just below the surface of the skin you may even be able to visualize some redness and swelling in the area. Some people will experience repeated bouts of bursitis with resolution of symptoms in between.
AM I AT RISK FOR DEVELOPING BURSITIS?
Both lifestyle habits and the presence of certain medical conditions can put one at risk for developing bursitis. Let’s take a look at how some activities or lifestyle habits may affect certain bursa:
Olecranon bursitis: The olecranon is the bony protuberance at the back of your elbow. Spend too much time leaning on your elbow on the desk while you work and you could inflame the bursa that lies just underneath the skin
Trochanteric bursitis: The greater trochanter is located on the lateral side of the thigh near the hip. Running and frequent stair climbing may irritate the bursa at the greater trochanter where several muscles attach that move the hip and leg.
Subacromial bursitis: The acromion is the front portion of your shoulder blade that protrudes across the top of your shoulder. Beneath the acromion and above the tendons that connect there lies the subacromial bursa that can become irritated and inflamed with repeated overhead motions such as throwing or reaching to stock high shelves.
Infrapatellar bursitis: One of the bursa located beneath the patellar tendon of the knee where it attaches on your lower leg, the infrapatellar bursa may also experience bursitis. Also known as “clergyman’s” knee, this bursa can become inflamed as a result of direct trauma to the patella or kneecap, from frequent kneeling and even overuse.
Being diagnosed with certain medical conditions that can affect the joints may also put you at risk for developing bursitis. These conditions include osteoarthritis, diabetes, rheumatoid arthritis and gout. In some cases it may be difficult to tell whether pain is coming from the joint itself or the nearby bursa.
Finally, septic bursitis is a less common but more serious cause of bursitis. In this case the bursa becomes infected by bacteria that has entered through a cut, scrape or abrasion on the skin. Rapid identification of this condition is important to allow for initiation of proper treatment.
WHAT ARE MY TREATMENT OPTIONS
Treatment of bursitis is typically conservative in nature. There are several treatment options, some which require the help of a physician. Let’s explore some common treatment options for bursitis.
Anti-inflammatories: Your doctor may recommend the use of anti-inflammatory medications to help calm the inflammation and reduce your pain. This may be prescribed in addition to other strategies like activity modification or the use of ice.
Corticosteroid injections: If you visit your doctor’s office for bursitis they may recommend that you undergo a corticosteroid and lidocaine injection into the affected bursa. This combination of medication can quickly reduce the inflammation and local pain.
Fluid aspiration: In some cases, when other options have failed, your physician may elect to aspirate the fluid that has built up in the bursa.
Physical therapy: Physical therapy is an important tool for treating bursitis. While the use of anti-inflammatories and corticosteroid injections can provide you with relief of your symptoms, it does not address the underlying cause of the bursitis thus placing you at elevated risk for developing future episodes.
With physical therapy, the goal is not only to address your immediate symptoms of pain and discomfort but to get to the root cause of the irritation on that bursa. Oftentimes optimizing flexibility and tissue mobility, muscle strength and coordination, motor control and balance along with some modifications to training or technique can provide long-term relief of symptoms.
Decreasing the pressure and irritation on the bursa while continuing to participate in the activities you need and love to do is physical therapy’s goal. So while you may be feeling discouraged from a bout or several bouts of bursitis, our team of skilled physical therapists at Evolve is here to help you onto the road to long-term symptom relief.
Click here for more information about physical therapy for Bursitis
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Torn Meniscus
MEET THE MENISCUS : The menisci (plural for meniscus) are small but important structures found in the knee. So important, in fact, that you have not one but two menisci on each side. The knee, anatomically known as the tibio-femoral joint, consists of the articulation between the end of the femur, or long thigh bone, and the flattened top portion of the lower leg or tibia bone.
Physical therapy for Torn Meniscus
An Updated Approach to Treating Meniscus Tears
A 15 year old soccer player is running down the field toward the goal. The ball comes their way and they plant their left foot and turn to kick the ball with their right. The ball sails into the goal but the player feels a sharp pain in their left knee as they jump up to celebrate.
What happened? Well, they may have just torn their meniscus.
MEET THE MENISCUS
The menisci (plural for meniscus) are small but important structures found in the knee. So important, in fact, that you have not one but two menisci on each side. The knee, anatomically known as the tibio-femoral joint, consists of the articulation between the end of the femur, or long thigh bone, and the flattened top portion of the lower leg or tibia bone. As you probably know, the job of the knee joint is to bend and straighten while you walk, run, jump and squat. There are quite a few structures within the knee that provide it strength and stability. One–or rather two–of those structures are the menisci.
The menisci are wedged, c-shaped discs anchored onto the flattened end of the tibia bone. There is one on the medial (inner) side and one on the lateral (outer) side and they curve toward one another. Their job is both to act as shock absorbers/cushions in the knee and to help stabilize the knee joint. Because of their location within the joint, these little cushions are subject to the stress and strain of all of the activities we do throughout our life while on our feet.
HOW DO MENISCI GET INJURED?
