What is Hip Impingement?

By Noah Poskanzer, SPT

 

 

As hockey playoffs are in full swing, overuse injuries, especially towards the end of the season, can hinder performance. “Hip impingement” is a common injury with hockey players.

 

 

What are the symptoms of Hip Impingement?

  • Stiffness/pain in hip/groin area, loss of full range of motion and pain in certain movements or positions

 

 

Best Treatment Options

  • The best treatment is to improve muscle balance, stretch areas of tightness, and strengthen areas of weak muscle surrounding the hip. Research shows that PT is the best first option for hip impingement. Removing the source of irritation, such as period of rest can help to reduce inflammation while focusing on PT. Surgical intervention is an option in severe cases and when conservative treatment isn’t effective.

 

 

What type of exercise is effective?

  • Exercise should include pelvic and hip stabilization, hip and abdomen strengthening. A large focus is placed on glut medius ( buttock) strengthening. A PT will also provide manual intervention such as hip capsular stretching, along with stretching

 

 

-At first exercises should be less complex to build a foundation, then progress to more complex exercises, and then incorporate higher level plyometric exercises for safe return to sport.

 

 

For more information on hip impingement, contact info@sptny.com.

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3 Tips to Reduce Back Pain While Gardening

 1. Plant Location

  • Ground level: Try to do ground level work on your hands and knees to minimize pressure placed on your spine. Periodically swapping your working hand with the one you’re putting weight through may reduce pressure on wrists/shoulders.

 

2. Lifting

  • Lift closer to your body: Objects further away prevent us from using our larger, stronger muscles. Using a closer approach with good form allows us to use these muscles.
  • Bend at your knees – not your back: A rounded spine with lifting causes increased pressure on the discs in our backs. Keep your back flat and squat down to lift target object by bending your knees and hips.

 

3. Tools

  • Keep your tools sharpened: Dull tools may cause us to use more repetitive motion creating more stress the joints in our hands and wrists. It’s a worthy investment to reduce effort. Local hardware stores often offer sharpening services at a reasonable price.

 

 

 

 

 

5 Tips to Improve Your Golf Swing and Prevent Low Back Pain

By: Meghan Diehl, SPT

 

 

 

Low back pain is a very common musculoskeletal problem affecting golfers of all ages and skill levels. In fact, low back conditions account for approximately 25% of all golf injuries.1

 

WHY? The lumbar spine is exposed to significant compression, shearing, torsion, and lateral bending forces during the golf swing.2

 

Follow these tips to maintain a healthy back during your golf season!

 

1) Raise your front heel during the backswing. This allows for increased hip swing and shortening of the backswing, which will decrease the amount of torque on the lumbar spine.2

 

2) Maintain an upright trunk during the acceleration phase. This will decrease the amount of lateral bending forces on the trailside of your body during the down and forward motion of the golf swing.2

 

3) Finish with balanced shoulders and an erect “I” position at follow-through. Standing upright at the end of the swing will decrease the compressive forces on the lumbar spine.2

 

4) Get stronger! Having strong trunk and hip muscles will improve your overall stability and control, which will protect your body from the increased forces imposed during the golf swing. Strengthening exercises to incorporate into your exercise routine include: planks, side planks, clams, and bridges.

 

5) Choose your equipment wisely! Push the golf cart instead of pulling to maintain an upright posture. Consider using a dual “backpack strap” to distribute the weight of the clubs more evenly across both shoulders.

 

Best of luck this season!

 

References

 

Lindsay D, Vandervoort A. Golf-related low back pain: a review of causative factors and prevention strategies. Asian J Sports Med. 2014;5(4):e24289. doi: 10.5812/asjsm.24289

 

Gluck G, Bendo J, Spivak J. The lumbar spine and low back pain in golf: a literature review of swing biomechanics and injury prevention. Spine J. 2008;8(5):778-788. pmid: 20161213

 

Rowing: The Total Body Workout

Looking for a great way to get in shape, stay in shape, or wanting to try something new? Rowing could be the answer!

 

What is Rowing?

Rowing (aka crew) is not kayaking or canoeing which is a common misconception.

