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.

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 medicine, 37(10), 907-921.

Chad LaChance, PT, DPT, ATC, CSCS

• Less than 1% of young athletes age 6-17 years old achieve elite status in basketball, soccer, softball, baseball or soccer
• Highly specialized youth athletes are at 2.5x greater risk of serious injury as opposed to their non-specialized peers
• In one study, those who trained more than 28 hours per week in their varsity sport before high school were more likely to report multiple injuries (90.0 vs. 56.7%).
• “Specialization” is classified as a young athlete that participates in year-round training > 8 months of the year, chooses a single main sport and quits all other sports to focus on single sport.
• In a study of 519 junior tennis players, 70% of them claimed to begin single-sport specialization by age 10.
• 20% of children ages 8 to 12 and 45% of those ages 13 to 14 will have arm pain during a single youth baseball season.
• The American Medical Society for Sports Medicine (AMSSM) published results of a 2012 survey that found 88% of college athletes surveyed participated in more than one sport as a child.

REFERENCES

1. DiFiori JP, Benjamin HJ, Brenner J, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse Injuries and Burnout in Youth Sports: A Position Statement from the American Medical Society for Sports Medicine. Clin J Sports Med. 2014;24(1):3-20.
2. American Orthopaedic Society for Sports Medicine. (2019, March 16). Early sports specialization tied to increased injury rates in college athletes. ScienceDaily. Retrieved July 16, 2019 from sciencedaily.com/releases/2019/03/190316162202.htm
3. Abbott, A., Collins, D., Sowerby, K. & Martindale, R. (2007). Developing the Potential of Young People in Sport: A report for sportscotland by The University of Edinburgh, sportscotland: Edinburgh.
4. Fransen, J., Pion, J., Vandendriessche, J., Vandorpe, B., Vaeyens, R., Lenoir, M., & Philippaerts, RM. (2012). Differences in physical fitness and gross motor coordination in boys aged 6‐12 years specializing in one versus sampling more than one sport. Journal of Sport Sciences, 30, 379‐
5. Jayanthi, N., Pinkham, C., & Luke, A. (2011). The Risks of Sports Specialization and Rapid Growth in Young Athletes. 2011 Annual Meeting of the American Medical Society for Sports Medicine. April 30th-May4th, Salt Lake City, Utah.

By Sports PT Blog Team

“Baby, it’s hot outside!” Just a few months ago we were complaining about the cold in Upstate NY, but now that summer has officially arrived, heat and all, it’s important to remember to stay hydrated!

So what’s all the fuss about water, anyway? Here are three reasons why it’s so important to our bodies:

1. Water boosts energy.
2. Water delivers important nutrients to all our cells, especially muscle cells, postponing muscle fatigue.
3. Water acts as a lubricant and cushion for your joints.

Water does many other helpful things, too, like regulate body temperature, flush body waste, and help maintain blood pressure; all of which helps keep us healthy and moving! So, grab a glass and take a sip! Your body will thank you!

By Amy Barbasch, DPT

Have you been looking to try Yoga? Here are just a few of the many health benefits that Yoga may provide. 

Improves Flexibility and Balance-  Yoga commonly incorporates poses and movements that work on muscle flexibility and balance training. Studies have shown that yoga not only improves flexibility and balance but can therefore improve athletic performance. 

increased muscle strength and endurance- Yoga is commonly known to improve flexibility, however the practice can also help to increase strength and improve endurance. A number of yoga poses are used to build muscle tone and endurance with prolonged holds and repetition. 

Improves posture-  A number of yoga poses work to combat the modern day posture that can be easy to achieve through desk and computer work. A number of poses encourage spine extension combating the seated ‘flexed’ spine, as well as work on strength and endurance of the upper back and postural musculature helping to improve overall postural endurance. 

Helps train proper breathing- Yoga incorporates movement with breath. It can help to train the use of the diaphragm to not only improve the function of breath, but reduce the use of accessory muscles. This can help to improve breathing and lung function. 

Improves bone health- Weight-bearing exercises done against gravity have been shown to improve bone density and overall bone health. Yoga incorporates weight bearing through many joints of both the upper and lower body helping overall bone health and fighting osteoporosis. 

May help to improve sleep- Yoga has been found to increase the secretion of Melatonin, the hormone that is responsible for regulating sleep. Studies have also shown that yoga can reduce the need for medications to help one sleep. 

Decrease Stress- Many studies have shown that yoga can help with relaxation and decrease stress by decreasing the secretion of cortisol the primary stress hormone. 

May help to reduce depression- This may be because yoga is able to decrease levels of cortisol, a stress hormone that influences levels of serotonin, the neurotransmitter often associated with depression.

