Great article written by Dr. David Geier! Some things to ponder for athletes, parents, coaches, medical professionals, and those in charge of the athletic associations across the Bluegrass!
Reducing the Risk of Injury in Young Athletes Through Sport-Specific Strengthening Programs - By Samantha Ashford PT, DPT
Most people assume that physical therapy is only warranted for those who are injured, recently had surgery, or for your 80-year old grandparent with balance issues. Yes, PT is beneficial for those particular instances yet it can be a source of reducing your risk of injury as well, particularly with athletes. Given the rigorous schedule of competitive sports nowadays, many athletes do not realize they have an underlying weakness or muscle imbalance until it causes an injury and forces them to be “sidelined” for an extended time.
A common finding amongst athletes as young as 8 years old is weak hip and core muscles, particularly in females. Weakness in these muscles can lead to numerous conditions that can actually be avoided by implementing a targeted strengthening program. For example, a volleyball player with weak hip muscles may eventually experience anterior knee pain caused by poor tracking of the patella, a condition known as patellofemoral pain syndrome. When a jumping athlete has weakness in the gluteus medius and minimus, upon landing their knees may cave inward, stressing the patellar cartilage and causing pain. Other conditions which may result from weak hip and core muscles include back pain, plantar fasciitis, patellar tendinitis, and greater trochanter bursitis.
Throwing athletes with weak hip and core muscles are just as vulnerable for developing an injury over time. As baseball pitcher throws, a great amount of force is generated from his core and hips to increase the velocity of the pitch. If weakness exists in these areas, he may compensate by generating excess force at his shoulder and elbow. Over time, this repetitive overuse can lead to rotator cuff tears as well as tears to the labrum (the cartilage of the shoulder). Another common condition is an ulnar collateral ligament sprain or tear, also known as “Little League elbow”. Such injuries can force a pitcher to sit out of games for several weeks to rest and give the structures time to heal.
Too many athletes are injured each year, and in many cases the risk for injury could have been reduced if appropriate preventative measures were taken. A physical therapist or an athletic trainer can easily assess for specific muscle imbalances and then create a personalized, sport-specific exercise program. Many PT clinics such as Orthopedic and Sports Physical Therapy in Louisville & Lexington, KY and Performance Physical Therapy in Nicholasville, KY offer such programs for athletes of all levels for a weekly fee. By incorporating sport-specific strengthening exercises into an athlete’s regular training routine, they can reduce their chances of acquiring an injury that takes them out of the game. Furthermore, many athletes are surprised to find that focusing on total-body strengthening rather than specific body groups greatly improves their sport performance.
Rotator cuff injuries are very common, and patients at every age can injure their shoulder. The belief that only baseball players suffer from these injuries is simply false - in fact, 50% of people over the age of 60 will have a tear in their rotator cuff. The shoulder joint has more motion than any other joint, and thus is most susceptible to instability. While there are very large muscles in and around the shoulder, very small muscles, the rotator cuff, control much of the stability around the joint.
Yes, baseball players are susceptible to rotator cuff tears, mainly due to the force the shoulder goes through each throw. But overhead activity of all kinds strains the rotator cuff - whether that is throwing a baseball, painting, serving in tennis, swimming, or even just reaching above one's head. Lifting heavy objects above the head creates a terrible atmosphere for these little muscles.
However, one single motion or lift is not always the cause of these injuries. Routine, everyday tasks like reaching for an item out of the cabinet, picking up a child, reaching behind your body, or even simply putting a shirt on can sometimes cause some pain in the shoulder. While these usually do not lead to full tears, a partial tear or pain from an inflamed tendon can often be exacerbated by these motions.
So how do we treat these common injuries? Keeping a good range of motion is the first step - this can either be achieved by a home exercise program or a more structured manual treatment by a therapist. Strengthening the small muscles around the shoulder to complement this increase in motion is also vital. Stability is key, and these small muscles do most of the work when it comes to stability. Continued work on simple exercises prescribed by a therapist will help you avoid continued shoulder pain in the future. "Continued focus on strengthening and stretching will help prevent shoulder problems, however good posture throughout the back and shoulders must also be addressed," says physical therapist Samantha Ashford.
