The snow keeps coming! Make sure you’re shoveling properly.

By: Lynn Steenberg, PT, ATC

 

The arrival of snow does not typically wait for the official start of winter in late December. And it’s unpredictable when the wintry precipitation will wind down. This year is no exception, as this week’s arctic blast ushers in one significant snowfall after another. So how do we avoid injury when addressing all of that snow in our driveway? Here are some simple tips:


1.   
Prepare

 

A. Dress in loose layers that can be removed to avoid overheating.

B. Choose a lightweight shovel with an ergonomic design that allows you to keep the load close to your body.

 

2.     Plan

 

A. Try to stay ahead of the storm by shoveling smaller amounts more frequently.

B. Rest when you get tired or feel out of breath. Avoid holding your breath when lifting snow, as this increases the pressure on internal organs, especially your heart.

C. Stay hydrated.

 

3.    Posture

 

A. Lift with your legs from a squat to an upright position.

B. Avoid bending over, and instead maintain a small inward curve in the low back at all times by tightening the core muscles that surround your spine.

C. Shift your weight using your legs.

D. Do not twist your spine.

 

4.    Push

 

A. Push snow whenever possible.

B. Move small amounts the shortest distance you can.

C. Make sure to hold the shovel as close to your body as possible.

 

5.    Pace yourself and ask for help!

 

6.    Pray for spring to come soon!

 

Here’s a short video demonstrating proper technique from our friends at the American Physical Therapy Association:

http://www.moveforwardpt.com/resources/detail.aspx?cid=05759494-38a8-42f7-bc08-bdcceca35fc7

 

The Gruesome Knee Injury for San Francisco 49er NaVorro Bowman

By: Alanna Pokorski, PT

The words “ACL tear” are notorious with sports fans who see this as a season-ending injury for their favorite athletes. The San Francisco 49ers’ stellar inside linebacker, NaVorro Bowman, suffered a gruesome knee injury on Sunday as fans gasped from their stadium seats or their sofas, watching his knee bend in seemingly opposite directions.

NaVorro’s injury affects two ligaments: the ACL and MCL. These are abbreviations for Anterior Cruciate Ligament (ACL) and Medial Cruciate Ligament (MCL). The ACL is a major stabilizer of the knee when cutting, running, jumping, and even going up and down stairs. The MCL is responsible for providing additional support side to side when performing the same activities. The combination of those two ligaments being stretched beyond their capacity created the visual of the football star’s knee being bent in two directions.

 

When ACL tears occur, some people hear and feel a strong pop in their knee. If forcefully combined with another ligament, such as in Bowman’s case, then the knee drastically “gives out.” Clinical testing such as an MRI typically confirms the diagnosis. Some people can rehabilitate a tear without surgery if they are returning to low-level activities throughout the day. In Bowman’s case, his physical requirement is extreme and his injury will require surgical repair along with intensive physical therapy afterwards.

 

ACL surgery typically consists of taking a tendon from another part of the leg and connecting it in place of the torn ligament. At times, surgeons will prefer to use a graft from a cadaver to replace the ligament. The incisions are small and barely noticeable once healed. The MCL oftentimes heals on its own with the use of a brace; however, many times the surgeon will perform some type of reconnection of that ligament if she or he is already inside the leg for the ACL repair.

 

After surgery, there is significant swelling and bruising. A brace locking the knee straight is typically used to help keep the knee from bending and pulling at the newly constructed ligament. Crutches are used to help take weight off, although most people can bear weight almost immediately.

 

The formal rehabilitation for this injury starts within the first week after surgery. It is a lengthy rehabilitative process, but important for restoring the same level of athletic function and speed. A minimum for this rehab is three months, whether it is an athlete or not. Oftentimes the rehab is closer to four to six months, depending on how quickly strength and agility can be regained.

 

The first phase of rehab focuses on range of motion, normal walking, swelling control, and getting the knee muscles to contract. The second phase focuses on extensive strengthening and the third phase is a return to sports or pre-injury function.

 

Most surgeons clear an athlete back to sport at four months after a series of sports-specific tests have been performed. At this point, Bowman has a long road ahead of him, but he’s expected to be back on the field with his team in the fall.

 

(Sports PT of NY treats ACL pre- and postoperative ACL injuries. For an appointment, please visit us at www.sptny.com)

 

Reference:

http://orthopedics.about.com/od/aclinjury/tp/acl.htm

 

Will running barefoot reduce my injury risk?

By: Christine Viola, PT, DPT, OCS

 

Running has become increasingly popular over the past three decades, and according to the National Sporting Goods Association there were over 40 million runners in the U.S. in 2012. Runners are also taking on longer distances, and in 2011 alone, 518,000 people in the U.S. completed a marathon. Despite advances in preventative medicine, training techniques, and prescribed footwear designs, the rate of injury continues to climb and has been estimated at 50 percent of all runners.