May help decrease Inflammation- Inflammation is a normal and needed immune response, however chronic inflammation can be a leading cause of pro inflammatory disease and pain. Some studies have shown that yoga may reduce inflammatory markers in the body and help prevent pro-inflammatory diseases and chronic inflammation. 

May help to reduce Chronic pain-  Although further research is needed on this, studies have shown that Yoga can help to reduce chronic pain in patients and improve overall physical function.

May help combat Migraines- 1 in 7 Americans deal with migraines each year; characterized as severe recurring headaches. Commonly migraines are treated with medications. Studies have shown that yoga may stimulate the vagus nerve helping to reduce migraine intensity and frequency. 

Whether you are an avid Yogi or looking to try a new form of exercise, Yoga has been found to be a safe and great form of activity. Roll out your mat and enjoy a Yoga class for International Yoga day! 

References: 

13 benefits of yoga supported by science: https://www.healthline.com/nutrition/13-benefits-of-yoga#section14

38 Health Benefits of Yoga: https://www.yogajournal.com/lifestyle/count-yoga-38-ways-yoga-keeps-fit

By Teresa Lindell, DPT, OSC

Everyone gets hurt whether they are male or female.  Did you know though that men are more susceptible to certain types of injuries than women?

• Achilles tears: Men are three times more likely to tear this powerful tendon in the back of the leg. This is usually a result of playing sports and is most common in men in their 30s and 40s.  This is often repaired surgically and takes several months to return to sports.
• Finger and Hand fractures: Men are also more likely to sustain fractures of the hand and fingers, usually due to a fight with yard or work equipment, or commonly in a fight with another person or wall when angry. The best way to prevent these types of injuries is to obviously avoid the cause of the situation.
• Muscle tears: While women tend to have more problems with bone injury, men’s muscles and tendons tend to tear more under stress. This typically has to do with sport and recreation activities as well
• Pelvic health: While men and women both have problems with pelvic pain at times, it can occur specifically in men after treatment for prostate cancer. Many men don’t realize that a physical therapist who specializes in pelvic floor rehab can make a really positive change for this population.

Physical therapy can help to prevent and treat many of these conditions and return men to their full participation in work, life, and sports.

By: Melissa Patnella, SPT

What is Alzheimer’s Disease?

Alzheimer’s Disease is a form of dementia that occurs due to degenerative neurological changes in the brain and primarily affects those who are over the age of 65. The most prominent effects caused by Alzheimer’s are loss of memory, confusion, difficulty problem solving, trouble speaking and writing, and withdrawing from social activity.

How do I know if I have Alzheimer’s Disease?

Only 16% of adults over the age of 65 are receiving cognitive assessments during their annual check-ups. If you believe you are experiencing the early signs of Alzheimer’s Disease, tell your primary care physician. You may see exams on the internet that claim to test for Alzheimer’s but speaking to your doctor is the best way to receive an accurate diagnosis.

What do I do if I have Alzheimer’s Disease?

• Be Open and Direct: Receiving an Alzheimer’s diagnosis can be an emotional experience. Create open conversation about your condition with your loved ones. Advocation for yourself and your feelings are important to open communication and mental well-being.

• Seek Support: 8 million Americans are living with Alzheimer’s, so you are not alone. Find local or online groups for emotional support and social activity with others with Alzheimer’s. In addition, push yourself to avoid withdrawal from your family and friends.

• Use Your Voice: The number of people affected by Alzheimer’s is increasing. Your voice is important and powerful in educating those around you about your condition. Education can lead us closer to a cure.

What do I do if I have a loved one with Alzheimer’s Disease?

• Create a Support System: If you are a care taker, remember that care taker burnout is a very real thing. Take advantage of online and local resources to ensure that you are adequately supported. You are taking care of someone in need; there is no shame in needing some support through your journey.

• Stay connected: Maintaining family and friend relationships is important for caretaker mental and emotional health. Make time to socialize and stay active in the things that you love.

• Use technology: MedicAlert+Alzheimer’s Safe Return is a technological device for your loved one with Alzheimer’s to wear. This allows their location to be tracked at all times and if they are lost they (or a person who finds them) can press the button and it will send an alert to you, as well as emergency services.

Resources for those who have Alzheimer’s:

• 1-800-272-3900: Free confidential 24/7 helpline for those with Alzheimer’s Disease to refer to local programs and provide education, crisis assistance, and emotional support.

• Alzconnected.org: Free online community for those affected by Alzheimer’s.

Resources for caretakers of those with Alzheimer’s:

• 1-800-272-3900: This is a free, confidential 24/7 helpline for caretakers of those with Alzheimer’s disease to refer them to local support groups and provide education and emotional support.

References:

https://share.upmc.com/2017/01/alzheimers-vs-dementia/

http://alz.org

http://alzheimers.net

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