If you think about all of the running, jumping, squatting, and stair climbing you’ve done throughout your life so far, you can imagine that the knees take on a lot of stress. Meniscus injuries, like any injury, occur when the stress or strain on the tissues of the meniscus becomes too great. When this happens, the meniscus can tear. Tears can be categorized as acute/traumatic tears which usually occur when leg is twisting while the foot is planted or as degenerative tears which occur in response to wear and tear over time. In either case, meniscus tears can be uncomfortable and painful and interfere with a person’s ability to walk and be active.
HOW DO I KNOW IF I’VE INJURED MY MENISCUS?
Meniscus injuries are definitively diagnosed using imaging technology like MRI or CT scan to visualize the tear. Clinically, however, we look for certain signs and symptoms such as:
An audible or felt pop
Pain in the knee joint on the inside (medial), outside (lateral), or back of the knee
Swelling
Catching or locking of the knee joint
Pain with walking
Inability to fully bend or straighten the knee
Pain when twisting the knee
Feelings of the knee giving out
These are signs and symptoms of a symptomatic meniscus tear but guess what? Not all meniscus tears are symptomatic. In fact, imaging studies have found incidental and asymptomatic meniscus tears in up to 5% of young people and up to 67% of older adults. In fact, the presence of a meniscus tear on imaging is not predictive of knee symptoms in middle age or older adults. It is associated with the presence of osteoarthritis in older adults, but not directly linked to symptoms. This is more evidence that as physical therapists, we treat symptoms, not imaging.
WHEN DO I NEED TO SEEK TREATMENT?
If you are experiencing knee pain or stiffness, locking or catching, instability or swelling it is time to have your knee examined. Physical therapists assess the knee through clinical tests like the Apley’s or McMurray’s tests and through palpation and examination of the knee. In the case of an acute or traumatic tear, the mechanism of injury combined with the symptom report may point your PT in the direction of suspecting a meniscus tear but they will also examine other structures in the knee. Due to the mechanism of injury with a meniscus tear, other structures in the knee such as the anterior cruciate ligament (ACL) or medial collateral ligament (MCL) may be injured at the same time. If your PT suspects a torn meniscus they will likely refer you to an orthopedist for further assessment.
PEACE & LOVE FOR MENISCUS TEARS
The acronym R.I.C.E used to be the standard of early treatment for an acute injury like a meniscus tear.
R: Rest
I: Ice
C: Compression
E: Elevation
Current practice guidelines continue to evolve, and many therapists now preach P.E.A.C.E. & L.O.V.E., baby. This creative acronym outlines a new, more active approach to addressing soft tissue injuries like a meniscus tear and you may encounter this approach you work with your physical therapist. Let’s take a deeper look at it. (*Note, this does not apply directly to post-surgical cases and as every case is different, your therapist or physician may still recommend ice and anti-inflammatories to manage pain and swelling)
(P)rotection: Protecting the injury in the first week or so is important to minimize disruption of early healing tissues which are still vulnerable. This includes avoiding activities that increase pain and swelling and sometimes modifying weight bearing with crutches or a walker.
(E)levate: elevate the limb above the heart as often as possible to allow swelling to drain from the area. You can achieve this by lying down and raising your leg on a stack of pillows.
(A)void taking anti-inflammatories: Unless recommended by your physician for other reasons, it may be beneficial to avoid interfering with the inflammatory process which is actually a necessary part of the healing process as it helps clear away unwanted debris and usher in helpful cells. This can apply to ice as well.
(C)ompression: apply an elastic band or taping around the knee to minimize swelling
(E)ducation: Your PT will educate you on how to protect the knee during the early healing phase and how to support your body in it’s natural healing process
AND
(L)oad: Gradually loading the tissues is important after the first week. The presence or absence of pain and inflammation will be your guide.
(O)ptimism: focus on what you can do and remain optimistic about your body’s power for healing
(V)ascularization: choosing pain-free cardiovascular training will increase blood flow to healing tissues
(E)xercise: Graded exercises should be used to help restore normal strength, balance, flexibility and proprioception in accordance with your stage or healing
While this acronym may seem a bit complicated, you won’t have to go through it alone. If you are dealing with a torn meniscus or think you may be, schedule an evaluation with one of our knowledgeable physical therapists and we will help you get on the road to recovery.
Click here to find out more information about physical therapy for a torn meniscus
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Spondylosis
Spondylosis: Wearing out its Welcome- Under the best of circumstances getting older means you have created a lifetime of good memories. Hopefully your body has carried you through lessons and adventures you can pass along to the next generation. With aging, however, our physical bodies undergo changes that can lead to sensations of pain, stiffness and even weakness.
Spondylosis: Wearing out its Welcome
Under the best of circumstances getting older means you have created a lifetime of good memories. Hopefully your body has carried you through lessons and adventures you can pass along to the next generation. With aging, however, our physical bodies undergo changes that can lead to sensations of pain, stiffness and even weakness. While this may seem like an inevitability, there is often a lot that can be done to alleviate these symptoms so that you can continue living your best life. As physical therapists, healthy aging is something we are passionate about and this article describes how physical therapists can address symptoms of spondylosis, an umbrella term for a number of degenerative changes that can occur in the spine.
