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ACL- Incidence and Prevention

The Anterior Cruciate Ligament (ACL) is one of four major ligaments (ligaments connect bone to bone) of the knee joint that coordinate function and promote stability of the knee joint. The anterior cruciate ligament (ACL) is the most commonly injured knee ligament. In the United States there are between 100,000 and 200,000 ACL ruptures per year, with an annual incidence in the general population of approximately 1 in 3500, although the actual incidence may be higher. These numbers are steadily on the rise from year to year.

Sports that are more at risk for ACL tears are Soccer, lacrosse, volleyball, and basketball. Females are more likely than males. An estimated 70% of ACL injuries are sustained through non-contact mechanisms, while the remaining 30% result from direct contact. The classic ACL injury occurs during a non-contact event usually when decelerating, stopping suddenly, twisting, cutting, or jumping. Stretching, strengthening, agility work, and PEP programs are all preventative measures to decrease your risk of this injury.

There are many advantages to seeking help and guidance to prevent such a significant injury from occurring. At BREAKTHRU, we have developed a team of skilled Rehabilitation specialists and personal trainers to fit the needs of the individual client to decrease the risk of injury. We make sure that the patient has exceptional biomechanics and functional movement patterns to not only decrease the likelihood of injury, but to enhance the client’s athletic ability. We have a strong relationship between therapy and fitness that enhances the quality of treatment and provides an aspect of health and wellness you do not find at other facilities.

The staff here at BREAKTHRU provides a winning combination to get you back on the field and keep you at the top of your game!

Dr. Kyle Hadden PT, DPT, Cert. MDT, OCS

 

Postpartum and Physical Therapy

Pregnancy is a long and beautiful process with each step a critical component to proper fetal development. Your body, which you have gotten used to for the past 20-30 years has now suddenly changed within a very short period. After pregnancy, during the postpartum period, it can sometimes be discouraging and exhausting to return to your pre-pregnancy body.  Let’s face it; taking care of a newborn is tough and difficult, no matter how many times you’ve been through it. Your body has gone through a traumatic event and every second is a new experience.  Taking care of yourself can be extremely difficult with a newborn, but it is during this time that your body is most vulnerable and susceptible to acute and chronic injuries.  With everything happening for your newborn, it can be easy to forget to take care of yourself!

Common problems postpartum

  • If you had a natural delivery, you may have had stitches and it is normal to have some discomfort with urination or sitting. If you had a c-section, the recovery process will generally take longer and you may have more precautions that your doctor will instruct you in. However, with either type of deliveries, you should not have to tolerate long term pain! Your physical therapist can help reduce any pain you may have and help you return to your normal lifestyle pre-pregnancy.
  • Back pain is a common problem as your center of mass has drastically changed in a very short amount of time. This gives your body less time to prepare for the shift in weight. Your body will move differently than it has in the past 9 months and it is vital to have proper guidance to return to activities.
  • Hip pain may also occur as natural delivery requires you to create extremely high pressure in an unfavorable position for your hips. In therapy, you can benefit from strengthening your hips, as well as decreasing pain.
  • Weakness in your core can be expected as your abdominals have been stretched. Again, this is common, but you should not have long term pain.
    • You may also have diastatis recti, which is a fancy term for increased gap between your middle abdominal muscles, called the rectus abdominus. This may be painful and you can see your physical therapist to help you with this.
    • Weakness in the pelvic floor can lead to urinary or bowel incontinence. If you have a uterine prolapse or rectocele, it is very important that you learn how to strengthen to muscles properly. A therapist specialized in pelvic floor can you regain proper control of these important muscles.
    • Postpartum depression – it took 9 months for hormones to develop in your body to have a healthy baby and in 2-3 days postpartum, the levels of hormones will reduce to pre-pregnancy base lines! Postpartum depression is a serious complication. Be sure to communicate with your doctor if you feel you have postpartum depression.
    • Joint pain is common because during pregnancy, your ligaments become lax to create space for the baby to come out of the birth canal. However, the hormones do not limit to only pelvic ligaments and will stretch out ligaments in your entire body. It is important to see a therapist to learn how to strengthen your muscles and avoid certain positions that could place your body at risk for further injury.

Choose PT first!

