By Kevin Brown, DPT

Approximately 50 million Americans are affected by arthritis and it has become one of the leading causes of pain and disability world-wide. With May being “Arthritis Awareness Month”, it seems appropriate to discuss a few areas of this condition. As a physical therapist at Sports Physical Therapy in New York, I have become extremely familiar with this disease and its progressive nature. 

It has become a common misconception that there are no effective treatments for arthritis. Unfortunately, many people become content with it and do not seek other options. One of the worst things people can do with this diagnosis is avoid exercise in fear of worsening their pain. Physical therapists need to educate people with arthritis on coping mechanisms including activity modification. For instance, people who are no longer able to run due to pain can still achieve the benefits of aerobic exercise by swimming, biking, or other exercises that reduce the impact through a joint. Education should also include the role of a diet on arthritis. Physical therapy can have a more direct role as well; manual therapy techniques provided within a PT clinic and an extensive home exercise program have both been shown to significantly improve symptoms associated with arthritis.  

One of the most common phrases I hear in the clinic is “I am bone on bone”. People often mistakenly accept this and give up on exercise all together. As I mentioned previously there are still treatment options. My best advice is to not give up and become complacent. Seek alternatives and stay as active as possible. You must consider other aspects of your physical well-being, and avoiding exercise has a tremendous impact on your cardiovascular health, mood, weight, other joints, etc. Mental health can also be significantly affected; depression is very prevalent in individuals with arthritis. When people are deprived of participating in their favorite activities it can be very debilitating.

Of course, there are cases in which arthritis is extreme and surgery is indicated such as total joint replacements. It is important to note two key aspects of joint replacements. 1) There is a shelf life of a joint replacement. Although many knee and hip replacements currently last up to 20 years, if you are young and active it may be wise to delay the surgery as long as possible. 2) The more range of motion and strength you have going into a total joint replacement, the better your prognosis will be. Many surgeons are now recommending “pre-habilitation services” prior to surgery to set themselves up for success afterwards.  A physical therapist can certainly help in this area to provide an appropriate exercise program individualized to one’s specific needs as well as educate them on expectations for surgery.        

Physical therapy for arthritis has been researched extensively and the benefits are well documented within the literature. If you are suffering from arthritis, I believe that is in your best interest to seek an experienced physical therapist to help guide you through the process and maximize your functional mobility.

By Teresa Lindell, DPT, OSC

Osteoporosis is a common disease that causes a thinning and weakening of the bones. It can affect people of any age but is most common in women over age 50. Osteoporosis affects 55% of Americans aged 50 or older; one-half of women and a quarter of men will fracture a bone as a result of low bone density (osteopenia) or osteoporosis.  Other risk factors for this disease are smoking, medications, and sedentary lifestyle.

Osteoporosis is typically diagnosed by a bone-density test ordered by a physician, which is a simple specialized X-ray.  It is very important that men and women advocate to have this test done, as osteoporosis is a “silent” disease and has often has no symptoms.  Left undiagnosed, a person can have a fracture occur from a simple misstep or even a big hug.

How can physical therapy help with a bone disease?  Believe it or not, weight bearing and resistance exercises are one of the most important methods of both prevention and treatment of osteoporosis.  Some of the most effective treatments include activities like dancing and lifting weights.  Physical therapists are specially trained to help determine the best exercises, dosage, and progression for each individual.  If you are at risk for osteoporosis or have already been diagnosed, please see your trusted physical therapist for treatment.

The following link has more information about this topic.

https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=b5e09439-77a8-497d-b8d9-b5250de60544

By Julie Wolfley PT, DPT, OCS

Happy National Women’s Health Week! This year marks the 20^th anniversary and runs from Mother’s Day to May 18, 2019 with a focus of encouraging women to be as healthy as possible. #NWHW

Celebrate YOU! Take this week to make a step toward improving your physical or mental health.

Here are a few physical ideas to celebrate you this week that may help you on your healthy path.

