Skiing & Snowboarding Injury Prevention Tips

By Sports PT Blog Team

 

 

Skiing and Snowboarding are great outdoor winter activities. The fresh air and exercise do you well on a lot of fronts. But, like every sport, there are risks when you participate in a sport. Here are a few safety tips that will help you have fun and be safe.

 

 

  1. Always wear a helmet designed for skiing or snowboarding.
  2. Wear ski googles that fit properly with a helmet.
  3. Make sure your boots fit properly and bindings are adjusted correctly.
  4. Do not ski or snowboard alone.
  5. Stay on designated trails.
  6. Stretch your muscles before you go!
  7. Stay hydrated with water.

 

 

Bruises and broken bones are the most common types of skiing and snowboarding injuries. However, traumatic brain injury can also be a serious injury with this sport. Be safe and have fun!

Urgent Care to PT ASAP

By Alison Synakowski, DPT

 

 


Many people are seeking the assistance of urgent care to assist with musculoskeletal pains. The access to orthopedic evaluations and imaging has significantly improved society.


While ruling out fractures or sinister pathologies is very important in many cases, the need to start an active course of care is equally important. More and more we are seeing referrals to PT from both orthopedic based and non-orthopedic based urgent care providers. This is because research is increasing- proving early initiation of physical therapy is instrumental to not only your short term vitality, but also your long term health.


Research has proven that early access to physical therapy (within 3 days of the onset of back pain) is associated with lower costs and utilization of healthcare. This study involved over 46,000 individuals. Research also shows that atrophy of muscles begins within 24 hours of injury. Physical therapists are trained to help reduce the effects of an injury and safely teach movements that help to minimize the impact of an injury.
Many times we are told to rest following an injury or if we have pain, however this should be considered relative rest. Meaning, rest the tissue(s) that have been impacted, but keep the rest of your body moving!!


It is an exciting time for our society in that we are learning to manage injuries faster, with less associated cost, and with better outcomes. The consumers are driving this movement, seeking out care that is now easy to access, asking for less invasive and less expensive strategies to overcome dysfunction and being proactive about managing injuries!

So if you are hurting, seek care sooner than later, it not only impacts your outcome but your finances too!!

Shoulder Impingement? Here’s why PT may be the best treatment for you!

By Josette Messere, SPT

 

My doctor told me I have Shoulder Impingement. Is this rare?

 

No need to fear, as you are not alone! Shoulder pain is actually VERY common.  In fact, roughly ⅓ of of individuals in the United States will experience some sort of shoulder pain in their life. Of those that report shoulder pain, up to 50% are said to have subacromial impingement syndrome, or SAIS. 

 

 

Subacromial Impingement Syndrome (SAIS)? What is that?

 

SAIS typically presents as pain on the front and side of one’s shoulder that progresses over time.  It occurs when one of your rotator cuff tendons is squeezed in a crowded space between part of your scapula and the head of the humerus. You may have pain with activities like reaching into high cabinets or even washing your hair.  

 

 

Who gets SAIS? 

 

  1. Athletes
    1. Overhead sports: ex. baseball, volleyball, and tennis
    2. Under the age of 25
  1. Middle Aged Adults
    1. Activities or occupation that requires repetitive overhead activities
    2. Aged 40-60
    3. Increased risk for women 

 

 

Is Physical Therapy a good Treatment option for me? 

 

Yes! PT is a great option and has been shown to have beneficial outcomes for those with SAIS.  PT’s will incorporate an exercise program into your treatment that will help to strengthen certain muscles, relax others, and address posture as well.  Best evidence shows that manual (hands on) work on your shoulder and spine also help to decrease pain and increase mobility. In addition, Physical Therapy has been proven to be just as beneficial long term, and maybe even more-so, than surgery.  