  • Your body changes drastically during pregnancy and you may benefit from the help of a physical therapist to get you back to the way you were prior to pregnancy
  • Don’t be okay with postpartum pain or body aches and think that is “normal.”
  • Don’t be scared to get back into physical activity
  • Taking care of yourself can be extremely difficult with a newborn but it is during this time that your body is most vulnerable and most susceptible to acute and chronic injuries

 

Physical therapy can benefit you!

  • Teach you about your body so you understand how to use muscles that have been overstretched or overused from changes in your body
  • Strengthen muscles to create proper stability in your body and core
  • Relieve pain

 

Taking Care of yourself while taking care of your child

  • When you carry your child, be careful of your posture. Try not to hike your hip up and use both arms.
  • When picking up your child, go into a proper squat and use your legs to lift. Your newborn might be a few pounds now, but they gain weight quickly!
  • If you are breastfeeding, try to use a pillow to prop your newborn instead of using your arms to keep him lifted

In the States, new mothers will meet with their doctors after 6 weeks to clear them for activities. Many times, mothers will be nervous about returning to exercises or think they will not have the time to exercise. Meeting with a physical therapist will allow proper guidance to return to you lifestyle, worry-free.

References:   Simonds, A. (2015, June 29). Evaluation and Management of Prenatal and Postpartum Clients in Physical Therapy. Lecture presented at Prenatal and Postpartum Lecture in Rutgers University , Stratford, NJ.

Meniscus Injuries: Surgery vs. Physical Therapy

To have surgery or not to have surgery… that is the question? At some point in most of our lives, we will be faced with this difficult decision regarding some injury, ache, or pain we are experiencing. Making informed decisions could be the difference between a pain-free existence or a potentially worse outcome. As physical therapists, we are frequently asked if “surgery is the right option for me?” In my experience, there is no instance where I hear this question more than with knee injuries, specifically, meniscus injuries.

You may be wondering, what the heck is a meniscus?  At its core, your meniscus is a thickened cartilaginous pad between the two joints formed by the femur (the thigh bone) and the tibia (the shin bone), also known as your knee! The meniscus acts as a smooth surface for the joint to move on, serving as a shock absorber, a lubricant, and a joint protector all at once. The anatomical position and make up the meniscus make it a relatively avascular structure, meaning it receives very little blood flow. Why is that important? Well, should you be unfortunate enough to injure or tear your meniscus, it will not simply heal on it’s own, medical intervention will be warranted to help manage your pain and dysfunction.

 

What are my options? Most Orthopedics Physicians will give you two: Arthroscopic Surgery (a Partial Meniscectomy/the removal the damaged tissue) or Physical Therapy. For some of you the answer may seem straightforward… if surgery is an option, why wouldn’t I just have it done? For a few reasons…outside of the cliched “no surgery is a minor surgery” answer. The risks involved with even “minor surgeries” can be significant. Knee surgery specifically has proven to be a catalyst for more problems in the future. Invasive procedures can accelerate the development of Osteoarthritis and degrade the integrity of the knee joint, ultimately increasing chances of future knee pain and even more surgical intervention. Avoiding surgery could extend the life and health of your joint! But don’t fret…more and more evidence has emerged suggesting that the rush to invasive procedures may not necessarily yield better results.

In a recent randomized controlled trial involving nearly 200 symptomatic participants, (>45 years old), it was found that at 6 and 12 month evaluations, pain scores and reports of improvement between a surgical intervention only group and a physical therapy only group were nearly identical. The study additionally reported that nearly 30% of the group eventually classified as a“crossover group,” receiving both surgery and PT. This group showed markedly better improvement when compared to the surgery only group as well. According to their findings, the researchers concluded that attempting a prolonged bout of physical therapy prior to exploring surgical interventions was shown to be equally as effective as immediately opting for surgery. Meaning surgical intervention and PT yielded similar results with PT presenting a fraction of the risks, making it the more highly recommended option.  

Studies like this exist throughout the literature and the evidence continues to remain consistent… physical therapy is the BEST FIRST option with meniscus injuries. The risks of surgery and possible consequences of invasive interventions simply outweigh the reward. Physical therapy presents a low-risk, high-reward option that has been repeatedly proven to be as effective as surgery with a fraction of risk and trauma involved. If bouts of PT are at first ineffective, it may then be time to consider secondary options.

