The 4 Most Common Symptoms Of A Concussion

By: Ben Antonucci, SPT 


A concussion is a mild form of a traumatic brain injury that can disrupt the way your brain function with every day activities. Some very common symptoms of a concussion include:


1)     Cognitive changes: Changes in memory, difficulty concentrating, feeling slowed.

2)     Physical symptoms: headaches, nausea, dizziness, poor balance.

3)     Emotional changes: moody, sadness, increased anxiety.

4)     Sleep changes: Increased or decreased sleep, difficulty falling asleep.


If you suspect that you may have suffered a concussion, what should you do?


1)     REST: First and foremost, you must rest both your body and your mind. That means take a break from the gym or playing those video games for at least one week!

2)     Go see your local Physical Therapist or Primary Care Physician: If you’re having cognitive changes or difficulties with balance, your local physical therapist can assist you with returning back to your normal function. A script from your doctor is not required for you to be seen by a physical therapist; simply call and make an appointment.


A concussion can drastically alter long term brain function if not properly treated when it first occurs. Make sure to properly address the symptoms you are experiencing with the suggestions above to prevent prolonged damage and ensure a normal recovery.


How Many PT Sessions Are Needed To Get Results?

By: Chris Campoli, SPT


A question that invariably comes up when discussing the course of treatment with a patient is how many sessions they’ll need until they have a desired result. The first step to come up with this number is determining your diagnosis. From there, physical therapists combine their assessment of you along with their research on tissue recovery and treatment to help decide the frequency and duration of your therapy. As exercises are added to your program it is crucial that they done with good form, so the feedback and reinforcement from your therapist is vital. After a few visits, hopefully you are beginning to feel better, but this is just the beginning! Muscles, tendons, and other structures take weeks to adapt to the new stresses on your body from therapy. Often the focus is on pain, but when you begin to feel an improvement it is important to continue addressing the cause of that pain to make those positive changes more permanent.


The length of time you may need to come to PT will vary based on the injury. For a case like shoulder impingement (compression of rotator cuff), research recommends 8 weeks of therapy to allow the PT time to improve flexibility and strength as well as educate the patient on postural awareness and how to control symptoms at home. The case of a surgical procedure like rotator cuff repair with a greater amount of tissue healing may require therapy over a 16 to 20 week period, as it is key to gradually stress the tendons involved. The average frequency of physical therapy recommendations is two visits per week, however there could be a routine that consists of one visit per week or 3 visits per week, depending on the extent of injury and urgency to return to activity.


Factors that can impact the amount of time it takes for your body to adapt:


  • Physical activity level
  • Posture
  • Age
  • Diet
  • Medications
  • Smoking


It’s important to keep all of the following in mind when talking with your physical therapist about frequency and duration of a physical therapy program.



Mueller MJ, Maluf KS. Tissue Adaptation to Physical Stress: A Proposed “Physical Stress Theory” to Guide Physical Therapist Practice, Education, and Research. 

Tate AR, McClure PW, Young IA, Salvatori R, Michener LA: Comprehensive impairment-based exercise and manual therapy intervention for patients with subacromial impingement syndrome: a case series. 


Shin splints Or Anterior Compartment Syndrome: When To Call A Professional?

By: Sean Dorman, DPT


The term shin splints have been a plague to the running community for what seems like eternity. It has been documented that 82% of runners experience injuries and it is well known that shin pain is one of the most common. So when do you know whether rest will cure the problem or if you need to seek further medical attention?


Shin splints involve inflamed muscles, tendons, and the thin layer of tissue that covers the bone. It is often painful enough to knock you to the sidelines for a while, but most cases can be effectively treated conservatively. Changing running routines, increasing distance too quickly, running on hard surfaces, or even improper footwear are common contributing factors to this impairment.


Shin splints are often confused with a more serious diagnosis known as anterior compartment syndrome (ACS), since they often present with similar symptoms.  ACS is a condition in which pressure increases within the front compartment of the lower leg, which cuts off blood supply causing swelling and pain resulting in a possible medical emergency.


The following clues can assist with distinguishing between the two.

– In ACS, lower leg pain begins during exercises (not before) and lingers long after you finish. Shin splints often occur during the run and progressively worsen as the run continues and subsides quickly when you are done.