WHAT WE MEAN WHEN WE SAY “SPONDYLOSIS”
Spondy- meaning “spine” and -losis meaning “condition or state of” gives us a generic term meaning condition of the spine. In the medical world, spondylosis is an umbrella term used to describe age-related changes that can occur in the spine, sometimes referred to as “wear and tear.” These degenerative changes can affect some or many of the different structures found in the spine such as the intervertebral discs, the ligaments in the spine and even the bony structures themselves.
Intervertebral discs become more dry and may crack and lose height, ligaments can thicken and cartilage may become worn down. Spinal stenosis in which the spinal canal or vertebral foramina are narrowed causing pressure or irritation of the spinal cord and spinal nerves may develop as a result of bone spur formation. Discs may be more likely to herniate causing pain and discomfort in the back and potentially into more distant areas of the upper and lower extremities. Finally movement may not be as smooth secondary to loss of cartilage.
The only way to truly identify these age-related changes is through imaging such as radiographs, CT scans or MRIs. It is interesting to note, however, that changes such as these can be observed in imaging of pain-free adults as well as adults experiencing pain. This is to say that the presence of spondylosis does not mean that you will experience pain or discomfort. The presence of these degenerative changes combined with other factors such as imbalances in muscle strength and length, changes in joint mobility and flexibility, patterns of movement and habits of movement may lead to the development of these symptoms, however. These factors are often the targets of physical therapy intervention to address spondylosis-related symptoms.
PHYSICAL THERAPY CAN IMPROVE SYMPTOMS OF SPONDYLOSIS
Physical therapists are skilled movement practitioners. They aim to address symptoms like pain, stiffness or weakness so that you can continue doing the activities that you love and need to do. This approach applies to spondylosis as well. If you are considering physical therapy to address some of your spondylosis symptoms, you may be wondering how physical therapists approach this condition. While an individualized approach is always best, let’s take a look at how physical therapists commonly address spondylosis:
Reduce pain, inflammation and irritation: While completely eliminating your symptoms may not be realistic in all cases, providing as much relief as possible is an important goal of physical therapy for spondylosis. In many cases, repeated irritation of involved structures results in symptoms of spondylosis. For example, in the case of a herniated intervertebral disc, irritation of the spinal nerves near the disc can cause localized and radiating pain, numbness or tingling. Similarly, the presence of a bone spur may irritate the spinal cord when the spine is moved or held in certain positions.
Reduction of pain, inflammation and irritation is a multi-step process. One step involves addressing local symptoms of pain, muscle stiffness or spasm and inflammation through modalities like ice, heat, electrical stimulation, soft tissue mobilization or dry needling. The other steps involve identifying and addressing patterns of movement or impairments in muscle strength, motor control, coordination, and flexibility, for example, that may contribute to increased irritation or stress across the area affected by spondylosis. Addressing and optimizing these components can help decrease the likelihood that the spondylotic changes in the spine will result in unwanted symptoms.
Movement is key
While there are certainly times when rest is necessary for recovery such as after an acute injury or surgery, in many other cases too much rest can be counterproductive. When addressing spondylosis-related symptoms, a physical therapist will educate you on the importance of staying active. Avoiding activity altogether may lead to worsening of contributing factors like muscle weakness or stiffness that can ultimately exacerbate your symptoms whenever you try to resume activity. If activity worsens your symptoms then the goal will be to find activities you can do comfortably. Sometimes simple modifications to movements is all you need while other times brainstorming other modalities of movement is indicated. As you discover new and different ways to move, your PT will work to address underlying factors contributing to your symptoms to improve the likelihood you can resume some of the activities that may have been problematic before.
AGING IS INEVITABLE, PAIN IS NOT
Aging is inevitable, but pain and discomfort is not and taking a proactive approach to managing your spondylosis-related symptoms is one way to fight back against the effects of aging. Movement is essential to healthy longevity so if pain, stiffness, discomfort or weakness from spondylosis of the spine is holding you back, we want to help. Schedule an evaluation with one of our skilled physical therapists so that we can partner with you to help alleviate your symptoms and get you back out there making memories for as long as possible.
Click here for more information about physical therapy for Spondylosis
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 Physical Therapy Clinic Locations!
https://EvolveNY.com
MCL Sprain Physical Therapy
MCL Injury 101- Knee injuries are hard to ignore. Even mild knee pain can interfere with your day to day activities. While a mild knee injury may heal and resolve on its own with a little rest, injuries to the ligaments of the knee can be more serious and physical therapists are often involved from the early protection phase to the return-to-activity phase to ensure the injury heals fully and that you are as protected as much as possible from future reinjury.
MCL Injury 101
Knee injuries are hard to ignore. Even mild knee pain can interfere with your day to day activities. While a mild knee injury may heal and resolve on its own with a little rest, injuries to the ligaments of the knee can be more serious and physical therapists are often involved from the early protection phase to the return-to-activity phase to ensure the injury heals fully and that you are as protected as much as possible from future reinjury. In this article we will discuss how these injuries occur and what factors affect their recovery.