If you take anything from this post, let it be this: Should you ever find yourself in this type situation, take the time to get informed! Ask your physician about your options or consult a physical therapist to see how they can help. It is a decision that could save you from the trauma of surgical intervention while  prolonging the health and integrity of your joints!

 

Make a SPLASH into Recovery

Spring is around the corner! With it comes the opportunity to participate in all of the exciting activities the season affords. Unfortunately, many individuals are unable to take full advantage of this warm weather due to chronic pain or other injuries that causes difficulty with movement and activity.  Being unable to engage in hobbies or activities you are accustomed to can lead to a decreased quality of life.

Thankfully, it is not too late to get back to performing the activities you, or someone you know, once loved. Aquatic Physical Therapy can aid in improving movement, decreasing pain, and restoring function for all daily activities. In this article, we will discuss how there is no better time to dip your toe in and try aquatic therapy at BREAKTHRU.

  • What is Aquatic Physical Therapy? 

Many individuals feel as if they have exhausted all options including physical therapy and must live with their pain.  This is simply not true. Aquatic physical therapy is distinctly different from land based physical therapy. In the water, buoyant forces push the body upwards, effectively causing you to “weigh” less. This results in less impact during activity and a decreased load on the joints, muscles, and bones.  Movement is easier and less painful than on land, and patients are able to perform exercises not possible out of the pool. Additionally, our pools have multiple massaging jets and are kept at a warm 90°F which provides relief to tight muscles, spasms, as well as decreasing pain.  

At BREAKTHRU, exercise programs are constructed individually for each patient to ensure the highest levels of success. The exercise program will be challenging, but manageable for you, and will work specifically to increase your endurance, strength, and flexibility. Most exercises that are performed on land can also be performed in the pool. Our aquatics facility has a plethora of water based exercise equipment including use of dumb bells and flotation devices.

Most notably, we uniquely offer an underwater treadmill that can be remotely controlled to reach the perfect, most comfortable speed for you. The treadmill allows individuals to walk, jog, or run in the water where they “weigh less.” Additionally, we also have the ability to provide gentle resistance through water based currents in the pool.  

At BREAKTHRU, our goal is to provide the highest quality care to patient’s during their path to recovery and fitness. To us, this means one-on-one care with a Doctor of Physical Therapy (DPT) is the utmost importance.  

You will be scheduled with the same PT at every visit which will allow him or her to get to know you and your health condition personally. The entire staff will make sure you are performing exercises correctly with proper form at the right dosage (reps, sets, and durations), as well as taking recommended breaks throughout.  

  • How can I get started?

FREE Screen: If you are unsure if aquatic therapy is right for you, it all starts with your FREE consultation with a Doctor of Physical Therapy. You can set up this FREE meeting at our Mt. Laurel location (Near the Whole Foods and LA Fitness) by calling (856) 722-1044 OR our Medford Fitness location by calling (609) 451-6582

Initial Evaluation: If you or someone you know could benefit from decreasing pain and moving better, you can see a Doctor of Physical Therapy by scheduling an initial evaluation. At the evaluation, your PT will take a detailed history of your condition by asking questions and listening to your story. He or she will then take a look at what impairments you may have (strength, flexibility, pain, motor control).  The process typically takes between 30-45 minute.  You will then meet the friendly staff, be given a tour of the facility, and scheduled for the first session.  

First session: will consist of becoming familiar with the pool, getting to know your physical therapist, and beginning your exercise program. A typical treatment session is around 1 hour in length and allows time for warm up on our underwater treadmill or massaging jets, as well as your exercise program and a cool-down.  At following sessions, your exercise program will be progressed appropriately in accordance with your plan of care and include more exercises that will benefit you.  

  • Who can benefit from skilled aquatic physical therapy?

Arthritis:Arthritis of the hip and knee are one of the most common diagnoses seen for aquatic therapy at BREAKTHRU.  Our patients are able to walk for longer distances on the underwater treadmill without pain. Additionally, physical therapy will strengthen the muscles of the lower leg, thigh, and glutes in order to decrease pain and improve strength. This will help take some of the stress off of your arthritic joint by allowing the muscles to stabilize and absorb force. Osteoarthritis is the most common form seen at our clinic, however water based therapy will improve function in RA as well.