If you do injure your rotator cuff, medical attention is needed to devise a plan. The type of treatment depends on a severity of pain, duration of pain, and the extent of injury to the muscles/tendons. Most patients receive physical therapy and are encouraged to seek guidance from a physical therapist even if the injury is severe. "If only one of the four rotator cuff muscles are injured, and the remaining three are in good health, they may be enough to compensate for the injured muscle," says Ashford. "Patients can function fine as long as they keep the remaining muscles strong and their flexibility and motion up." A team approach to treatment that includes the patient, the physical therapist, and the MD should help guide which direction is needed to ensure a positive outcome.
Any questions about shoulder pain, please do not hesitate to contact one of our physical therapists.
OSPT - Hamburg is helping @toysfortots_usa with a holiday collection through this month. Jim Rothbauer, PT, ATC says "We did this last year, in which each patient can bring in a toy and in response they get to pick one of the therapists or technicians to do an exercise." This was a big success last year and they're hoping for another good outcome this year. Patients - Remember that one exercise that was your least favorite? Why not have a therapist perform that, all while helping a good cause! Pics and videos to follow!
More information about the program can be found here - http://toysfortots.org/default.aspx.
Spigelman T, Sciascia A, Uhl T. RETURN TO SWIMMING PROTOCOL FOR COMPETITIVE SWIMMERS: A POST‐OPERATIVE CASE STUDY AND FUNDAMENTALS. International Journal of Sports Physical Therapy 2014;9(5):712-725.
Lexington, KY Area Researchers!
Abstract: A large percentage of swimmers report shoulder pain during their swimming career. Shoulder pain in swimmers has been attributed to duration of swim practice, total yardage, and break down in stroke technique. Rehabilitation programs are generally land‐based and cannot adequately address the intricacies of the swimming strokes. Return to swimming protocols (RTSP) that address progression of yardage are scarce, yet needed. The purpose of this clinical commentary is to familiarize the clinician with the culture and vernacular of swimming, and to provide a suggested yardage based RTSP for high school and collegiate level swimmers.
Full Article Here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196335/
Almost everyone will experience back pain at some point in their lives. While normal wear and tear of an aging spine is a common cause, there are certain activities that can increase an individual’s chance of developing back pain.
Based on a 2012 National Health Interview Survey (NHIS), more than 65.8 million adult Americans reported that they had low back pain.
Orthopaedic surgeons provide both non-operative and operative treatment for back and spine conditions. The American Academy of Orthopaedic Surgeons (AAOS) offers tips on how to protect your back and reduce the risk for pain and injuries.
“Many people with lower backaches say symptoms disrupt their daily routines; however, everyday habits may be the factors causing the pain,” says orthopaedic spine surgeon and AAOS spokesperson Dr. Michael Gleiber. “It’s important to identify some of those behaviors, avoid them and adapt healthy ones.”
Consider these five tips from the AAOS:
Although most people recover fully 7-10 days after a concussion, there are some that last much longer, and how quickly those patients improve is at times directly correlated to how they take care of themselves after the injury.
Andrew Carlson, MS, ATC, offers some helpful tips to follow after concussion:
1. Get plenty of sleep at night, and rest during the day - no late nights!
2. Avoid activities that require a lot of concentration, or are mentally/emotionally stressful
2. Avoid activities that are physically demandings/increase heart rate and energy consumption
4. Driving could be hazardous depending on the severity of injury, as your reaction time is slower. Please consult your MD regarding when it is safe to drive a car, ride a bike, or operate equipment.
5. Consider returning to work/school gradually. Begin with 1/2 days, and slowly work towards a full day.
6. Adults - No Alcohol!
7. Kids - No Video Games!
8. Avoid anything that will increase your sensatory system, i.e. loud music, reading, television, texting, being around many people, bright lights, etc.
9. Mental and physical rest is challenging in today's work, but essential for the brain's recovery.
After your concussion it may be a good idea to let your employers, teachers, family and friends, know exactly what happened. You may rely on them to make accommodations, and they may then also understand any challenges you may be facing and be more patient with you through this time.
Lastly, as with any injury, if symptoms continue to linger, please let your MD know and they can direct you with the appropriate care.
MDs that may be able to assist with concussion:
Louisville Area - Dr. Tad Seifert, Norton Healthcare
Lexington Area - Dr. James Jagger, University of Kentucky
Over lunch today at our Performance Physical Therapy location, some our employees attempted to walk/balance/function with a prosthesis. Cindy Crook, PT has had a long history working with patients that have had amputations. For the last few months Cindy has been working at our newest clinic with amputees who want to return to a higher level of function. It is always good for therapists to fully understand what they are having their patients do in exercise, and today was a great example of the challenge these particular patients have on a daily basis. They are amazing!