 

 

 

References: 

 

Gutierrez-Espinoza, Hector et al. “Effect of supervised physiotherapy versus home exercise program in patients with subacromial impingement syndrome: A systematic review and meta-analysis” Physical Therapy in Sport vol 41. 34-42. 5 Nov. 2019, https://doi.org/10.1016/j.ptsp.2019.11.003

Khan M, Alolabi B, Horner N, Bedi A, Ayeni OR, Bhandari M. “Surgery for shoulder impingement: a systematic review and meta-analysis of controlled clinical trials.” CMAJ Open. 2019;7(1): E149–E158. Published 2019 Mar 7. doi:10.9778/cmajo.20180179

Larsson R, Bernhardsson S, Nordeman L. “Effects of eccentric exercise in patients with subacromial impingement syndrome: a systematic review and meta-analysis.” BMC Musculoskelet Disord. 2019;20(1):446. Published 2019 Oct 14. doi:10.1186/s12891-019-2796-5

Linaker CH, Walker-Bone K. “Shoulder disorders and occupation.” Best Pract Res Clin Rheumatol. 2015;29(3):405–423. doi: 10.1016/j.berh.2015.04.001

Pasin, Tuğçe et al. “Comparison of the Effectiveness of Platelet-Rich Plasma, Corticosteroid, and Physical Therapy in Subacromial Impingement Syndrome.” Archives of rheumatology vol. 34,3 308-316. 28 Mar. 2019,  doi:10.5606/ArchRheumatol.2019.7225

 

De-Stressing the Holidays

It’s the Most Wonderful Time of the Year! Or is it? While the time between Halloween and New Year’s can be exciting and fun for many people, it can be a time of stress, depression, and anxiety for others. It’s important to understand stressors so that you can begin to manage them, especially during this heightened time of the year. Below are a few tips we hope will help you enjoy a healthy and happy holiday season.

 

 

First, understand that stress is both internal and external. Here’s a quick breakdown of each type:

 

 

 

So why does the holiday season worsen our stress? Sometimes it’s due to grief. Sometimes it’s because we live in an “either/or” situation or we set excessive expectations of ourselves or others.

 

Here’s how we can de-stress:

 

  1. Acknowledge your feelings. They are real.
  2. If you’re grieving, let the grief process continue, but be sure to reach out for help. Don’t grieve alone.
  3. Be realistic.
  4. Plan ahead.
  5. Stick to a budget.
  6. Learn to say no.
  7. Do less, enjoy more.
  8. Laugh like crazy!
  9. Go tech-free during holiday & family events.
  10. Find 5-10 minutes every day for reflection or meditation.

 

Happy Holidays!

Black Friday Shopping Tips: How to Avoid Low Back Pain

 

 

 

 

It is time to begin planning your Black Friday shopping trip. With the stores releasing their deals, you may have already begun making your list of must buy gifts. Remember that a long day of shopping can lead to pain throughout the body, but especially in the back. Here are a few tips to help avoid such pain:

 

  • Wear supportive shoes 
  • Choose a smaller purse
  • Carry your packages evenly/unload them often

 

Wear supportive shoes:  Wearing supportive shoes is vital when heading out to shop on the biggest shopping day of the year. Keeping your attire comfy while still providing support can help prevent back pain. It is recommended that supportive shoes be broken-in and offer plenty of support to the foot. Research suggests that when the feet are properly supported there is less likelihood of back pain. 

 

Choose a smaller purse:  Research suggests that toting large heavy bags can put a strain on the back, which can lead to pain. Using a smaller purse can help you keep from lugging around a heavy bag all day long. While shopping the day after Thanksgiving, you are sure to find the deals you need to have bags galore. Many of these will be stuffed to the brim and heavy. Give yourself a break by skipping the heavy purse too.

 

Carry your packages evenly/unload them often: As you find success with those shopping deals, be sure to carry your gifts evenly between both arms. If possible, make a few trips back to your car and unload them safely so that you don’t have to carry too many packages at once.

 

My Knees Crack… Should I Be Worried?

Katelyn Thies, SPT

 

 

Besides pain, joint noises (cracking, clicking, popping) are one of the most common concerns people have about their knees. Many people wonder if these sounds mean there is something wrong. To answer this, it is important to ask yourself if these noises cause pain.

 

Answer 1: No, these noises are not painful

 

Explanation—knee sounds themselves do not indicate injury or joint disease. In fact, it’s completely normal for everyone’s joints to make sounds at times, especially with movement after sitting, standing, or lying still for a long time. Inside the knee joint is a substance called synovial fluid—this lubricates the joints and allows joint surfaces to glide smoothly. Synovial fluid is made up of gases and other substances; with movement, changes in pressure cause tiny gas bubbles to form. These bubbles can burst and be released into the knee joint, leading to cracking or popping sounds. This is one of the most common explanations for painless knee sounds and should not be a cause for concern.