Low Back Pain: Low back pain is the most common diagnosis seen in physical therapy and can cause patient’s difficulty in walking, bending, and lifting items. Additionally, some low back pain may even be felt in the legs and feet.  In the pool, the water can relax the low back muscles and the jets can help de-sensitize an area by providing gentle stimulus to the nerves.  Stretching can be performed in the pool. Additionally, we will work to strengthen the core in the water which will act as a “natural back brace” to strengthen your spine’s support.

 

 

Post Joint Replacement: A large amount of evidence exists through research studies supporting using pool based therapy following total knee arthroplasty (TKA) or total hip arthroplasty (THA). These patients can benefit from water based therapy when cleared by a surgeon. Walking can be performed for longer periods of time with less rests. Most exercises can be performed with decreased pain in the pool, which can provide relief to patient’s looking to get moving sooner. These patients will eventually progressed to land based exercises.

Sports related surgeries:  Athletes who suffer ACL, PCL, or Meniscal injuries requiring surgery are often braced for several weeks. Afterwards, they typically follow a protocol in place by a physician in order to return them to sport safely. Many protocols recommend water based jogging in order to begin loading the joint before beginning these activities on land, however most physical therapy centers do not have access to pools. At BREAKTHRU, we can begin jogging activities early in the pool, which allows the athlete to return to running and sport sooner. Additionally, jogging in the pool will keep the athlete at a high level of conditioning during their recovery.

 

General Deconditioning: The pool is a great way to begin physical therapy for individuals who lack strength or endurance in their legs or core.  These individuals may report getting tired with walking after a short distance, having difficulty going up or down stairs, or feel “weak” in the legs. Exercises can be initiated in the pool and progressed to improve strength. Water-safe weights can be incorporated into programs to challenge the patient. Once the patient has gained sufficient strength, physical therapy can begin on land. This is a great “stepping stone” to begin land-based physical therapy.

References:Waller B, Ogonowska-Slodownik A, Vitor M, et al. Effect of Therapeutic Aquatic Exercise on Symptoms and Function Associated With Lower Limb Osteoarthritis: Systematic Review With Meta-Analysis. Physical Therapy. 2014;94(10):1383-1395. doi:10.2522/ptj.20130417.
Barker A, Talevski J, Morello R, Brand C, Rahmann A, Urquhart D. Effectiveness of aquatic exercise for musculoskeletal conditions: a meta-analysis. Physiotherapy. 2015;101. doi:10.1016/j.physio.2015.03.250.
Prins J, Cutner D. Aquatic Therapy In The Rehabilitation Of Athletic Injuries. Clinics in Sports Medicine. 1999;18(2):447-461. doi:10.1016/s0278-5919(05)70158-7.
Schonewill A, Rogers K, Spear A, Weinberg D, Pitt R. Combined Effects of Aquatic and Land-Based Rehabilitation in Female Soccer Players Post ACL Reconstruction: An Overview of Current Evidence. Journal of Physical Therapy and Health Promotion. 2015;3(2):11-19. doi:10.18005/pthp0302001.
Villalta EM, Peiris CL. Early Aquatic Physical Therapy Improves Function and Does Not Increase Risk of Wound-Related Adverse Events for Adults After Orthopedic Surgery: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2013;94(1):138-148. doi:10.1016/j.apmr.2012.07.020.

Your Spine Does Not Go Out Of Place

It is a common report in the physical therapy clinic that a patient’s spine or hips go out place. This belief is followed by a need for the patient to seek healthcare practitioners that can simply “put their bones and joints back in place” using manual force through joint manipulation or adjustment. This results in lifelong visits and dependency for continuous adjustments as the spine continues to go “in and out of place”. What if I told you that this concept of the spine going out of place is not true and has been scientifically disproven through multiple studies?