– In ACS pain is on the outside front of the lower. Shin splints are more likely to be on the front, inside of the lower leg.

– ACS can mimic nerve damage; numbness, tingling, pins and needles.


Physical therapists are experts in diagnosis and treatment of your musculoskeletal injury. Allow them to evaluate you to get the best advice to further your running careers.


Will Sherman Have Tommy John Surgery? Our Expert Weighs In On UCL Reconstruction.

By: Drew Jenk, PT, DPT


If you watched the Super Bowl, like a large part of the world, you probably noticed Richard Sherman of the Seattle Seahawks closely guarding his left arm. It turns out that he tore his ulnar collateral ligament (UCL) in his left elbow and will require off-season surgery. Generally, this injury is thought of as a baseball injury, as the majority of research has focused on UCL reconstruction in pitchers. However, there are cases in which other athletes such as wrestlers and gymnasts will tear the ligament in a weight bearing position. Regardless of the mechanism of injury, Sherman will likely undergo the famed Tommy John surgery.


According to the British Journal of Sports Medicine, the success rate of UCL reconstruction varies between 63% and 97% depending upon the technique. However, complication rates are relatively low, at 10%. Other research has shown a return to prior level of play for pitchers to vary between 9 months and 18 months. This is largely dependent upon the point in the season that they are injured and when they elect to have the surgery relative to the next season. In Sherman’s case, if he has the surgery sometime in the next month, we can likely expect a full return in time for next season; barring any complications. The biggest rehab consideration for him will be the stability of the elbow with pushing and pulling movements, as well as tolerance to weight bearing at high loads and velocities due to the level of contact associated with playing professional football. The challenge with the typical Tommy John patient centers around the ability to resist repetitive stresses at the medial elbow during the pitching motion, but Sherman will not face similar sport specific challenges.


In summary, we can likely expect this to be just a larger pothole than usual in the typical recovery that a professional football player typically goes through in any off-season. And perhaps of greater concern to many football fans, this should not be a major deciding factor in selecting the Seattle Defense in next season’s fantasy football draft.


Is It Safe To Search The Internet For Injury Advice?

By: Alanna Pokorski, PT


The first place many people go to find medical advice is the internet. While there is much information online, some of it is valuable and some of it isn’t. Oftentimes, information can be misleading, cause unnecessary worry, or even lead to worse injury. If you are not a health care expert, it can be difficult to differentiate good advice from bad advice.


We often hear from patients on their first visit that they have been self-diagnosing their conditions based on information they have read or heard from a friend. Many times, they try with good intention to treat the injury themselves. We caution our patients to turn only to experts to gain advice for their musculoskeletal injury. Just as we go to accountants for expert tax preparation or a hair stylist to give us the best cut, people should see expert advice for their health care needs. If a pain lasts for more than 7-10 days or is progressively getting worse, it is likely not a just simple muscle pull.


Physical therapists are experts in diagnosis and treatment of your musculoskeletal injury. According to the BMC of Musculoskeletal Disorders in June 2005, experienced Physical therapists are skilled experts in diagnosis and treatment of musculoskeletal injuries, second only to orthopedic surgeons.


Our recommendation is to not take your injury in your own hands but rather partner with a skilled Physical therapist (PT) for the quickest recovery. You don’t need a referral in New York State to be evaluated by a PT. If you need to see an expert, request an appointment here.


Pain: What You Should Know

By: Allison Hoestermann, PT, DPT


Ever wonder why some people tend to deal with pain better than others? Here are some facts you should know:


1. Pain is a direct signal from the brain. There is a roadmap from the brain to the affected tissue. Additionally, the degree of pain often depends on our perception of the danger of pain. The greater the perceived danger, the greater the signal from the brain to the tissue.


2. The degree of pain isn’t always reflective of the degree of injury. Everyone experiences differences in how their brain processes pain. Some people perceive and process pain with very strong coping mechanisms, and others find even the slightest scrape a potential threat. Helping children early on to cope with their cuts and cruises will help them with more serious injuries later in life.