MEDIAL COLLATERAL LIGAMENT (MCL) ANATOMY
The knee joint is considered a hinge joint whose main function is to flex and extend in a single plane. This joint is made up of the articulating surfaces of the rounded femoral condyles at the end of the long thigh bone and the flattened end of the tibia or lower leg bone. Within and around the knee joint, four main ligaments exist to limit the movement of the knee to primarily flexing and extending. When these ligaments are torn or stretched, the stability of the knee can become compromised.
The medial collateral ligament is, as it implies, on the medial or inner side of the knee joint. Unlike some of the other ligaments, the MCL is located outside of the joint capsule itself. It runs from the end of the femur to the top of the tibia. Because of its location, the MCL resists what is called a valgus moment at the knee, meaning it prevents the knee from bending inward toward the opposite knee. It also provides some rotational stability to the knee. An excessive valgus force or sudden rotation outward of the lower leg will stress the MCL. If this stress exceeds the tolerance of the ligament an injury can occur.
HOW COMMON ARE MCL INJURIES?
While there are a variety of injuries and conditions affecting the knee, MCL injuries are not uncommon. In fact, according to the American Academy of Physical Medicine and Rehab Physicians (AAPMR), around 74,000 MCL injuries occur annually. This type of injury can occur in anyone under the right circumstances, however, we most often see this type of injury in athletes.
MCL injuries are the most common knee injury experienced by high school athletes. Athletes involved in contact sports like football, rugby, hockey and soccer are at higher risk for experiencing MCL injuries but skiers may be at the highest risk. In fact 60% of skiing-related injuries are either MCL or LCL (lateral collateral ligament) injuries likely due to the forces applied to the knee while the foot is held in place by the ski.
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 or slide tackle. As you can see, any sport that requires a lot of pivoting, cutting or contact with other players can put the knee at risk for an MCL injury. That being said, this type of injury can also occur outside of sport. A misstep off a curb or a fall that occurs while your foot is stuck in one position can easily lead to an injury to the MCL.
WHAT ARE THE SIGNS AND SYMPTOMS OF AN MCL INJURY?
Following a knee injury, there are several signs and symptoms that point to involvement of the MCL:
Hearing a popping sound at the time of injury
Pain or tenderness along the inside of the knee joint
Swelling along the inside of the knee joint (note, because the MCL is located outside of the joint capsule localized swelling can occur outside the joint but effusion inside of the joint would suggest that other knee structures may also be injured)
Sensation of locking or catching in the knee joint
Feeling like the knee may give out when you put weight on it
Your physical therapist can help determine if your MCL has been injured based on physical exam techniques like palpation of the tissues over the MCL for pain or swelling and also with special tests that assess the integrity of the ligament. These special tests can help determine the severity of the injury based on how much laxity is felt in the knee when the MCL is stressed. Because the mechanism of injury for an MCL tear may cause injury to other areas of the knee, imaging may be recommended. X-rays are frequently utilized to ensure there are no fractures in the bones around the knee and an MRI may be recommended to confirm the diagnosis of MCL injury, assess the severity and determine if any other soft tissue structures like the ACL, PCL or menisci are involved.
WHAT’S THE PROGNOSIS?
The prognosis of an isolated MCL injury is typically good. Return to play or unrestricted activity in an isolated MCL injury depends largely on the severity of the injury.
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. Typically requires 3-6 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. If joint instability is minimal, it may take 2-3 months to heal. If valgus instability is present, surgical repair is likely to be recommended to re-establish joint stability.
When other joint structures like the PCL (posterior cruciate ligament), ACL (anterior cruciate ligament), menisci or bones are also injured, the timeline for healing will vary. While it is necessary to modify or take a break from certain activities to allow the ligament to heal, there is still a lot that can be done under the watchful guidance of a physical therapist to minimize loss of strength and endurance and facilitate the quickest and most complete recovery possible. If you have suffered an MCL injury or think you may have, don’t wait to schedule an appointment with one of our physical therapists, we can help you start your recovery right away.
Click here for more information about physical therapy for MCL sprains
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 Physical Therapy Clinic Locations!
https://EvolveNY.com
Physical Therapy for Labral Tears
Feeling Hopeful About Hip Labral Tears- Hip pain in both the athletic and non-athlete population is a common complaint heard by orthopedic physicians and physical therapists. The hip joint is a ball-and-socket joint and is designed to move through a large range of motion…
Feeling Hopeful About Hip Labral Tears
Hip pain in both the athletic and non-athlete population is a common complaint heard by orthopedic physicians and physical therapists. The hip joint is a ball-and-socket joint and is designed to move through a large range of motion. The labrum is a cartilaginous ring that lines the socket part of the joint also known as the acetabulum. The labrum acts almost like a suction cup holding the head of the femur in place while it moves in all directions. Injury to the labrum can be chronic or acute but when symptomatic, can cause pain and discomfort with both athletic and everyday activities. Physical therapy is considered to be the first line of treatment for labral tears and this article will describe this injury and as well as some of the exercises that are commonly used to manage symptoms of a labral tear.
WHAT DOES A LABRAL TEAR FEEL LIKE?