In actuality, your joints and bones do not easily move in and out place unless there is a large traumatic force causing a
dislocation, which is a medical emergency. This belief can be quite detrimental to patient recovery and facilitates a dependence on a healthcare professional, requiring monthly and sometimes weekly “adjustment” to put bones and joints back in place. In addition, having this belief creates a fear of movement which then causes avoidance of particular motions that ultimately hinder recovery. Both of these factors result in a worse prognosis for the patient and can actually do more harm than good. Our bodies are much stronger and more resilient than we think. Studies have shown that it takes over 1000 pounds of force to deform fascia (a connective tissue covering) by only 1%! Performing a joint manipulation/adjustment cannot come close to the amount of force to put a joint “back in place”.
Tullberg et al. performed a study on joint position in patients with one sided low back pain involving the sacro-iliac joint (better known as the SI joint). He performed joint manipulations/adjustments to the SI joint and measured the position of the joint pre- and post- manipulation to assess if the joint was moving in and out of place. The findings of the study were that there were positive changes in terms of pain, but no change in joint position in any of the participants of the study!
What patients are actually feeling when they perceive a bone or joint to be out of place is a combination of unilateral low back pain, a lack of muscle stability in the low back area and a reluctance of the body to fully bear weight on the affected side, secondary to pain. Joint manipulations can be a useful technique to decrease pain and improve movement, however, the effects are only temporary in nature leading to the need to be continuously “adjusted.” Patients who are experiencing low back pain actually require a combination of manual therapy techniques, such as manipulation, followed by specific exercise and strengthening techniques to address pain and weight bearing/muscle instability to facilitate long term changes in pain. There is a large growing body of evidence through research on the positive and sustainable impact that physical therapy has on patients with low back pain.
In conclusion, it is a scientific fact that your joints are unable to go in and out of place so easily and that the adjustments or manipulations received are a temporary change in pain. Our bodies are much stronger than we think and are capable of the long term changes. Patients with low back pain require appropriate strengthening and stability in combination with manual therapy techniques. Schedule an appointment with BREAKTHRU Physical Therapy and Fitness for a free consultation for assessment of the low back and the development of a treatment program aimed to reduce or eliminate your low back pain, teach independent management of your low back pain and to facilitate a return to normal activities that may be currently hindered by your pain!

 

-Dr. Brandon Fredhoff PT, DPT

Spring Off the Treadmill

The transition from winter to spring can be a difficult time of year to get out of the house for a run. Rainy, cold days can lead us to opt for a run on the treadmill rather than braving the elements for a long run outside. The question becomes how different is running on a treadmill versus running over ground? Today we are going to be discussing a recent research article looking at different forces through the knee and ankle when running on treadmill versus running over ground.
Knee pain, specifically patellofemoral pain, and achilles tendon injuries are two of the most common injuries sustained by runners. Patellofemoral pain occurs due to an increased load between your kneecap and your femur. This can cause pain with prolonged sitting, climbing stairs, or standing up from a seated position. Achilles tendon injuries are often associated with overuse, and can be painful with push off while running/walking or going up a hill. These injuries can be lingering issues for runners, and if left untreated, can be very painful, often resulting in an inability to run. This study evaluated the different stresses placed on these two areas between running on a treadmill and overground.
Previous studies have shown that when running on a treadmill, runners tend to adopt a 1 to 5 percent shorter step rate compared to their selected step rate on ground. An increase in step rate has also been shown to decrease patellofemoral stress while running. This helps to limit stride length, decreasing the tendency to overstride. The research showed no difference between patellofemoral stress on the treadmill versus overground running. This was not the case for the achilles tendon loads. Running on a treadmill produced a higher loads sustained through the tendon, meaning that the calf muscles are working much harder when running on a treadmill. Further studies are needed to determine how this may impact injury rates for those who prefer to run on treadmills, and how this information can be utilized for returning from injury.
As April showers turn into May flowers, it is good to get out on the road and leave the treadmill behind. For those runners who have been experiencing pain in their achilles, or even knee pain, please contact your local Breakthru Physical Therapist to help you get back to running pain free.
-Dr. Dan Pinto PT, DPT
Williy R. et al. Patellofemoral Joint and Achilles Tendon Loads During Overground and Treadmill Running. JOSPT 2016. 46:8.

Breakthru is excited to announce…

Dr. Mark Kitz PT, DPT is the NEW Facility Manager at our Medford Fitness office!

Dr. Mark Kitz is a lifelong resident of Southern New Jersey. He graduated cum laude from Thomas Jefferson University in 2009 with a Doctorate in Physical Therapy. As a Graduate Research Assistant at Thomas Jefferson, he conducted scientific literature reviews for faculty and assisted with human motion analysis and electromyographic studies. He completed his undergraduate studies at Rutgers University where he earned a BS in Exercise Science & Sport Studies.
Mark’s extensive background and full time experience in fitness as a Personal Trainer and Fitness Specialist allows him to facilitate patients along the continuum to achieve health and fitness, no matter what their injury or problem is. BREAKTHRU’s continuum model empowers patients and clients to achieve meaningful and lasting change in their lives with the consistent monitoring and support created by the entire team from the front office to the Doctors of Physical Therapy, personal trainers, sports performance coaches, and massage therapists.