• Schedule your annual Primary MD visit to get your preventive screening and bloodwork
• Schedule you annual mammogram
• Drink more water, 11 cups a day is recommended for the average female by the National Academy of Medicine
• Get at least 7-9 hours of sleep
• Calculate your BMI ( bmi-calculator.net)
• Be physically active for at least 30 minutes a day
• If you have aches and pains with your physical activity, contact your physical therapist to assess your symptoms to restore your activity level.
• Consult with a nutritionist if you want some healthy eating tips

References:

Onemedical.com

Womenshealth.gov

By Sports PT Blog Team

Bike riding is an excellent form of exercise and brings many health benefits. Today is National Ride Your Bike to School Day and we are excited to see all the students riding their bikes today!

Bicycling has increased in popularity over the years. There are outdoor biking clubs and indoor cycling programs readily available in most communities now. Just like all forms of exercise, good form is essential when performing this exercise to avoid injury.

Bicycles are designed to position your body in the right posture and allow for efficient aerodynamic movement. If you feel pain or discomfort in your wrists, neck, back or knees, then it is likely that your body is being pulled out of alignment from an improperly fitted bike. The careful placement of your seat, center tube and handlebars can make the difference between a cramp in your back and an optimal ride.

Here are a few tips that will help keep your form good when riding bikes:

1. Always wear a helmet!
2. Find the proper seat height. Your best form begins with having the correct height so that you are not bending incorrectly.
3. Your shoulders should be down and back when riding to minimize any neck pain—even when you’re tired!
4. Keep your back flat and your chest up. Keeping your back flat will help you keep your weight evenly distributed and not put too much pressure on your lower back.
5. How you pedal is important. Your knee should never be completely straight when pedaling; there should be a very slight bend in the most extended position.

Enjoy your bike ride! Keep moving!

By Sports PT Blog Team

Breanna Stewart, a WNBA MVP, former Syracuse native and recipient of just about every women’s basketball honor during her career, was helped off the court on Sunday during Dynamo Kursk’s EuroLeague title game vs UMMC Ekaterinburg. It looks like Breanna will need surgery to repair an injured Achilles tendon. So what does that mean for her career and how long should her rehab be?

An Achilles injury can take up to a year of recovery and rehabilitation before a basketball player returns to the court. Former WNBA and Olympic star Tamika Catchings had surgery on her Achilles in Sept. 2007 and played in the 2008 Olympics and in the 2008 WNBA season. DeMarcus Cousins ruptured his Achilles in January 2018; he returned to the NBA a year later. This shouldn’t be a career-ending injury, but Breanna will definitely be in rehab for a while.

The Achilles tendon is one of the strongest in the body and when surgery is needed to repair it, it’s one of the longest rehab periods of any surgery. Usually at six weeks, patients are allowed full weight-bearing out of the cast or boot. Physical therapy is started and is aimed at restoring ankle range of motion. Strengthening of the calf muscles and Achilles is gradually allowed as the tendon heals. Patients are usually able to return to full activity by six months.

We send our best wishes to Breanna for a healthy recovery! #GetPT1st

By Jessica Kim, SPT

What is Parkinson’s Disease?

Parkinson’s disease is a chronic and progressive brain disorder that affects movement. It involves malfunction or death of neurons in brain that produces dopamine. Dopamine is a chemical that controls movements to be smooth and coordinated. Patients with Parkinson’s disease experience symptoms including resting tremor, slow movement or bradykinesia, rigidity, loss of posture reflex, flexed posture, and “freezing” episodes.

Physical Therapy Management for Parkinson’s Disease

Evidence based physical therapy management for Parkinson’s disease include progressive aerobic training, skill acquisition, and big amplitude exercises. Progressive aerobic training should be intensive and exerting enough to promote brain protection and health. Physical therapists can guide you with selecting the appropriate intensity for best optimization and results. Progressive aerobic training slows down progression of Parkinson’s disease and provides protection to your brain by reducing inflammation and oxidative stress from the brain. Skill acquisition is a repeated movement exercises to acquire new movement and skill. It is important to continue practicing acquiring new motor skills, since patients with Parkinson’s disease lose the ability to acquire new motor skills as the condition progresses. Research shows big amplitude exercises improve posture response, bradykinesia or slow movement, and anticipatory postural control. Anticipatory postural control is crucial for balance during daily activities such as walking, moving your arms, shifting your weight, and more to prevent risk of falls.