 

 

 

 

Answer 2: Yes, these noises are painful

 

Explanation—painful popping, snapping, or clicking in the knee may (but not always) be a result of tissue injury or irritation—but there is no need to worry! If you are experiencing frequent knee pain, it may be time to see a physical therapist. PTs can perform a full evaluation on your knees and create a therapy program that fits your specific needs. They specialize in treating this type of pain by using hands-on techniques, teaching stretches for structures that may be preventing normal motion, and prescribing exercises for muscles that can help take stress off the knees.

 

 

Bottom line: There is no need to stress about knee sounds! Most of the time, this is a normal process that leads to no future issues. Even if injured or irritated tissues are involved that are causing pain, many people are very successful at managing their symptoms after attending physical therapy and learning about what movements work best for their body.

 

 

How Hard Should Your Workouts Really Be?

By Julian Bermingham PT, DPT, CSCS

 

 

If you are a hard-charging weekend warrior, the answer to this question might surprise you!  On the other hand, if you have just recently joined the gym and are unsure how to appropriately execute a fitness plan, then read on, as the information below will be tremendously valuable to you.

 

But first, a quick vocab lesson. Quantitative data refers to the hard, measurable numbers in a workout: the number of sets, repetitions, and the amount of weight being lifted. Most people have a good grasp of this portion of their workout plan. Qualitative data, on the other hand, refers to data that can’t be measured, but must be observed/experienced. 

 

In 1982 the Swedish researcher Dr. Gunnar Borg published his Rating of Perceived Exertion (RPE) scale, which was effectively the first widely used qualitative rating system that was applied to physical activity. The Borg Scale ranges from 6 (no exertion at all) to 20 (very, very hard).  Why these seemingly arbitrary numbers?  If the researchers added an additional zero to the chosen exertion number, they would get an accurate estimation of heart rate for a given activity (for instance 6 on the BORG = 60 heart beats per minute). 

 

In recent years, members of the strength and conditioning community have come to adopt a modified and more user-friendly version of Dr. Borg’s RPE scale. Following a given exercise or task, the participant can use a 0-10 scale of difficulty, with 0 being no exertion at all, and 10 being “I could not have continued”, or “I could not have performed 1 more repetition.” In this way, trainees are assigning a qualitative measure to their training.  Why is this important?  Well let’s take this hypothetical example:

 

On week 1, a trainee performs 1 repetition of a 100 pound bench press and labels it as a 10/10 difficulty.

On week 2 that same individual performs 1 repetition of a 100 pound bench press and labels it as a 7/10 difficulty. 

 

Although the number of sets, reps, and weight lifted are the exact same, we can conclude that from week 1 to week 2, the trainee has become stronger, as the same task is now performed at a lower relative exertion rating.

 

 

So why is any of this important to the average gym goer? For every training session there exists some relative risk to performing the exercise, as well as some potential reward for performing the exercise. As intelligent trainees, we want to minimize risk as well as maximize reward. One could easily imagine that if an entire workout was performed at a 10/10 intensity, the risk of injury would be much higher than if all exercises were performed at a 1/10. But if the intensity of the exercise was only a 1/10, very little benefit would be attained by that session.

 

So here are my recommendations based off of clinical and personal experience. If performance is the goal: most training sessions should be performed between a 7-9 relative intensity on a 0-10 scale. True 10/10 efforts should be reserved for when they matter the most: a competition, a meet, or the big game. In this way we can maximize our benefits of training and minimize the risk of injury. 

 

One final note: in the rehabilitation setting all the above recommendations still apply, but as we attempt to retrain movement patterns, and decrease the perception of threat/harm, exercise intensity can be decreased to a 5-7 RPE, at least until the patient has been successfully rehabilitated.

Plantar Fasciitis Awareness: What’s Causing Your Heel Pain?

By Nick Puleo, SPT

 

 

What is plantar fasciitis?

 

 

Your heel pain may be associated with plantar fasciitis, as it is the most prevalent condition of the foot and most common cause of heel pain! Plantar fasciitis is characterized as inflammation of the plantar fascia, a thick band of connective tissue that travels along the bottom of the foot from the heel bone to the toes and serves to support the arch of the foot. Plantar fasciitis is typically an overuse injury that is self limiting. Inflammation associated with plantar fasciitis can cause a stabbing, sharp pain that is relatively localized to the bottom of the foot on the heel bone. People suffering from plantar fasciitis often explain that their symptoms are worse with walking their first steps in the morning, or walking after any prolonged period of inactivity. Pain associated with plantar fasciitis usually subsides with activity. 