3. A diagnostic test doesn’t always determine the cause of injury. MRI’s, X Rays, and CT scans are often used as a first line of diagnosis. However, there are times when the results tell us very little about the pain. For example, a study was performed on people 60 years or older with NO symptoms of low back pain. Despite the lack of pain, 36% had a herniated disc, 21% had spinal stenosis and 90% had a bulging disc.


4. “I have a high pain tolerance.” There is no accurate way of knowing whether or not you have a high pain tolerance. Often times, stating that fact is a coping mechanism for handling the perception of pain.


5. Psychological factors such as depression increase pain. A recent study in the Journal of Pain showed that an individual’s depression or anxiety level before total knee replacement had a direct effect on the patient’s long term pain post operatively. The happier a patient is, the greater chances of reduction of pain.




Fractured Clavicle: How Long Does It Take to Heal?

By Alanna Pokorski, PT


If you watched the Buffalo Bills game last Sunday, you likely held your breath as you saw running back C.J. Spiller land very hard on his left shoulder and fracture his clavicle.


A clavicle fracture is a painful bone fracture that occurs from a high force due to a fall on an outstretched arm, a fall on the shoulder, or a direct hit to the clavicle.


The clavicle, more commonly known as the collarbone, is an S-shaped bone that connects the trunk of the body to the arm and is positioned right above the first rib. On one end, it attaches to the sternum or breastbone, and on the other end, it connects to the scapula, or shoulder blade.


Following the fracture, there is typically extreme pain and swelling over the clavicle and upper chest. There is often pain in the surrounding muscles, and severe pain with any movement of the shoulder. On Sunday, you could see how much pain Spiller was in immediately after his injury.


Following the diagnosis by X-ray, the shoulder is typically placed in a sling, and an orthopedic physician determines the course of treatment.  Depending on the location of the fracture and the extent of the break, surgery may or may not be indicated. In Spiller’s case, surgery was indicated.


Recovery time varies, but for adults who have had their collarbone repaired, six weeks of sling immobilization is the recommended initial treatment for healing.


This of course is a challenge for any athlete who wants to resume competitive activity. After immobilization, the athlete starts to restore active motion and strength training, with the goal of returning to their sport.


For a football athlete, rehabilitation strongly focuses on strengthening, closed kinetic chain strengthening (when the arm is essentially in a weight-bearing or pushup position), end ranges of motion, and the ability to handle direct collision to the shoulder pain-free.


The general timeframe for returning to competitive football is anywhere from six weeks to three months, depending on the pain level, location of fracture, surgical intervention, and severity. Some articles have shown that surgical repair may take a few weeks longer to return to a sport; however, the chance for re-injury is less.


In C.J. Spiller’s case, Buffalo Bills fans are crossing their fingers and hoping for a quick recovery. The running back is a key player, and this is also his contract year.


For more information on how Physical Therapists help clavicle fractures, please contact us at





Corporate Wellness Programs Makes Good Sense

By Dot Hall, VP, Human Resources



Corporate Wellness Program

It is no secret that medical costs in the United States are continuing to escalate. There are mixed opinions on what approach would help alter this cycle, everything from a country-wide insurance plan for all as well as more preventative coverage, to a reduction of unnecessary procedures and medications. All of these approaches have pros and cons, but one thing is for sure: as a society, we need to understand our medical system better. We need to educate medical consumers, medical providers, and insurance carriers with evidence-based information that will help us make better decisions about treatments, with the goal of quicker healing and lower costs.


Employers play a key role in educating consumers on medical insurance and treatments. With 90% of our population employed in some capacity, employers can serve as a conduit to sharing programs that create lower costs, provide alternatives to medication-only treatments, and encourage a healthier lifestyle. For the 1 in 5 adults who have high cholesterol, early detection can make the difference in avoiding or controlling heart disease (and all the higher costs associated with treating the condition). Early detection of diabetes can have a significant impact on the cost of treatment. Given the 20.6 million people dealing with Type 2 diabetes, and 54 million with pre-diabetes, just getting these symptoms in control early can reduce overall medical costs. And perhaps eliminate the 2 out of 3 people with diabetes who will die from heart disease or stroke.


Employers who offer wellness programs are helping reduce our nation’s medical care costs. We encourage employers to think about offering these types of programs:


  • Smoking cessation
  • Reimbursement for exercise programs
  • Annual blood draw analysis to detect cholesterol, blood pressure, and diabetes conditions
  • Walking programs
  • Weight management programs

Many of these are low or no cost to employers. The investment also pays huge dividends to both individuals and the business in the long run.