When sitting in a boat, a person’s feet are strapped onto a “footplate” and the person is sitting on a seat which is on wheels on a track which allows the seat to slide up and down, finally the person is holding a 12’ oar in their hands. The oar is secured to the side of the boat by an “oar lock” which allows the oar to move as the person pulls it through the water during the rowing motion.

This sounds rather daunting but don’t let it scare you!

 

Why rowing?

Rowing is a wonderful sport because it is accessible to everyone from high school athletes to middle aged individuals looking to be active, and there is even a program in the Rochester area made up entirely by cancer survivors.

Another wonderful benefit of rowing is that due to the amount of precision and concentration required, it is just as much about sharpening the mind as it is about strengthening the body.

If you are looking for a new exciting experience which fosters teamwork and community, rowing may be the sport for you!

 

What makes Rowing unique?

Rowing is great for overall fitness because it requires the use of nearly all the major muscles in your body!

Most of the power comes from your legs (about 60%), then your back and abdominal muscles engage and finally your arms pry the oar out of the water. Another unique thing about rowing is one gets to be on the water!

Whether it is a canal, river, or lake the experience of being out on the water is what makes rowing most enjoyable and unique. 

 

 

 

Muscles used while rowing

What Does a Rowing Machine Do For Your Body?

 

How Can Blood Flow Restriction Training Help Patients and Athletes Alike?

By Robert Crandall, SPT

 

 

Blood flow restriction (BFR) training is a hot topic in both the fitness and health care world right now due to its ability to increase strength and muscular hypertrophy more quickly than traditional progressive resistance exercise. It is performed by the occlusion of blood circulation, with either a blood pressure cuff or elastic bands placed proximally on the limb, in a working muscle group while performing resistance exercises. The objective of BFR is to occlude venous blood return without significantly affecting arterial circulation. In this way, blood enters into the muscle but cannot escape until the pressure of the restricted implement is released. The pressure used with blood pressure cuffs is typically placed at a pressure between 50-80% of the pressure for which it takes to stop arterial flow into the limb. When using elastic wraps or tourniquets, which were found to be as effective as blood pressure cuffs, should be placed at a subjective 7/10 tightness level.

 

Many research articles are being published about the strength and muscle enhancing effects of performing this novel type of resistance training. There are clinical trials that show that blood flow restriction alone, without any resistance, or even muscular activation of the limb, can be effective enough to decrease the typical muscular atrophy and diminished strength subsequently following the immobilization of a limb in a cast.  The research also boasts larger strength gains for untrained individuals with restricted blood flow and low load exercise performed with low resistance loads (20-40% of MVIC or 1RM) for 3-4 sets with a total of 50- 80 reps performed total. These sets are done with limited rest between them, 30-45 seconds, 2-4 times a week. This is particularly beneficial for individuals who cannot tolerate the typical training with 70% of MVIC required to increase muscular strength. The research even shows decreased metabolic stress factors and joint compressive forces while using blood flow restriction training as compared to traditional strength training.

 

For athletes, even as well trained as at the collegiate level there is a benefit to the addition of blood flow restriction training to their normal strength training programs. Studies have shown increased bench press and squat 1RM in division 1A football players as well as faster sprinting times in collegiate track athletes. For these well trained individuals they should perform the blood flow restriction training described above following their typical high load resistance training for maximum benefits.

 

The mechanisms for which blood flow restriction training work through include increased accumulation of metabolites in the muscle tissues causing a larger decrease in the local pH which in turn increases the overall excitability of the afferent nerves in the local musculature. Meaning that muscular fibers require less overall stimulus for activation, thus increasing the number of muscle fibers stimulated during a muscular contraction by amplifying the signals sent from the central nervous system.The restricted flow of blood also increases the levels of muscle building hormones like free testosterone and IGF-1 in the muscle tissue as compared to typical progressive resistance exercise.

 

With all of these benefits the use of blood flow restriction training should only steadily increase, especially as more and more clinical research is performed. Although due the increased demands placed on the peripheral vasculature of the limbs being trained, people with a history of DVTs, who are pregnant, who have cardiovascular disease, diabetes, cancer, or peripheral vascular disease are generally contraindicated from participating in blood flow restriction training.