Other Activities for Patients with Parkinson’s Disease

● Tai chi
● Boxing
● Juggling
● Rebound/trampoline activities
● Dancing involving multi directional stepping and sequence

If you or your loved one is living with Parkinson’s disease, contact Sports PT today to speak to one of our physical therapists, who can provide you with patient centered and evidence based treatments for improved function, balance, and quality of life!

References:

Park, Jeong-Ho et al. “What Is Wrong with Balance in Parkinson’s Disease?” Journal of movement disorders vol. 8,3 (2015): 109-14.

Salgado, Sanjay et al. “An evidence-based exercise regimen for patients with mild to moderate Parkinson’s disease” Brain sciences vol. 3,1 87-100. 16 Jan. 2013.

Farley, Becky. Amplitude-Focused FUNctional Exercise for Individuals with Parkinson Disease. University of Arizona, Tucson, Arizona. https://www.parkinsonnet.nl/media/14756007/sessie_3_-_becky_farley.pdf

By: Andrew Taylor, SPT

I was just diagnosed with a concussion, what now?

Most evidence suggests resting for the first 24-48 hours. This includes both physical rest and cognitive rest, avoiding activities that are physically strenuous as well as mentally stimulating (television, electronics, driving, work, and reading/writing) for the first day or two. Concussions have wide variety of symptoms, and each person will experience symptoms differently, be sensitive to different activities, and recover in a slightly different time frame; although, typically concussive symptoms resolve within 7-10 days.

After resting for 24-48 hours most people can begin to easing back into daily activities that aren’t symptom provoking. This means light exercise, some school or work assignments, and tv/electronics if they don’t bring on your symptoms. Recommendations will vary depending on the doctor’s judgment of how severe each concussion is, but generally extended total rest doesn’t lead to faster healing. But remember, start light and gradually work back into your daily routine with activities that are not bothersome.

What if my symptoms last longer than 10 days?

Although most concussive symptoms resolve within ten days, it is not uncommon for them to extend beyond that time period. At this point your doctor may recommend physical therapy to help treat residual symptoms to help get you back to work, school, or on the field.

Physical Therapy can help with the resolution of many lingering symptoms post-concussion including dizziness, balance and coordination trouble, difficulty concentrating, eye fatigue, neck pain and tension headaches, and general feeling of fatigue to name a few. Physical therapy has been shown to help with residual concussion symptoms but remember, just like any other injured body part, your brain will take time to heal.

Sources:

Broglio, S. P., Collins, M. W., Williams, R. M., Mucha, A., & Kontos, A. P. (2015). Current and emerging rehabilitation for concussion: a review of the evidence. Clinics in sports medicine, 34(2), 213-31.

Ellis, M. J., Leddy, J., & Willer, B. (2016). Multi-Disciplinary Management of Athletes with Post-Concussion Syndrome: An Evolving Pathophysiological Approach. Frontiers in neurology, 7, 136. doi:10.3389/fneur.2016.00136

Leddy, J., Baker, J. G., Haider, M. N., Hinds, A., & Willer, B. (2017). A Physiological Approach to Prolonged Recovery From Sport-Related Concussion. Journal of athletic training, 52(3), 299-308.

Leddy, J. J., Sandhu, H., Sodhi, V., John G., & Willer, B. (2012). Rehabilitation of Concussion and Post-concussion Syndrome. Sports Health, 4(2), 147–154. https://doi.org/10.1177/1941738111433673

Thomas, D., Apps, J., R. H., McCrea, M., & Hammeke, T. (2015). Benefits of Strict Rest After Acute Concussion: A Randomized Controlled Trial. Pediatrics, 135(2). doi:10.1542/peds.2014-0966d

By Annelise Modica, SPT

What is Chronic Ankle Instability?