What’s The Difference Between a Physical Therapist and a Physical Therapist Assistant?

By: Lisa Gudlin, SPTA


You may have been in a physical therapy clinic that had both a physical therapist (PT) and a physical therapist assistant (PTA) helping you with your rehabilitation. You may have wondered, “What exactly is the difference between them?” Here is a brief explanation:


One of the major differences is the level of education. A PT will typically attend four years of undergraduate college and receive a Bachelor degree and then attend three years of graduate school. This allows a PT to earn their Doctoral degree in Physical Therapy, totaling seven years of schooling.


The PTA typically attends a two-year program at an undergraduate college and receives an Associate of Science degree. Even though a PTA program is relatively short, many science topics are covered: math, chemistry, physics, biology, anatomy and physiology, kinesiology, and pathology. Thus, a PTA is very knowledgeable in how the body works, especially how muscles work and how to strengthen them. A PTA program also has a lot of hands-on training, including lab work in school and clinical experiences in various facilities, such as nursing homes, hospitals, private practices and school settings.


The PTA program prepares graduates to help a supervising PT carry out the plan of care for a client. The physical therapist assistant does not do the following: diagnose injuries, perform initial evaluations, create a plan of care (exercise plan) for a patient, or decide when the patient should stop coming to physical therapy. However, in many clinics, the PTA may be the main person involved with instructing patients in their exercises or performing manual techniques (e.g., stretching); the PTA will always keep an open line of communication with the supervising PT to keep him or her updated or to bring any changes to the PT’s attention.


Both PTs and PTAs are compassionate and caring health care providers, who always put patients first and strive to improve people’s lives through therapeutic exercise. Together, they are a highly effective team that can impact society for the better through knowledge, education, hard work and compassion.


For more information about physical therapists and physical therapist assistants, visit or



The Importance of a Functional Squat

By: Matt Ryan, PT, DPT, FMSC


When I mention the word squat, what do you think of? If you frequent the gym, you may visualize a bodybuilder who loads a barbell with the heaviest weights available and then lowers his or her body as close to the ground as possible, with the hope of not collapsing under the pressure of the weight. Or you may think of some popular aerobic-type workouts, where the participants have to perform as many body weight squats, squat jumps, or other variations of the basic squat movement as possible in a short amount of time, with minimal regard for form.


But would you believe me if I said you need to squat to work in your garden? Or, that a squat is essential for helping to lift your young children into and out of a car seat? And you should definitely be squatting to get that bag of groceries from the ground to the counter. Even sitting down in a chair incorporates the basic squat movement. A functional squat is part of our everyday routine – and many of us are potentially squatting with an incorrect movement pattern. Proper mechanics of a squat require stable feet with good arch support, flexible ankles, knee stability, hip and abdominal muscle activation, and a mobile mid-spine. Asymmetries in flexibility, muscle function, and joint mobility anywhere along the line can lead to poor squat mechanics – which may become a source of pain! 1


At Sports PT, we may ask you to squat as part of an evaluation – it is a tool that helps us diagnose what is contributing to pain in your feet, ankles, knees, hips, or back2. If we find any dysfunction, we will retrain your squat mechanics as part of a comprehensive treatment plan to get you moving through the day with greater function. By incorporating a functional squat into everyday life, you may also help to prevent future recurrence of pain (especially once the snow shoveling season starts up again!). So if you are having difficulty or discomfort with daily activities around the house, at work, or with gym or sporting activities, set up an appointment at one of our convenient Sports PT locations. And don’t be surprised if we ask you to show us your squat!


Photo Source:



1. Cook, G., Burton, L., Hoogenboom, B.J., & Voight, M.  (2014).  Functional movement screening: The use of fundamental movements as an assessment of function – Part 1.  The International Journal of Sports Physical Therapy, 9(3): 396-409.

2. Butler, R.J., Plisky, P.J., Southers, C., Scoma, C., & Kiesel, K.B.  (2010).  Biomechanical analysis of the different classifications of the Functional Movement Screen deep squat test. Sports Biomechanics, 9(4): 270-279.