Mark specializes in treating patients with a variety of orthopedic, neurological, and cardiopulmonary diagnoses. He utilizes an innovative, patient-centered approach to providing physical therapy emphasizing hands-on care and close guidance with individualized exercise programs. He also focuses his efforts on proper patient education to help individuals alleviate their symptoms, restore function and prevent recurrent injury. Mark has a strong interest in evaluating and treating patients with balance and vestibular issues.

 

 

 

Balance Program: We use standardized measurement tools to assess your current balance level, and then apply best practice
treatments which incorporate Tai Chi, balance exercises, unstable surface training, dynamic movement, and motor learning.

 

Vestibular Rehabilitation Program: Our physical therapists are trained to differential diagnose vestibular problems in order to provide the correct treatment.  The program will address one’s individualized impairments with balance, vertigo, and dizziness and aim to decrease associated symptoms and any risk of falling.  Some conditions such as Benign Paroxysmal Positional Vertigo (BPPV) can be treated effectively in a few treatments.

 

 

 

 

Scoliosis and The Schroth Method

A Conservative Treatment Approach to Combat the Progressive Nature of the Condition

For far too long, individuals and their family members have expressed the feelings of helplessness, like “there is nothing that can be done” and are forced to adapt a “wait and see” approach as the only model of care after a loved one is diagnosed with scoliosis. This condition can present at any point in development, but onset typically occurs during the adolescent years, when growth and skeletal maturity are really starting to progress. Physical therapy over the years has not been considered as a “primary treatment option” for patients diagnosed with scoliosis, however evidence is being developed and global techniques which have been around for decades are being studied and introduced more frequently now more than ever. This is resulting in at least “options” for patients and their families as a means to combat this condition. Instead of “wait and see”, the mantra is shifting to “try and see”. The Schroth Method is one of these options that could be beneficial for you or a loved one who has been diagnosed with scoliosis.

The Schroth method is a cognitive & sensory-motor 3-dimensional approach to treating the scoliotic spine through trunk elongation and rotational breathing strategies to improve trunk and spinal imbalances. The goal is to strengthen and develop the inner muscles of the rib cage and torso in order to influence the shape of the unique spinal curve pattern of each individual patient, while also maximizing the patient’s postural awareness. This technique has been used in Europe for decades; however, only recently began growing in popularity in the United States.

There is growing evidence to support the need of incorporating scoliosis specific exercise techniques, or this “try and see approach”, to provide alternative options for patients and families who are not exactly sure what the future looks like or what to expect in regards to the “severity and progression of the curve”. The Scoliosis Research Society advocates that the goal of conservative treatment should be to “reduce the risk of a curve progressing to a point where surgery is indicated”1. It also acknowledges that recent evidence studying patients with mild scoliosis of 10-20 degrees revealed that scoliosis specific exercises may prevent curve progressions to further levels of deformity resulting in additional medical management, such as surgery.1,2

What are the Goals of Treatment?
• Correction of the scoliotic posture
• Stabilize the spine and arrest the curve progression
• Improve self-image
• Improve function
• Improve pain
• Improve respiration and lung function
• Improve confidence and empowerment over scoliosis

Who would benefit from the Schroth Method?
Although onset typically occurs in adolescence, patients of ALL AGES can benefit from this method of treatment. The exact strategy and approach is dictated by the unique curve patterns as well as levels of skeletal maturity; however The Schroth Method can be beneficial for patients in all stages of scoliosis. This includes patients who have not yet begun bracing, patient who are currently being braced, as well as pre-operative or post-operative treatment when surgery is indicated.

In addition, research on the Schroth Method and similar treatment strategies is also developing to evaluate the benefits and effectiveness on postural related spinal deformities for people of all ages.

What are the exercises like?
During each session, you will be guided through specific exercises designed for you based on the curve pattern, curve severity, age, overall health, and other factors. Your certified Schroth Therapist will provide extensive verbal and tactile cuing throughout each exercise to facilitate curve correction through appropriate muscle activation, spinal positioning and breathing patterns.