Chronic ankle instability can be broken down into two categories: Mechanical instability and Functional instability. Mechanical instability is when there is a laxity in the ligaments of your ankle joint and you have a history of previous ankle sprains. Functional instability is when you feel that your ankle is unstable or that it is “giving way” without any other physical symptoms such as pain.

How does Chronic Ankle Instability happen?

This usually arises from repeated ankle sprains where the ligaments do not heal properly or completely. The most common mechanism of injury (~80%) involves a forceful inversion (foot turning in) and plantarflexion (extension of the ankle) motion of the foot and ankle. This results in damage to the structures of the lateral (outside) ankle including: the Anterior talofibular ligament (ATFL) and the Calcaneofibular ligament (CFL).

Did you know that up to 20% of lateral ankle sprains can lead to chronic ankle instability?

How can I treat chronic ankle instability?

You can treat ankle sprains and instability with a variety of conservative methods including:

• Rest
• Ice
• Bracing
  • For protection and stability during weight bearing
• Taping
• Orthotics
• Physical Therapy
  • To work on:
    • Muscle strength and endurance
    • Ankle range of motion
    • Balance (proprioception) training

If conservative methods fail, due to increased damage to the ligaments resulting in a high level of instability, surgery may be an alternative an option. Consult with your PT and MD to discuss the best option for you!

References:

1. Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: Evolution of the model. Journal of Athletic Training. 2011; 46(2):133-141.
2. Waterman et al. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am. 2010; 92-A(13):2279-2284.
3. Li et al. Treatment of chronic lateral ankle instability: A modified brostrom technique using three suture anchors. Journal of Orthopaedic Surgery and Research. 2009; 4 (41). DOI: 10.1186/1749-799X-4-41
4. Wainright et al. The Effect of Modified Brostrom-Gould Repair for Lateral Ankle Instability on in Vivo Tibiotalar Kinematics. Am J Sports Med. 2012; 40(9): 2099-2104.
5. Sherry, M. Rehabilitation guidelines for Lateral Ankle reconstruction. University of Wisconsin Sports Medicine. 2014. https://www.uwhealth.org/files/uwhealth/docs/sportsmed/SM-39916_Laterl_AnkleProtocol.pdf

By Chris Nentarz, PT

The New Year provides an excellent opportunity for us to inventory our lives, reflect on our wins and losses, and set new goals.  When it comes to making lasting improvements in our lives, sometimes good intentions just aren’t good enough.  The truth is that only 8 percent of us will actually keep our new years resolutions.  There are many things that side track us along the way, but here are some tips to turn some of the most common new years resolutions into healthy habits that will last into this year and beyond. 

1. Don’t “Lose Weight,” try to “Gain lean mass while increasing your fitness level!”

Losing weight is quite possibly the most common, and honestly one of the most difficult, resolutions.  The scale tells how much one weighs, but not how strong, fit or mobile one is.  The scale can also be misleading because it does not account for how much lean muscle you have gained!  Muscle gain is a desirable effect of a good fitness program and can certainly have a seemingly negative effect on the scale. 

Forget the scale and focus on fitness outcomes, such as strength measures and endurance tests to measure your results.  If weight loss is your primary goal, try measuring your weight every 2 weeks or measure body mass composition instead.

2. Don’t just “Get organized,” create a lifetime habit by scheduling “Daily Morning Movement Sessions!”

Finding time for a daily movement program is vital to sustained health.  Unfortunately, working out is one of the first things to go out the window when schedules get busy.  If this sounds familiar, try scheduling your workout time in the morning.  Evidence shows most people who regularly exercise perform their training in the morning before they start their day. 

Life happens, and working out in the AM naturally removes some of the barriers to late day plans.  In addition, morning movement routines offer many other benefits that will help you have a successful day, including increasing concentration and improving mood!  Incorporating morning movement sessions will increase your fitness levels and have a positive effect on the rest of your day!

3. “Enjoy life to the fullest” by finding a “FUNctional training routine.”

More than ever we are beginning to understand the connection of our mind and body.  A regular exercise program significantly reduces stress and depression while simultaneously boosting immunity and enhancing mood. However, all exercise is not created equal.