 

 

References:

  • Abe T, Kawamoto K, Yasuda T, et al. Eight days KAATSU resistance training improved sprint but not jump performance in collegiate male track and field athletes. Int J KAATSU Train Res. 2005;1(1):19–23.
  • Cook CJ, Kilduff LP, Beaven CM. Improving strength and power in trained athletes with 3 weeks of occlusion training. Int J Sports Physiol Perform. 2014
    Jan;9(1):166-72. doi: 10.1123/ijspp.2013-0018. PubMed PMID: 23628627.
  • Scott BR, Slattery KM, Sculley DV, et al. Hypoxia and resistance exercise: a comparison of localized and systemic methods. Sports Med.2014;44(8):1037–54
  • Takarada Y, Takazawa H, Ishii N. Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc. 2000;32(12):2035–9
  • Yamanaka T, Farley RS, Caputo JL. Occlusion training increases muscular strength in division IA football players. J Strength Cond Res. 2012 Sep;26(9):2523-9. doi: 10.1519/JSC.0b013e31823f2b0e. PubMed PMID: 22105051.

 

5 Healthy Tips for Airplane Travel

By: Dr. Alanna Pokorski, PT, DPT

 

 

1.) Hydrate, hydrate hydrate! Drinking 8-10 glasses of water per day is recommended especially when going on an airplane. Airplanes are very dry and you don’t want to kick off your vacation with dehydration (muscle cramping, headaches, body aches, nausea).

 

 

2.) Bring a travel pillow. Airplane seats are certainly getting more comfy, however when resting on a plane, the neck needs more support to prevent the “neck flop”. A travel cervical pillow keeps your neck and mid back in good alignment as you dream of your vacation plans. Don’t forget your kids too! Their little necks need support as well.

 

 

3.) Minimize swelling. Move your ankles and feet in fun alphabet shapes randomly throughout the flight. This will help decrease any swelling that can occur in your calves, especially if you struggle with circulation.

 

 

4.) Straighten up! Take that extra sweater you have and carefully roll it into a log shape and place it behind you on your tailbone. This will serve as a “lumbar roll” for your low back during the flight to maintain good seated posture.

 

 

5.) Luggage Love! Keep your luggage symmetrical on both sides of you if possible. Maybe one bag on one shoulder and one suitcase in the other hand. This will help keep you spine straight as you walk (or run) through the airport.

 

 

Enjoy your travels!

 

 

Cupping – An Effective Solution for Pain Relief?

If you tuned into the 2016 Olympics, you have probably heard about cupping, and how “everyone”, including gold medalist Michael Phelps, is having it done.

766x415_What_is_Cupping_Therapy[1]

So, what is cupping?

 

Cupping started out as a traditional practice in Chinese medicine but has recently become very popular in western medicine. The application of cupping and uses for cupping are slightly different when used in western medicine, but the basic purpose is for mobilization of tissues. Most specifically it’s used for mobilization of myofascial tissue to allow structures that pass through the area of treatment, such as nerves, to move more smoothly.

 

The research…

 

In a pilot study researching cupping, 21 patients received cupping treatment to their low back for relief of chronic low back pain. Patients experienced both a significant decrease in perceived pain in the low back as well as a significant increase in tolerance to applied pressure on the back before pain was felt.

 

One cupping study was performed on women who had just given birth with the desired outcome of relieving low back pain and preventing chronic pain in the future. The women in the cupping group had significantly higher reduction in low back pain symptoms after 24 hours, as well as 2 weeks after receiving treatment in comparison to the control group.

 


Another study of 21 patients with knee osteoarthritis receiving 8 sessions of pulsatile dry cupping within 4 weeks, twice per week. The cupping group showed significantly better pain relief at 4 weeks and 12 weeks post treatment than for the 19 patients in the control group who did not receive cupping.

 

So What?

 

While more research is needed to further validate the pain relief effect cupping can have for many other pathologies, it is apparent that it can be a very useful pain relief tool to be used by physical therapists. It is a technique I have been lucky enough to have had done on myself to help relieve nerve pain.

 

You don’t have to be an Olympian to receive gold medal treatment!