The symptoms of a labral tear can be mild or severe. They can come on suddenly and persist or present only during certain activities. In some cases, there are no symptoms at all. Oftentimes a labral tear causes a deep, aching sensation in the front of the groin where your underwear line is located. This pain is often worse upon standing and initiating walking after rest or prolonged sitting. You may experience this pain or even a pinching sensation in that area when you squat down or rotate the hip inward. Some people will notice a clicking or catching in the hip and stiffness in the joint. If the tear is severe or chronic, you may even notice some feelings of weakness or instability around the hip.
Because a number of conditions affecting the hip can present with similar symptoms, labral tears can be mistaken for other conditions or even misdiagnosed. In runners training at high volumes, for example, a femoral neck stress fracture should always be considered as these conditions may mimic one another but need to be treated differently. Other conditions that should be considered when these symptoms present are hip flexor strains, bursitis, osteoarthritis and even pelvic floor or pelvic pain syndromes.
WHO IS AT RISK FOR A LABRAL TEAR?
Labral tears are often considered to be a repetitive stress injury. This means that repetitive micro-stresses to the labrum results in the development of a tear over time. You may be able to pinpoint the exact moment that the tear worsened enough to become noticeable but there is a chance it was slowly developing and worsening over time. In many cases the presence of a labral tear is an incidental finding on hip imaging and may not cause any symptoms at all.
Repetitive performance of certain movements can place someone at higher risk for developing a labral tear. Running, deep squatting, twisting and cutting, for example, can put strain on the labrum and may cause it to tear. The presence of bony abnormalities on either side of the joint (hip impingement) may increase the likelihood that an activity like running or squatting will injure the labrum. Similarly, weakness or lack of motor control around the hip joint and even improper biomechanics with repetitive movements can increase the risk of tearing the labrum.
HOW IS A LABRAL TEAR TREATED
While surgery is recommended in some cases that don’t respond to conservative care, physical therapy is often the first line of treatment to address a torn labrum. Even if a surgical approach is eventually needed, a course of physical therapy to strengthen the hip and improve its mobility can make recovery from the surgery that much easier. When working with a physical therapist they may perform joint or soft tissue mobilization techniques to address pain and joint mobility but addressing strength and motor control around the hip and lower extremity is essential for long term improvement. While you may have to decrease or modify activities that are provoking symptoms in the beginning, the long term goal for labral tear rehab is to get you back to pain-free movement! With chronic labral tears symptoms may be aggravated intermittently but with a solid PT program you should feel confident that you can manage these symptoms.
An exercise program for labral tear rehabilitation should be individualized. The severity and irritability of your symptoms will dictate which exercises you start with but let’s take a look at some exercises that can be helpful in managing a labral tear long term. Note, these are more advanced exercises and you should talk with your physical therapist about where to start with your own recovery as they are not appropriate for everyone, especially those recovering from recent surgery!
Adductor Plank: This exercise is performed like a side plank but the top leg is resting on a bench while the lower leg rests underneath. By pressing the inside of the top leg into the bench, raise your hips and lower leg off the ground until your body is in a straight line. This exercise works the adductors or inner thigh muscles in both legs. To make this exercise easier, place the top knee on the bench so most of your lower leg is supported. To make this exercise harder, place only the ankle or foot on the bench.
Dead Bug with Resisted Hip Flexion: Tie a resistance band or loop around your feet. Lie on your back with your knees and hips bent to 90 degrees and arms parallel and pointed toward the sky. To begin the exercise extend one leg out away from your body and toward the ground while extending the opposite arm overhead. Bring the arm and leg back to the starting position and perform this movement with the other arm and leg. Continue to alternate sides until the desired number of repetitions is reached. Contract your abdominals to limit arching of your spine as you lower the leg. The resistance band on the ankle will challenge the hip flexors on the stationary leg to keep the hip flexed.
Standing Kettlebell Hip Flexor March: Standing on the edge of a step or box with one foot, slide the opposite foot into the handle of a light kettlebell. Flex this hip to raise the knee to hip height with the kettlebell hanging below your foot. Slowly lower the kettlebell back to the floor. Make sure to keep your pelvis level as you raise and lower the kettlebell. Hold on for balance if needed or challenge your balance by performing this activity without a hand hold.
Box Squats: Squatting may provoke symptoms early on in labral tear rehabilitation but there is still a great deal of benefit from performing a squat. Sit on a box or bench that is low enough to feel challenging but not provoke a pinching or painful sensation in the hip. Bend forward at the waist to rise to a standing position then slowly lower back to sit. Hold onto a dumbbell or kettlebell for added resistance and challenge.
We hope this article has helped you feel more knowledgeable about hip labral tears and reassured you that this condition can often be managed with a great physical therapy protocol. If you have a labral tear and are looking for ways to manage your symptoms and get back to pain-free activity, schedule an evaluation with one of our physical therapists to get started on your recovery today.
Click here for more information about physical therapy for labral tears
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 Physical Therapy Locations!
https://EvolveNY.com
Physical Therapy for Neck Pain
Getting to the Bottom of Your Neck Pain- It is unlikely that you will get through your life without ever having neck pain. If you are lucky, it’s the result of sleeping in the car on a long drive or picking up a new tennis hobby and will resolve as quickly as it develops. In some cases, however, neck pain can be more severe or more persistent and you are left wondering where in the world it came from. If you are experiencing neck pain for the first time or for a while now, here are some questions you can ask yourself to try and get to the bottom of it.