 

 

 

Factors that increase the likelihood of developing plantar fasciitis

 

 

Age: most commonly affects individuals between the ages of 40-60.

 

Improper footwear: walking barefoot or wearing shoes that do not support the arch of your foot increase the chance of developing plantar fasciitis. Footwear that does not support the arch of the foot increases the amount of stress placed on the plantar fascia.

 

Foot biomechanics: flat feet result in a foot that has a stretched plantar fascia, which is not optimal for foot function. High arched feet create a shortened or tight plantar fascia, which results in a decreased ability to accept loads placed on the tissue. 

 

Running: plantar fasciitis is the most common injury for runners.

 

Obesity: increased BMI places excessive loads on the plantar fascia, making it more susceptible to becoming irritated.

 

Jobs that require long periods of standing on your feet: The weight of your body in standing flattens the arch of the foot, increasing the amount of tension placed on the plantar fascia. Increased tension to this tissue can increase the likelihood of plantar fasciitis.

 

Multiple corticosteroid injections: corticosteroid injections are a common non-conservative treatment method for plantar fasciitis because they offer fast relief of pain. However, chronic corticosteroid injections decrease the extensibility and integrity of the plantar fascia, increasing the likelihood of a tear or rupture.

 

 

 

What should I do if I have plantar fasciitis?

 

 

See your PT!! 

 

Physical therapists are trained to treat impairments associated with plantar fasciitis. Physical therapy for plantar fasciitis focuses on stretching of calf musculature, strengthening of the intrinsic foot muscles that support the arch of the foot, and improve joint mobility in the foot. PTs will use different manual techniques to address soft tissue and joint mobility restrictions to improve mobility of the foot. PT’s can also prescribe specific exercises that promote muscle strengthening and normalization of gait. Consult with your PT about trying orthotics. Orthotics can provide artificial support to the arch of the foot. In many cases, correcting the position of the foot will reduce symptoms associated with plantar fasciitis. Don’t neglect rest from activity! Although it may be difficult to heal (especially for runners), plantar fasciitis will often resolve with rest from intense activity. Plantar fasciitis is self limiting; rest will allow the inflammation of the plantar fascia to subside. Avoiding aggravating activities will speed up the recovery process.

How Can a Physical Therapist Help With Turf Toe?

By Sports PT Blog Team

 

 

 

 

Immediately following a turf toe injury, the RICE protocol is recommended: Rest, Ice, Compression, and Elevation. The goal of the RICE protocol is to decrease pain and swelling and protect the joint from further injury until it can be more thoroughly assessed. Most turf toe injuries do not require surgery and are treated with physical therapy. The treatment depends on the severity of the injury.

 

  • Grade 1. To treat a Grade 1 injury, your physical therapist may use narrow athletic tape to immobilize your big toe with your second toe to restrict painful motion. Your physical therapist may also place a firm insert in your shoe to limit motion and promote healing. In many cases, an athlete may be able to return to sport soon after a Grade 1 injury.
  • Grade 2. Treating Grade 2 injuries may require immobilizing the foot in a brace or walking boot and allowing several weeks of rest.
  • Grade 3. Treatment of Grade 3 injuries is dependent on the severity of the damage to the structures of the foot. Surgery may be required if there is a fracture of a bone, damage to the cartilage (the tissue that lines the bones of the joints), a complete tearing of the tendon, or excessive movement of the joint that causes repetitive instability (subluxation or dislocation).

 

In each case, your physical therapist will work with you to design an individualized treatment program specific to the exact nature of your condition and your goals. Treatment may include:

 

 

Range of Motion Exercises. It is important to regain a full range of motion of your big toe. Your motion may be limited after a turf toe injury, particularly one that requires immobilization in a brace or boot. Your physical therapist will teach you gentle stretching exercises to help regain motion.

 

Muscle Strengthening. It is common to lose strength in the muscles of your leg, particularly around your foot and ankle after a turf toe injury due to the limited weight-bearing and activity that is required to allow the injury to heal. Your physical therapist will determine which muscles are weak and teach you specific exercises to treat them, such as strengthening with resistance bands, balance activities, and functional activities, like stair climbing.