 

The consistently high injury rate among runners has led many to question the traditional model of footwear prescription to match foot morphology and even to consider whether shoes are advantageous to runners at all. The issue was brought to the forefront in 2009 with the publication of the book Born to Run by Christopher McDougall. The author outlined the running success of the Tarahumara people of Mexico, who run hundreds of miles barefoot with very little rest or injury.

 

Advocates of barefoot running suggest that the large, flared, cushioned heel of modern running shoes facilitates a rear-foot-first (heel-strike) running pattern. Most traditional running shoes are constructed with the heel lifted higher than the forefoot by 8-12 millimeters (or less than ½ inch), which may also facilitate a rear-foot landing pattern. Proponents of barefoot running suggest that the heel strike results in a braking force at initial foot contact and increased shock to the body. When running barefoot, you cannot rely on the cushioned and elevated heel for support and stability. As a result, most barefoot runners strike the ground first with their mid-foot or forefoot, which results in a softer landing with less braking force and less shock absorbed by the body. The mid-foot or forefoot strike is also associated with decreased stride length and increased stride frequency.

 

While many runners tout the benefits of running barefoot or in minimalist shoes, there are no qualitative studies that show a significant difference in injury risk among running styles or among those who wear shoes vs. those who do not. Researchers in North Carolina sought to quantify the differences in stress on the knees and ankles as well as the rate of loading through the body between rear-foot and mid-foot runners to compare the potential for injury between the two groups. In their study, entitled A Comparison of Negative Joint Work and Vertical Ground Reaction Force Loading Rates in Chi Runners and Rearfoot-Striking Runners, authors Goss and Gross examined 22 rear-foot strikers and 12 Chi runners with a mid-foot strike. Each ran on an instrumented treadmill, where a 3-D motion analysis system obtained data that included the rate of loading through the body and stress on the ankle dorsiflexors (front of shin muscles), ankle plantar flexors (calf muscles), and knee extensors (quadriceps). The results revealed that the rear-foot strikers demonstrated greater stress to the quadriceps (and knee), whereas the Chi runners demonstrated more stress to the calf muscles (and Achilles tendon). The rear-foot strike runners also demonstrated a greater rate of loading through the body at initial foot strike than the Chi runners.hich results in a softer landing with less braking force and less shock absorbed by the body. The mid-foot or forefoot strike is also associated with decreased stride length and increased stride frequency.

 

The take-home message from the study appears to offer helpful information for at-risk runners. If you are prone to knee injuries such as “runner’s knee” or knee osteoarthritis, there may be some advantage to shifting toward a mid-foot strike running pattern, which many achieve with a minimalist shoe. If you are prone to calf strains or Achilles injuries, you will need to exercise extreme caution when considering transitioning to a mid-foot strike pattern or minimalist shoe. It should be noted that although the mid-foot strikers demonstrated a decreased rate of loading through the body with each step, a mid-foot strike is often associated with increased step frequency, and cumulative stress may be similar. In addition, a mid-foot or forefoot strike — as is often seen in a minimalist or barefoot running shoe — may also lead to increased shock absorption through the metatarsals. This in turn may increase your risk of metatarsal stress fracture.

 

The bottom line? There is no optimal running style or shoe (or lack thereof) for every runner. Each runner has unique biomechanical demands and various risk factors that come into play when considering injury risk. If you are considering changing your running style or transitioning to a barefoot running shoe, it is recommended that you consult with your Physical Therapist before making the change to optimize your performance and reduce your risk of injury.

 

What type of running shoe works best for you? Share in the comments below.

 

References:

 

Goss, D.L., Gross, M.T., A Comparison of Negative Joint Work and Vertical Ground Reaction Force Loading Rates in Chi Runners and Rearfoot-Striking Runners. Journal of Orthopaedic & Sports Physical Therapy, 2013, Vol. 43, Issue: 10, Pages: 685-692.

 

A letter from our President.

Dear Friends,

 

As I look back on the year we’ve had here at Sports PT, I am struck yet again by all that makes this organization so very special. I proudly share with you some of the highlights of 2013.

 

  • We served more than 208,000 patients. (And we really do have the best patients on the planet.)

 

  • In May, we were recognized as one of “CNY Best Places to Work” by the Central New York Business Journal & Biz Events. In addition, Saratoga was recognized as “Saratoga’s Best Physical Therapy Practice”.

 

  • We continued to invest in the professional development of our employees through expanded internal mentorship programs, journal club, career pathways, external continuing education, and much more.

 

  • We promoted our profession through involvement at the national, state, and local levels, as well as through our comprehensive student affiliation program.  Our clinicians presented at national and regional conferences. And five clinicians received their Orthopedic Specialist Certification.