Some training techniques can be harmful to our bodies moving parts or too heavily focused on aesthetics.  Functional training includes integrated, multidimensional movement that requires stability and mobility through a range of motion.  Functional training isn’t a direct method but comes in many forms, including Tai Chi, TRX suspense training, and many other traditional exercises, including squats and lunges.  Your training should mimic the movement you perform in life.  Lastly, functional training should be FUN and enjoyable!  After all, why do something you don’t enjoy?

While in reality, each day represents a new beginning, the energy of new years resolutions can be used to change our health and wellness for the better.  This year, move away temporary resolutions and towards permanent solutions!  Gain lean mass, get moving early, and incorporate FUNctional training methods! 

References:

Norcross JC1, Mrykalo MS, Blagys MD.  Auld lang syne: success predictors, change processes, and self-reported outcomes of New Year’s resolvers and nonresolvers. Clin Psychol. 2002 Apr;58(4):397-405.

By Kacper Kazibut, SPT

Tai chi & Qigong have been part of eastern culture for thousands of years and has slowly made its way into the western world. If you are new to the idea of tai chi or qigong, they have their origins as martial arts and have been utilized as both a way of activity and mindfulness. Tai chi involves a series of large sweeping movements, shifting of one’s body weight and prolonged holds to promote both mobility and strengthening. It also incorporates mindfulness and a focus on the present.

Qigong focuses on the movement of energy within the body known as qi (chee) to promote health, wellness and longevity. It too involves the same low impact movements, weight shifting and mindfulness as tai chi. While they may sound like some sort of esoteric rituals, the recorded benefits of both qigong & tai chi have been well documented over the past decade. Here are a few things that they can help improve and manage:

Improved Balance: Due to the large sweeping, positional holds, and weight shifting one’s balance is not only challenged but can also provide someone the ability to recover from a loss of balance. It has been shown in a recent 2018 study, the incidence in falls in people 65 and older over a 6-month time had significantly reduced.

Heart & Lung Health: The slow and rhythmic movements in conjunction with deep, controlled breathing has shown improvements in blood pressure and heart rate. Another study had found it to improve feelings of breathlessness and fatigue.

Arthritis Management: The repetitive shifting of weight over joints have shown to improve the quality of the life of participants. In addition, there have been documented results of decreased pain and improvement in function (stair climbing, walking etc.)

Strengthening: The use of large muscle groups and maintenance of posture and form provide increases in strength and endurance. In a study conducted in 2016 found significant strength gains were made after a 12 weeks tai chi program in individuals with knee osteoarthritis.

Look into your community programs to see if they offer any group classes so that you can experience the benefits yourself! Discuss with your PT or health care team to see if it is right for you!

References:

Jahnke R, Larkey L, Rogers C, Etnier J, Lin F. A comprehensive review of health benefits of qigong and tai chi. Am J Health Promot. 2010;24(6): e1-e25.

Lan C, Lai J-S, Chen S-Y, Wong M-K. Tai Chi Chuan to improve muscular strength and endurance in elderly individuals: A pilot study. Archives of Physical Medicine and Rehabilitation. 2000;81(5):604-607. doi:10.1016/s0003-9993(00)90042-x.

Li F, Harmer P, Fitzgerald K, et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling. JAMA Internal Medicine. 2018;178(10):1301. doi:10.1001/jamainternmed.2018.3915.

Reid K, Price L, Harvey W, Driban J, Fielding R, Wang C. Changes in leg muscle strength and power after Tai Chi exercise in patients with symptomatic knee osteoarthritis. Osteoarthritis and Cartilage. 2016;24. doi: 10.1016/j.joca.2016.01.776

Tousignant M, Corriveau H, Roy P-M, Desrosiers J, Dubuc N, Hébert R. Efficacy of supervised Tai Chi exercises versus conventional physical therapy exercises in fall prevention for frail older adults: a randomized controlled trial. Disability and Rehabilitation. 2012;35(17):1429-1435. doi:10.3109/09638288.2012.737084.