 

Manual Therapy. Many physical therapists use manual (hands-on) therapy to gently move and manipulate muscles and joints to improve their motion and strength. These techniques can target areas that are difficult to treat on your own. Manual therapy can be especially effective for joints that become stiff following immobilization; with turf toe injury, your physical therapist will use different techniques to mobilize your big toe as well as the other joints of your foot and ankle that may have become stiff during your recovery.

 

Patient Education. Your physical therapist will educate you on the do’s and don’ts following turf toe injury to ensure that your recovery is a smooth one. Your physical therapist will work with you to develop an individualized rehabilitation program, including expected timelines and goals to give you a roadmap for your return to full activity.

 

Hydration for Young Athletes

Improving performance while reducing the risk of injury and serious illness

By Chad LaChance, PT, DPT, ATC, CSCS

 

 

It’s hot out there in most areas of the country right now and many of us aren’t taking the proper measures to make sure we can hold up against the heat. This is especially important for our young athletes participating in outdoor sports. Maintaining proper hydration doesn’t only reduce the risk of serious injury or death, but it can help boost performance while reducing the risk of an orthopedic injury.

 

 

Why is Hydration Important?

 

 

Internally, our bodies consist of 65% water! Our blood relies on proper amounts of water to remain at optimal consistency for pumping blood and regulating our blood pressure. Our muscles rely on water to allow them to use energy efficiently and deliver oxygen and nutrients to working muscles. Without this, we wouldn’t be able to meet the increasing demands of physical activity and sport. Our brain is 85% water. An athlete’s ability to concentrate and be alert during sport rely on adequate amounts of water in the brain. When some or all of these are affected, the risk of injury increases substantially.

 

 

Numbers to Remember:

 

50% : Approximately 50% of all athletes (youth through professional) report to sport inadequately hydrated; this can lead to muscle cramping, muscle fatigue decreased alertness and ultimately injury.

 

2% : A 2% loss in body weight through sweating causes the body to experience increased fatigue, reduced endurance, declining motivation and beginnings of heat-related illnesses. It’s recommended that you limit weight loss to <2% through adequate hydration before, during and after activity.

 

16 oz : Athletes should replace every pound of body weight lost after activity with at least 16 ounces of water for proper re-hydration.

 

 

Signs of dehydration

  • Dark colored urine
  • Decreased frequency of urination
  • >2% loss in body weight pre vs post exercise
  • Dry mouth, extreme thirst
  • Dizziness, light headedness
  • Lethargy

 

 

 

Preparing for Activity in the Heat

 

Before a workout or competition, properly hydrate by drinking 1 to 2 cups of fluid an hour before starting, one cup about 15 to 30 minutes prior and then 5 to 10 ounces of fluid every 15 to 20 minutes of activity. These amounts can be adjusted based upon heat index and the amount the individual sweats (ie: sweat rate)

 

 

How to Monitor Hydration

 

Monitor urine color: Well-hydrated persons will have clear to light yellow urine; dark colored urine indicates hypohydration.

 

Calculate Sweat Rate: There’s no cookie-cutter approach to hydration. Each athlete should consider their individual sweat rate to assist in preparation and rehydration. Sweat rate is the amount of fluids lost during a workout. To calculate sweat rate:

 

Body Weight (before exercise)Body Weight (after exercise) + any fluids consumed during workout = Sweat loss

 

Sweat Loss / Exercise time = Sweat Rate (mL/min or mL/hour)

 

Online Sweat Rate calculator

 

 

Know the signs of dehydration and measures to help prevent it! Keep our young athletes healthy and in the game!

 

 

For more information please visit: https://ksi.uconn.edu/prevention/hydration/

 

 

 

References:

McDermott, Brendon P., et al. (2017) National Athletic Trainers’ Association position statement: fluid replacement for the physically active. Journal of Athletic Training 52.9: 877-895.

Casa, Douglas J., Priscilla M. Clarkson, and William O. Roberts (2005). American College of Sports Medicine roundtable on hydration and physical activity: consensus statements. Current sports medicine reports 4.3 115-127.

Judelson, D. A., Maresh, C. M., Anderson, J. M., Armstrong, L. E., Casa, D. J., Kraemer, W. J., & Volek, J. S. (2007). Hydration and muscular performance. Sports medicine37(10), 907-921.