 

 

References

 

Akbarzadeh, M., Ghaemmaghami, M., Yazdanpanahi, Z., Zare, N., Azizi, A., & Mohagheghzadeh, A. (2014). The Effect Dry Cupping Therapy at Acupoint BL23 on the Intensity of Postpartum Low Back Pain in Primiparous Women Based on Two Types of Questionnaires, 2012; A Randomized Clinical Trial. International Journal of Community Based Nursing and Midwifery, 2(2), 112–120.

 

Markowski, A., Sanford, S., Pikowski, J., Fauvell, D., Cimino, D., & Caplan, S. (2014). A pilot study analyzing the effects of Chinese cupping as an adjunct treatment for patients with subacute low back pain on relieving pain, improving range of motion, and improving function. Journal Of Alternative And Complementary Medicine (New York, N.Y.), 20(2), 113-117. doi:10.1089/acm.2012.0769

 

Teut, M., Kaiser, S., Ortiz, M., Roll, S., Binting, S., Willich, S. N., & Brinkhaus, B. (2012). Pulsatile dry cupping in patients with osteoarthritis of the knee – a randomized controlled exploratory trial. BMC Complementary And Alternative Medicine, 12184. doi:10.1186/1472-6882-12-184

Don’t wait to have that nagging pain looked at!

By: Dr Allison Hoestermann, PT, DPT

 

IMG_9142 (002)

 

WHY? More and more studies are showing that the longer you wait to address pain, the more difficult your condition will be to treat. The reason being: Once your body experiences pain, it will begin to compensate, thus creating further dysfunction and pain in other areas.

 

Musculoskeletal pain is pain that is felt on the skin or in the muscle, joints, bones, or ligaments. These structures are particularly sensitive to inflammation or swelling due their 1.) High blood flow and 2.) Relationship to movement.

 

 

A Doctor of Physical Therapy is an expert at treating musculoskeletal pain, second only to an orthopedic surgeon.1 You do NOT need a Physician Referral to see a Physical Therapist.

 

 

What to expect when you see a Physical Therapist for your pain:

 

  • A Physical Therapist will take a thorough medical history and ask several questions about your pain. Questions may include: Where is the pain? What is the quality of the pain? What aggravates the pain? What relieves the pain? When does the pain occur throughout the day? What impact does the pain have on your function and mood?

 

  • Next, the Physical Therapist will examine and evaluate the quantity and quality of movement. He/she will identify abnormalities with walking/running, assess posture, find areas of tenderness, assess joint mobility, nerve tension, motion, strength, flexibility, balance, check lifting, bending, and squat mechanics to figure out where the source of your pain may be originating.

 

  • They will be able to take those findings and identify where the muscles are not functioning properly and may be shut down, causing abnormal movement patterns.

 

  • Putting all of the pieces together, the PT will be able to make an individualized exercise plan, as well as perform manual techniques to improve movement quality and reduce dysfunction.

 

 

Research has shown that patients who went to physical therapy within 90 days of onset of low back pain avoided having an MRI, x-ray imaging, spinal injections, surgery, and prescription of opioids versus those patients who waited longer to attend PT. http://www.apta.org/Media/Releases/Consumer/2015/4/9/

 

 

References:

  • A description of physical therapists’ knowledge in managing

musculoskeletal conditions. JD Childs, JM Whitman, PS Sizer, ML Pugia,

TW Flynn, A Delitto. BMC Musculoskeletal Disorders, 2005

6:32.

 

  • http://www.medicalnewstoday.com/articles/145750.ph

Non-Operative Physical Therapy Treatment of Rotator Cuff Tears

By: Tina Memarzadeh, SPT

 

SHLDR

 

Rotator cuff tears affect at least 10% of individuals over the age of 60 in the United States, which accounts to roughly 5.7 million people.1, 2 An estimate of 75,000-250,000 rotator cuff surgeries are done per year, indicating that only 5% of patients with rotator cuff tears are being treated surgically.3 A number of recent studies suggest non-operative treatment of full thickness rotator cuff tears can be successful in some patients.4  Research shows that physical therapy alone can produce results equal to those produced by arthroscopic surgery and open surgical repair.

