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.

 

Why Physical Therapy Is Common For Gymnasts.

By: Allyson Long, PT, DPT

 

Gymnastics is the second leading cause of serious sports injuries in female athletes.. According to Elsevier Global Medical News, more than 86,000 injuries occur annually in the sport of gymnastics due to children beginning the sport at earlier ages, spending more time practicing, and performing more difficult skills. Additionally, an increased routine complexity translates into increased potential risk of injury.

 

Common gymnastics injuries include:

  1. Concussions
  2. Ankle Sprains
  3. Wrist Sprains/Strains
  4. Back Pain- Spinal Fractures & Herniated Discs
  5. Knee Ligament Sprains
  6. Shoulder Joint instability

When does an ache/pain turn into an injury that should needs medical attention? Let’s look at two different types of pain.

 

Acute pain:

  • A pain that begins in practice that typically goes away the next morning
  • Does not last longer than two weeks
  • Pain is intermittent and not constant
  • Does not interfere with daily life (chores, school work, PE class)

 

Here, physical therapy can be used to improve flexibility and muscle imbalance to prevent further injury. Rest from the sport may also be needed.

 

Sub-Acute Pain:

  • Pain that continues for several days after onset
  • Lasts longer than 2 weeks up to several months
  • Pain starts to become constant and never really goes away
  • Pain begins to interfere with daily life (pain while sitting at school, during PE class, and during gymnastics)

 

Here, physical therapy and medical attention are needed to ensure a severe injury is not present, and to improve overall strength and stability. Rest from the sport is almost always needed.

 

If you have any questions about gymnastics injuries or aches/pain, please contact a physical therapist for more information.

 

How Long Until Kobe’s Back? A Look Into Rotator Cuff Surgery and Rehab.

By: Stephen Austin, SPT

 

In the recent Los Angeles Lakers versus New Orleans Pelicans basketball game, star player, Kobe Bryant suffered a rotator cuff tear to his right shoulder. These types of injuries are common among athletes due to the high demand placed on their shoulders. However, even individuals who don’t play sports that perform repetitive overhead arm movements or lifting are at a risk for developing rotator cuff injuries.

 

The shoulder joint is made up of a boney joint between the head of the humerus (upper arm) and the glenoid cavity, which is part of the shoulder blade, in addition to the clavicle.  The rotator cuff, which is comprised of 4 muscles (supraspinatus, infraspinatus, teres minor, and subscapularis), serves to help hold the head of the humerus into the socket.

 

Kobe underwent rotator cuff repair surgery on January 28th and his rehabilitation phase of recovery is expected to last about 9 months. There are 3 common types of surgeries: Open repair, mini-open repair, and arthroscopic repair (from most invasive to least invasive respectively). These all help reattach the rotator cuff tendons to the humerus.

 

Following conventional protocol, Kobe’s post-surgical rehabilitation program with a physical therapist would include 5 basic phases that can take about 6 months: immobilization/protection, passive range of motion, active range of motion, early strengthening, and advanced strengthening. The goal of physical therapy is to restore functional motion and strength of the arm to fit the individual’s needs, which is Kobe’s case, is basketball.

 

Rotator cuff repair success rate and rehabilitation length of time can vary depending on the severity of injury and previous level of function. Due to playing at an elite level, Kobe’s rotator cuff repair rehabilitation may take longer than expected.

 

To learn more about physical therapy to restore rotator cuff motion and strength, contact us here.

 

References:

1.)   Armstrong, A. M.D. American Academy of Orthopedic Surgeons. Rotator Cuff Tears. OrthoInfo. May 2011.

2.)   Armstrong, A. American Academy of Orthopedic Surgeons. Rotator Cuff Tears: Surgical Treatment Options. OrthoInfo. May 2011.

3.)   Freedman, J. M.D. American Academy of Orthopedic Surgeons. Arthroscopic Rotator Cuff Repair Post-Operative Rehabilitation Protocol. Orthodoc. May 2011.

4.)   Manaka T, Ito Y, Matsumoto I, Takaoka K, Nakamura H. Functional recovery period after arthroscopic rotator cuff repair: is it predictable before surgery?. Clinical Orthopaedics And Related Research [serial online]. June 2011;469(6):1660-1666. Available from: MEDLINE with Full Text

5.)   Slabaugh M, Nho S, Verma N, et al. Does the literature confirm superior clinical results in radiographically healed rotator cuffs after rotator cuff repair?. Arthroscopy: The Journal Of Arthroscopic & Related Surgery: Official Publication Of The Arthroscopy Association Of North America And The International Arthroscopy Association [serial online]. March 2010;26(3):393-403. Available from: MEDLINE with Full Text

 

The Marathon of Snow Shoveling…Upstate NY in February!

By: Lynn Steenberg, PT, ATC, LAT 

 

We seem to be experts at this point in the winter with handling and planning for several feet of snow. The recent snow is heavy and wet making proper posturing very important. Here are some simple tips to help avoid injury:

 

Prepare: Dress in loose layers that can be removed to avoid overheating and choose a light weight shovel with an ergonomic design that allows you to keep the load close to your body.