 

  • We worked to better serve our patients by consolidating our Union Square locations and adding a new one in downtown Buffalo.

 

  • We continued to promote our patients’ right to Direct Access – allowing them to get the therapy they need without a referral.

 

  • We entered the world of corporate fitness by adding a  satellite location at EmblemHealth’s headquarters in Manhattan. (Here’s to more partnerships in 2014!)

 

  • We lived our mission to serve our communities by supporting countless charitable organizations through monetary donations and personal service. We raised thousands of dollars to support disaster recovery efforts in the Philippines.

 

  • We continued to be a multi-generational organization that is geographically and culturally diverse.  An organization with a hardworking team that remains unified in a commitment to the Sports PT mission and values.

 

We have much to be proud of in 2013, and I look forward to what we can do to improve our patients’ lives in 2014. Thank you for a wonderful year.

 

Sincerely,

Lynn Steenberg

President & CEO

 

EmblemHealth Embraces Corporate Wellness

By Crystal Thomas & Dot Hall

 

We recently teamed up with EmblemHealth – a NY-based health insurance company – to offer physical therapy services to employees in their downtown Manhattan location.

 

So what is Corporate Wellness?

 

Corporate Wellness is any program or activity to promote healthy behavior in the workplace and to improve health outcomes for employees. Corporate Wellness programs are designed to nurture wellness in workers, regardless of the work environment.

 

Why is Corporate Wellness beneficial?

 

Corporate Wellness is among the most vital investments that a company can make. Businesses are striving to control costs to stay financially viable which is difficult to do when medical costs continue to skyrocket. Zoe Consulting recently analyzed a sample of 2.5 years of medical claims data from a mix of over 300 employer groups connected to Interactive Health Solutions [IHS]. According to the findings, employer groups that used a corporate wellness program had a 54% lower medical trend during the 2.5-year timeframe compared to employer groups that did not. In addition, employers who used the IHS program and a disease management program had a 65% lower medical trend during the same timeframe compared to those who did not.

 

A healthier workforce means lower healthcare costs, improved work quality, a reduced number of sick days and less presenteeism, lower long-term healthcare workers’ compensation costs, and lower recruiting and retention costs. Research supports the idea that if healthcare is made easy and accessible through a wellness program, individuals are more likely to participate. Employers who provide onsite wellness initiatives are facilitating earlier detection of serious medical situations, allowing better management of critical diseases such as coronary heart disease and diabetes.

 

Employers that start Corporate Wellness programs aren’t only investing in the physical wellness, safety, and mental health of their employees – they’re also taking powerful preventive measures by creating a healthier environment for the entire organization. Health promotion is defined as “the process of enabling people to increase control over, and to improve, their health”.  Other examples of corporate health promotion include health fairs, health education, medical screenings, wellness newsletters, onsite fitness programs, and/or facilities and educational programs.

 

We are proud that EmblemHealth has expanded their corporate wellness initiative by partnering with Sports PT. Here’s to a happy, healthy, and more productive workplace!

Tips for making your exercise plan stick.

By Brian Collins

 

For many of us, the beginning of the year is a time to renew our commitment to living healthy. However, it is no secret that this is much easier said than done. In fact, it is estimated that 50% of people beginning a new exercise routine will abandon it within a few months1.  Therefore, it is important to put strategies in place to help yourself be successful in your exercise routine. Below are some tips to help you as you begin your 2014 fitness journey.

 

1. Get into a routine. Set a specific time every day to exercise. Write it on your to-do list or set a reminder in your outlook calendar or phone.

 

2. Choose an activity that you enjoy. The American College of Sports Medicine recommends 30-60 minutes of moderate intensity exercise at least 5 days a week2.  So choosing activities you actually enjoy will greatly increase your chance of success.

 

3. Exercise with a friend or in a group. Surround yourself with people that will hold you accountable and encourage you along the way.

 

4. Set attainable goals. There is nothing like working hard to achieve a goal. Set reasonable milestones and reward yourself for achieving them.

 

5. Progress your exercise slowly.  Begin with an exercise intensity that you can tolerate comfortably. Progress your exercise intensity, duration, and frequency slowly, as this will reduce your chance of injury2.

 

Whether your fitness goal for 2014 is to lose a few pounds or to train for your first Iron Man Triathlon, just stick with it and enjoy the journey. Best wishes for a happy and healthy new year!

 

References:
1S Lippke BK. Subjective theories of exercise course instructors: causal attributions for dropout in health and leisure exercise programmes. Psychology of Sport and Exercise. 2003;(2):155–173.
2Garber CE, Blissmer B, Deschenes MR, et al. Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise. Medicine & Science in Sports & Exercise. 2011;43(7):1334–1359.