Getting to the Bottom of Your Neck Pain
It is unlikely that you will get through your life without ever having neck pain. If you are lucky, it’s the result of sleeping in the car on a long drive or picking up a new tennis hobby and will resolve as quickly as it develops. In some cases, however, neck pain can be more severe or more persistent and you are left wondering where in the world it came from. If you are experiencing neck pain for the first time or for a while now, here are some questions you can ask yourself to try and get to the bottom of it.
1. Did I sustain an injury?
The neck is susceptible to injury just like any part of the body. Injuries to the neck can range from mild to severe and in most cases a person will experience pain as a result of this injury. Some examples of injuries to the neck that can lead to neck pain are whiplash following a car accident, for example; a muscle strain caused by a fall; a spinal cord injury to the neck; and a herniated disc in the cervical spine. While mild injuries may heal well on their own using common sense techniques like avoiding painful movements for a while and gradually returning to your previous activity level, moderate to severe neck injuries can often benefit from assessment by a physical therapist.
After an acute injury, injured tissues go through three phases of healing: acute, subacute and chronic. Understanding what actions to take and what actions to avoid during each of these stages will help support your body’s natural healing process. One of the ways physical therapists support their patients is guiding them through these stages. Waiting too long to begin active recovery can slow down healing time just as trying to do too much too fast can set you back to the beginning of the healing cycle. Full resolution of a neck injury can take time depending on its severity and whether surgery is needed, however, addressing and minimizing pain is one of the primary goals of rehabilitation for neck injuries.
2. Have I checked my posture?
If you find yourself rubbing the aches and tightness out of your neck and shoulders after working for a few hours, your posture may be to blame. We are meant to be moving around throughout our day but many find ourselves maintaining sustained postures for long periods of time while working, scrolling on our phones, driving and so forth. Postural alignment can be a contributing factor to neck pain. Because our bodies are connected from head to toe through a complex network of bones and joints, nerves, skin, muscle and fascia, the neck is affected by the position of the rest of the body.
Sometimes by making changes to your sitting or standing posture you can decrease irritation on the structures of the neck to relieve pain. Adjusting the height of your laptop or phone screen, for example, may allow you to obtain a more neutral neck position. In some cases, adjusting your posture to improve neck pain may require only mindfulness around how you are sitting or standing. In other cases, muscles may have shortened, lengthened or weakened and joints may have stiffened as a result of holding certain postures so often and may need to be addressed through an individualized stretching, strengthening and mobility program.
3. Have I evaluated my activities?
In the absence of an acute injury, evaluating the activities that you have been doing lately is a helpful way to discern the cause of your neck pain. Have you started a new activity recently? Is there an activity that you are performing daily or frequently leading up to an episode of pain? As we mentioned above, the neck is connected to and affected by the actions of the rest of the body. Poor body mechanics, muscle tightness or weakness, restricted mobility and even motor control impairments in the neck and surrounding areas may be resulting in increased stress and strain in the neck thus causing your pain. The key to addressing the pain in this case is to have someone carefully evaluate your movements, identify problem areas and develop a plan to address those issues to provide long term relief.
4. How am I sleeping?
Ever woken up with a stiff neck? Sometimes we sleep so deeply that our body doesn’t get the message to wake up and change positions when it is uncomfortable. Other times, however, your nightly sleep posture may be contributing to your neck pain. In this case, making changes in your sleep posture may provide relief. While there is no need to find a perfectly “neutral” position of the neck for sleeping, you will likely find that your neck and body are most comfortable and most well-supported in a specific position using a specific pillow, for example. When working with a PT they can give you some suggestions on how to modify your sleep set-up to help you wake with fewer symptoms. If you aren’t yet working with a PT, however, purchasing a few different pillows or even a new mattress to try may be needed until you find the right one.
WHEN IN DOUBT, ASK FOR HELP
We hope that asking yourself these questions will give you some insight into what is causing your neck pain. With any luck, you will be feeling better in no time but if you didn’t find your answer here or are looking for help in addressing your pain, our team of therapists are here to help. We offer a thorough and individualized assessment of your neck pain and will create a plan to provide you long term relief. Give us a call today to schedule an evaluation. Call 1-718-258-3300
Click here to find out more about physical therapy for neck 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.
Physical Therapy for Spinal Cord Injuries
Spinal Cord Injury Recovery- Injuries to the spinal cord can be devastating. In most cases these injuries are sudden and often require prolonged rehabilitation to restore or compensate for the function lost in the arms, trunk and/or legs. Because the spinal cord carries sensory and motor information between the brain and the rest of the body, injury to the nerves in the spinal cord can have serious consequences.
Spinal Cord Injury Recovery
Injuries to the spinal cord can be devastating. In most cases these injuries are sudden and often require prolonged rehabilitation to restore or compensate for the function lost in the arms, trunk and/or legs. Because the spinal cord carries sensory and motor information between the brain and the rest of the body, injury to the nerves in the spinal cord can have serious consequences.