Plan: Try to stay ahead of the storm by shoveling smaller amounts more frequently. 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. Most of all, stay hydrated!


Posture: Lift with your legs from a squat to upright position. Avoid bending over, maintain a small inward curve in the low back at all times by tightening the core muscles that surround your spine. Shift your weight using your legs. Do not twist your spine.

 

Bad shoveling form:


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Good shoveling form:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Push: Push snow whenever possible. Move small amounts the shortest distance you can. Make sure to hold the shovel as close to your body as possible.


Pace yourself and ask for help.


Pray for Spring!
 

 

The State of Sports PT

By: Lynn Steenberg, President and CEO

 

Dear Friends,

 

It is hard to believe that this summer will mark our tenth anniversary! As I reflect back over the years, I am reminded of how, together, we have transformed every challenge and/or change into an opportunity. That is certainly true for this past year.

 

The decision to divest the downstate region in June was one of the most difficult, and yet most disciplined, decisions of my career. The subsequent feedback from our downstate colleagues has been positive as they now have more local support. More importantly, it has afforded us the opportunity to focus solely on our communities across the thruway in Upstate New York.

 

Lots of exciting things are happening! Today, we are an organization of 75 incredibly dedicated professionals serving nearly 340 patients daily in eight locations from Buffalo to Saratoga. The acquisition of Championship PT in July expanded our presence in Central New York leading to a new strategic partnership with the YMCA in Manlius. The Buffalo clinic which opened in late 2013 established itself as a leader in the downtown market.

 

I am extremely proud of our collective commitment to living our values each and every day. Here are some of our accomplishments as a “values-driven” service provider:

 

  • Superior Clinical Care: We added online continuing education training through Medbridge for all clinicians. Internal mini-courses were offered on the shoulder and knee.  And every market was represented at a weekend course presented by internationally renowned, Stu McGill.
  • Professional Integrity & Ethics: We continued to be invested in comprehensive compliance auditing and are already prepared for the ICD-10 conversion.
  • Outstanding Communication: We are a leader in social media with nearly 1200 followers on Facebook. Our weekly blogs share valuable information with the general public.
  • Respectful, Courteous Service: The newly formed FAST team provided valuable support in our commitment to providing the best service at all levels.
  • To provide Effective, Evidence-based treatment: Latest research is reviewed and discussed on our monthly journal club calls and is regularly shared internally.
  • Service in a Friendly, Ethical Atmosphere: A smile, a hug or a cup of coffee are part of each clinic culture. And our Saratoga clinic was recognized as the best PT practice in Saratoga.
  • Patient Confidentiality: We invested in new computers with advanced security measures and improved operational efficiencies.
  • To Have Fun: We enjoyed a company-wide summer picnic and holiday celebrations in every region.

 

Our mission clearly points to the compassion that makes this organization special. We continue our commitment to giving back to the communities we serve. Examples include food and clothing drives at the holidays, therapeutic yoga (Buffalo), education open house (Rochester), Fleet Feet presentations to runners (Syracuse), and Sportsmetrics (Saratoga) – just to name a few.

 

Sports PT is unique in its focus on professional growth opportunities through regular clinical, leadership and administrative trainings that led to multiple promotions in 2014. We continue to promote the physical therapy profession by involvement in the APTA at the national, state and local levels as well as through our extensive student affiliation program. Our clinicians represented Sports PT at national and regional conferences.

 

As we look forward to this year, we will be guided by three main principles. We will employ strategies to improve reimbursement and reduce operational costs. We will fully recognize our expertise and educate others to see us as the first stop in the patient care continuum for most musculoskeletal conditions. And we will deliver results through a framework of “Love, Serve and Care”.

 

Sports PT is proud of its high standards. It is not easy. We are open long hours, on most holidays, and Saturdays. We are committed to living our values to serve – through exceptional teamwork and unselfish dedication to our customers. Thank you all for making that a reality! This will be an exciting year!  The sky’s the limit!

 

With gratitude,

Lynn

 

Can Superstitions Affect Physical Performance? Some Say Yes!

By: The Sports PT Team

 

Today’s a fun day to think about superstitions! You may have a few you believe in, such as breaking a mirror or brings seven years of bad luck.

 

It may sound silly, but research has shown that superstitions can have a placebo effect on physical performance and fitness as well. When you believe in a ritual, your mind becomes focused and more relaxed. In this state, you are able to concentrate on mechanics and technique, which allows your mind and body to sync up. Some people call it “the zone”, which is when all athletes perform their best. Some athletes use visual routines, others follow the same sequential pattern, others wear clothing, eat the same foods….you get the idea.

 

Beliefs are clear thoughts we keep thinking over and over again. If you believe that wearing the same pair of sneakers will get you baskets in a basketball game, you’re probably more likely to make baskets. If you believe that eating brussel sprouts before every training session will make you stronger, you’re probably right!

 

Sports psychology is based on visualizing all the details of winning as a technique to prepare both mentally and physically for competition and superstitions can free up your mind to do just that. And, those superstitious routines you follow? Well, they are more important than you think!

 

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.