 

 

Many researchers have worked on creating an effective physical therapy protocol in treating rotator cuff tears non-operatively. Of note, is the Multicenter Orthopaedic Outcomes Network (MOON), a group of doctors from around the country focusing on research to enhance care of patients with shoulder problems. MOON shoulder group has developed a set of protocols to be used by physical therapists and at home by patients to treat non-traumatic rotator cuff tears. Study done by the MOON shoulder group demonstrated greater than 85% success rate using their physical therapy protocol, with the beneficial effects of this program lasting for a minimum of 2 years.5

 

 

The home therapy program created by MOON shoulder group is used to compliment a therapist directed program. Therapists will guide patients through a protocol which consists of three parts:

  1. Range of motion: done every day to get shoulder motion back
  2. Flexibility: done every day to stretch tight tissues
  3. Strengthening: done 3 times per week to regain strength

 

 

Example of range of motion exercises include pendulum exercises, posture exercises, active assisted range of motion exercises using unaffected shoulder, active training of the shoulder blade muscles, and active range of motion exercises. Flexibility exercises include door stretch, sleeper stretch, golfer stretch, and towel stretch. Lastly, examples of strengthening exercises are isometrically activating rotator cuff muscles against a wall, shoulder internal and external rotator strengthening using elastic bands or dumbbell, rowing using elastic bands, chair press ups, shoulder shrugs, shoulder blade push-ups, and Jackin’s exercises.

 

 

 

To learn more about physical therapy to treat rotator cuff motion and strength deficits, contact us at info@sptny.com.

 

References:

  1. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ Ann R Coll Surg Engl. 2006 Mar; 88(2):116-21
  2. Werner CA. The older population: 2010, US Census Briefs, C201 OBR-09. US Department of Commerce, Economics and Statistics Administration, US Census Bureau. 2011 Nov; 1–19. ( http://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf
  3. Rotator cuff repair: an analysis of utility scores and cost-effectiveness. Vitale MA, Vitale MG, Zivin JG, Braman JP, Bigliani LU, Flatow EL J Shoulder Elbow Surg. 2007 Mar-Apr; 16(2):181-7.
  4. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomised controlled study of 103 patients with one-year follow-up. Moosmayer S, Lund G, Seljom U, Svege I, Hennig T, Tariq R, Smith HJ J Bone Joint Surg Br. 2010 Jan; 92(1):83-91.
  5. Kuhn JE, Dunn WR, Sanders R, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013; 22(10):1371-9.

‘Tis the Season on the Court: Overuse Injuries in Basketball

By: Dr. Trevor Stutz, PT, DPT

 

IMG_8175

 

Basketball is a great game! The fast-paced, high scoring, team driven sport is one of the most popular games in America and the season is now in full swing for thousands of athletes across the country. Basketball requires a plethora of physical skills including strength, power, agility, speed, hand-eye coordination and endurance. I may be biased because I grew up in a house where basketball was a big deal, but I feel basketball requires the most well rounded athlete of any sport.

 

While it is such a great game, the stress playing basketball places on the body can cause injury. Consider that in 2009 an estimated 170,000 kids ages 5-14 were treated in emergency rooms following basketball injuries. While all sports carry some risk of injury, proper education and training can reduce the risk for injuries and missing game time due to injuries.

 

Many of the most common injuries related to basketball, such as patella tendinitis (jumper’s knee) are due to overuse and can be prevented with proper stretching, core strengthening, and monitoring intensity of playing time.

 

Other common injuries such as ankle sprains, ACL and MCL injuries (ligaments of the knee), and back strains can be also be reduced with proper core training and guidance to make sure muscles around these areas are strong and can handle the quick movement of basketball.

 

Whether it’s managing an existing injury, lowering the risk for a future problem, or maximizing performance,  a physical therapist can help you stay on the court and excel this season. Physical therapists are musculoskeletal experts who have extensive training in the treatment and prevention of injuries and are movement experts who can help determine the best way to keep you moving and get you back to the sports you love. If you are dealing with an injury now, or are more interested in finding out how to prevent a future injury and maximize your performance and time on the court, see a Sports PT physical therapist today.