Team Approach is Essential:
Proper management of the scoliotic spine requires a successful multi-disciplinary team approach between the treating Physician, Schroth Therapist, Orthotist (when bracing is required), and family members. Our certified Schroth Therapists understand these relationships are essential and work closely with these health care providers in order to provide seamless care for the patients to achieve optimal outcomes.

Ask for the “Schroth Method” to schedule an evaluation with our certified Schroth Experts!

References:
1. https://www.srs.org/about-srs/quality-and-safety/position-statements/screening-for-the-early-detection-for-idiopathic-scoliosis-in-adolescents2. Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S: Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. Eur Spine J (2014) 23:1204–1214

Acute Management of Lateral Ankle Sprains

Ouch! You rolled your ankle running pick-up basketball this weekend with your friends. Frustrating….we know.

Lateral ankle sprains are injuries that pose a major inconvenience. They limit your ability to walk, move, sleep, and perform your typical self-selected physical activities… plus your friends will be short a player next weekend. Don’t lose hope, we are here to help teach you how to properly manage these injuries and provide advice and strategies for the most effective and efficient rehabilitation.
Lateral Ankle Sprains account for nearly 25% of all musculoskeletal injuries and nearly 10% of all admissions to emergency rooms. However this rush to the emergency room is often unnecessary. The gold standard in the diagnosis of acute lateral ligament injury is the delayed physical examination. Research has shown that, barring the complete inability to bear any weight through the injured ankle, you should be waiting 4-5 days before seeking medical attention. Rushing to the doctor during this acute phase of injury has been shown to result in unreliable diagnosis of the injury. Because of the diffuse location of the pain and swelling, the examiner cannot differentiate the pain or instability you are feeling, leaving you without a true answer or diagnosis.

So what should you do? Remember what your parents always said… ice it! Well how about RICE it.

Well how about RICE it. The combination of Rest, Ice, Compression, and Elevation during that first 4-5 day period has been shown to very effectively reduce pain and swelling. Following this initial period, researchers can tend to disagree. However a majority feel that a brief period of immobilization (5-7 days via air-cast/walking boot) should follow. But don’t baby it! Prolonged use of immobilization (>10 days) can have a detrimental impact on muscles, ligaments and other joint surfaces, resulting in inferior outcomes post-injury. Instead, switch over to a less-rigid support, i.e. compression wraps, lace-up braces, tape.
Finally, at the 7-10 day period, it is now time for a structured, individualized rehabilitation program. Structured physical therapy, from a Certified Doctor of Physical Therapy, focusing on pain relief, swelling reduction, dynamic stability, mechanical analysis/correction of movement, and progressive strengthening of surrounding musculature, has been shown to significantly accelerate the healing process. Not only can therapy help rehabilitate an old injury, it can help prevent a new one. Did you know that the #1 risk factor for a lateral ankle sprain is a previous lateral ankle sprain? With a skilled, trained professional guiding your care, not only will your current injury improve, you will be preparing your body for a safer and more efficient return to activity with an eye towards preventing another injury in the future.
Ankle injuries can be a nuisance. They are painful and difficult to manage. However, utilizing the strategies and guidelines laid out above, you are now equipped with a well rounded approach on how you can help address your injury. By taking the proper steps and seeking the proper care at the appropriate times, you have the tools to turn this potentially chronic issue into an afterthought and before you know it, you will be that mighty weekend warrior once again!

-Dr. Dave Pasi, PT, DPT

Source:
Van den Bekerom, M., Kerkhoffs, G., McCollum, G., Calder, J., Niek, C. (2012). Management of acute lateral ankle ligament injury in the athlete. Knee Surgery Sports Traumatology Arthroscopy, 21, 1390-1395

Hip and Groin Injuries in Athletes- A New Frontier in Sports Medicine

Growing body of Knowledge

There is increasing optimism for athletes and everyday athletes with hip and groin pain due to a growing body of knowledge and recent advances.  There is a better understanding about the anatomy and function of the hip.  For accurate diagnoses, a proper biomechanical exam is imperative.  Hip experts are coming together to collaborate on the best available tests to examine the hip joint to rule in and rule out conditions more precisely.  There also have been improvements in imaging, such as MRI’s.  There have been advancements in fitness and prevention, physical therapy, and arthroscopic surgery. Continue reading