Symptoms range from mild to severe and recovery often depends on the cause and severity of the injury. The location of injury will determine the part(s) of the body affected. In general, any areas innervated by the spinal cord below the level of injury have potential to be partially or completely impacted by the injury. There are many different causes of injury to the spinal cord. Some of the more common causes of spinal cord injury include:
Trauma such as a fall, diving accident, motor vehicle accident or assault
Infection in the spinal cord
Stroke in one of the arteries supplying the spinal cord
Surgical complications
Acute compression of the spinal cord by a herniated disc or unstable vertebra
As mentioned above, symptoms of a spinal cord injury depend on the location and severity of the injury but these are some common impairments associated with injury to the delicate nerves of the spinal cord:
Muscle weakness or paralysis in the arms, trunk or legs
Diminished or complete loss of sensation in the affected areas
Nerve pain
Spasticity or changes in muscle tone
Difficulty or inability to stand and walk
Difficulty using arms for functional tasks
Impaired breathing or inability to breathe on one’s own
Changes in bowel and bladder function
Impaired balance
Difficulty or inability transferring oneself from one surface to another
In almost all cases, physical therapists will be a part of your care team from the very beginning but you can expect the support from a number of other healthcare professionals as well. Read on to learn about many of the different providers you may encounter after a spinal cord injury.
MANY HEALTHCARE PROFESSIONALS MAKE UP THE CARE TEAM
Treating a spinal cord injury requires the help and expertise of a variety of healthcare professionals. In the immediate aftermath of the injury the focus is on stabilizing the spine, reversing or minimizing injury to the spinal cord and addressing any other injuries or medical concerns that may be life-threatening. This is primarily the role of the neurosurgeon or spinal surgeon, nurses and other doctors that care for you in the hospital. When it is deemed safe to do so, you will begin to meet the other healthcare professionals that make up your care team. While you may not need all of these professionals or you may seek the care of others not on this list, here is a list of the most common healthcare professionals involved in the aftercare for a spinal cord injury:
Neurologists and Physiatrists: Neurologists specialize in the care of conditions and injuries affecting the neurologic system like a spinal cord injury. Physiatrists are physical medicine and rehabilitation physicians that often handle complex cases like spinal cord injuries.
Respiratory therapists: Respiratory therapists may be encountered in the hospital or in a rehabilitation or skilled nursing facility to manage mechanical ventilation and other treatments related to compromised lung function.
Physical therapists: Physical therapists aim to help restore, recover and compensate for lost or reduced function in the arms, trunk and legs. Physical therapy will address skills like transferring in and out of bed, standing and walking, balance, muscle weakness, coordination, bed mobility, equipment like wheelchairs or walkers and much more. You will meet them in the hospital, inpatient rehabilitation and also in outpatient rehabilitation.
Occupational therapists: Occupational therapists also help to restore, recover, and compensate for lost or reduced ability to perform or participate in activities of daily living. This can range from the ability to get dressed and cook a meal, to the ability to use the toilet and return to work. They also address impairments in fine motor function of the fingers and hands, transfers, bed mobility and much more. They will also help you get adaptive equipment to increase your independence. You will meet them in the hospital, inpatient rehabilitation and also in outpatient rehabilitation.
Speech therapists: If your injury occurred in the cervical spine (neck) or midback (thoracic spine) or if you experienced prolonged bed rest or mechanical ventilation then you will likely work with a speech therapist to address issues with breathing, coughing, lung health, speech and swallowing. You will meet them in the hospital, inpatient rehabilitation and also in outpatient rehabilitation.
Orthotists: Orthotists order and make splints and orthotics to optimize movement and function. Splints and orthotics for the hands and legs, for example, can improve the ability to stand and walk, maintain range of motion and flexibility and improve the ability to use the hands for daily tasks. You will meet them in the hospital, inpatient rehabilitation and also in outpatient rehabilitation.
Counselors and mental healthcare professionals: A spinal cord injury is a life altering event and having adequate mental health support is essential.
Seating and Mobility Specialist: Seating and mobility specialists are specially trained to provide adaptive equipment like custom wheelchairs or standing frames. If long term use of a wheelchair is expected then a custom option can improve comfort and independence with mobility.
Nurse Case Managers: Nurse case managers are often encountered in the hospital and play an essential role in coordinating services and helping to arrange an appropriate discharge location for those with recent spinal cord injury.
We know that you have many professionals on your care team and our skilled physical therapists at Evolve would like to be one of them. If you are ready for outpatient physical therapy after an injury to the spinal cord, call us here at Evolve to get started with an initial evaluation.
Click here for more information about physical therapy for spinal cord injuries
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 Physical Therapy Clinic Locations!
https://EvolveNY.com
Physical Therapy for Upper Back Pain
Upper Back Pain 101: If you find yourself wondering what is causing the relentless pain or tightness in your upper back, this article is for you. The upper back, like the rest of the spine, is a multi-layered entity. While not technically its own distinct anatomical area, the upper back is often a target for treatment by physical therapists. Understanding the various structures that compose the upper back…
Upper Back Pain 101
If you find yourself wondering what is causing the relentless pain or tightness in your upper back, this article is for you. The upper back, like the rest of the spine, is a multi-layered entity. While not technically its own distinct anatomical area, the upper back is often a target for treatment by physical therapists. Understanding the various structures that compose the upper back is an important first step in addressing pain or dysfunction that occurs here. Let’s review these structures and how they may be contributing to your symptoms.
MANY DIFFERENT STRUCTURES COMPOSE THE UPPER BACK
Bones: The upper back might include the last two or three cervical vertebrae of the neck and the first four or five thoracic vertebrae. These vertebrae are stacked atop one another and separated by an intervertebral disc. Small joints called facet joints, created by adjoining vertebrae, allow for the multidirectional movement of the spine.
Nerves: Running through the column created by the stacked vertebrae is the spinal cord which carries sensory and motor information between the brain and the rest of the body. Exiting through small channels or foramina in the vertebral column are spinal nerves that innervate skin, muscles, organs, and other tissues in the arms and trunk.
Ligaments: thick ligaments like the anterior and posterior longitudinal ligaments help maintain alignment and limit excessive movement of the spine.
Muscles: Many muscles are located in the upper back. These muscles have different functions based on their location and attachment points. The deepest layers of muscles provide stabilization and movement to the spine itself. More superficial layers of muscles often act to move or control the scapulae or shoulder blades, the arms, shoulders and neck.
Fascia and skin: Like the majority of our body, skin plays an important role in protecting and facilitating sensation over the upper back. Fascia, on the other hand, exists as sheets of connective tissue that wind their way throughout the entire body encapsulating organs, separating muscles, imparting strength and stability to the body.
One or many of these structures may be implicated in a case of injury or irritation of the upper back. While it may not always be possible to discern exactly which structures are involved, consideration of these structures is helpful when crafting a customized physical therapy treatment plan. Now that we have examined the different anatomical structures that exist in the upper back, let’s discuss some conditions that may affect these structures.
POTENTIAL CAUSES OF INJURY OR DYSFUNCTION INVOLVING THE UPPER BACK
Bones: The bones of the upper back may be involved in the development of pain or dysfunction in this area or even adjacent areas.
Scoliosis: Scoliosis refers to an abnormal curvature and rotation of the spine. Leading to a dysfunction in posture, scoliosis can cause pain and stiffness, alterations in appearance and even impact breathing if severe. Treatment modalities like the Schroth Method are considered effective tools in helping to slow curve progression and provide symptom relief.
Fractures: It is important that fractures in the upper back are ruled out in the case of trauma to the upper back. These fractures can cause injury to the delicate nerves and spinal cord in this area and may need to be treated with immobilization or surgery.
Hypomobility: Hypomobility or stiffness in the upper back may cause localized symptoms of pain or stiffness but may also cause issues in the neck or arms.
Facet joint syndrome: Facet joints in the spine are susceptible to arthritis just like any other joint in the body. This can result in pain, stiffness or difficulty moving the spine.
Rib dysfunction or injury: While we most often think about the anterior portion of our ribs, they actually originate along each of the thoracic vertebrae. The upper most ribs articulate with the vertebrae of the upper back. Acute injury, muscle stiffness and hypomobility can occur where the ribs attach to the spine and along the upper back.
Nerves: without healthy nerves our ability to perceive and interact with the world around us would be greatly impaired. Pressure, irritation or injury of these nerves can cause an array of symptoms locally and referred to more distal sites. Numbness and tingling, weakness in the forearm or hand and radiating pain into the arm, hand or ribcage can occur. Some conditions that can affect the nerves in the upper back are as follows:
Spinal stenosis: A narrowing of the spinal column or foramina can result in pressure and irritation of the spinal nerves or spinal cord resulting in the above noted symptoms. If the spinal cord is involved, symptoms may extend into the lower body as well.
Disc herniation: Disc herniation is most common in the neck and lower back but it is possible that a disc herniation can occur in the lowest cervical vertebrae causing irritation of the nerves in the area.
Ligaments: The ligaments of the spine are considered quite strong and play an important role in maintaining the structure and alignment of the spine. These ligaments can thicken and contribute to spinal stenosis as we age. Additionally, these ligaments may be sprained or injured in the case of a trauma like a car accident, for example.
Muscles: The muscles in the upper back are workhorses and commonly contribute to upper back pain and discomfort. Tightness in the upper trapezius muscles on top of the shoulders, for example, is common among people working at a desk. A strained muscle from sleeping wrong or getting into a fender bender can also cause symptoms in the upper back as many of the neck muscles attach along the spine or scapulae in the upper back.
Fascia: proper fluid balance and mobility of fascial layers is thought to be extremely important in normal movement of the body. Impairments in fascial mobility in the upper back may contribute to localized problems as well as issues in the neck, shoulders and arms.
YOU DON'T NEED TO DIAGNOSE YOURSELF
While we hope this article provided some insight into the possible cause of your upper back pain, the good news is you do not need to diagnose yourself. Our team of PTs at Evolve are experts in the musculoskeletal system and will help you get to the bottom of your symptoms. Call us today to schedule an evaluation and let us help you get on the road to long term resolution of your symptoms.
Click here for more information about physical therapy for upper 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 Brooklyn Physical Therapy Clinic Locations!
https://EvolveNY.com
