Posted 1/12/2023 | 4 min. read
You may think about physical therapy as a way to get back on your feet after an injury or regain strength after surgery.
And you would be right.
A typical idea of what physical therapy looks like might include a room with padded tables, balance balls and exercise equipment. These are traditional items well-known to those working through movement issues with the professional help and guidance of a physical therapist.
Treatments using these items are pretty standard for improving strength and restoring movement.
But did you know there are other types of treatments – and equipment – that while maybe not be as common are also effective in improving movement?
As a movement expert, your physical therapist can evaluate the type of treatment or treatments that can benefit your condition. Chances are, there may be a mix of traditional and not-so-traditional treatments to:
- Increase your range of motion
- Decrease pain and discomfort
- Build endurance
- Lower or avoid the need for medication
- Recover quality of life
Depending on your condition or diagnosis, the success of some less familiar physical therapy treatments can make them a consideration for your care plan.
Cupping treats muscle and soft tissue dysfunction, like spasms, swelling and pain.
This manual technique uses small silicone “cups” or “domes” (sometimes glass) pressed against the flesh to create suction.
The technique stimulates blood flow as the suction pulls the skin upward into the cup. This expands tiny blood vessels under the skin to increase blood flow, turning the cupped area a reddish or pink color.
Cupping has been around for thousands of years, but is one of the lesser known techniques employed to ease:
- Back and neck pain
- Headache relief
Much different than cupping, which targets broader areas of the body, dry needling is a micro treatment.
As the name implies, dry needling uses thin needles inserted into the skin at precise points in the muscle where there is pain or sensitivity. These points in the muscle, when touched or stimulated, can trigger pain, which is why this treatment is also known as “trigger point dry needling.” There is no medication delivered through the needle, like with a vaccine, which is why it’s called a dry needle.
When inserted into the skin, the needle shuts down the trigger point, easing or eliminating the pain.
Though it uses needles, this alternative method of pain relief is not acupuncture, a common misconception.
Dry needling is a technique for stimulating and releasing trigger points, while acupuncture is a practice that’s focused on restoring energy flow in the body.
In the dry needle procedure, the length of the needle will depend on the area of the body being treated. Most people feel little or no pain, and the procedure lasts about 15 minutes.
If appropriate for your type of pain, our therapists will create a treatment plan that includes dry needling along with other therapies.
Dry needling is not a service provided in every state. Find a location near you that provides dry needling services.
Instrument-assisted soft tissue mobilization (IASTM)
Ever had a deep tissue massage? That firm pressure targeting a deep ache or an area of chronic pain?
Well, IASTM is a technique that gets deep into the tissues, including the muscles.
Similar to deep tissue massage, soft tissue mobilization works like standard massage, but using specialized instruments. Used quite often in physical therapy, it allows for more direct treatment than just using the hands.
IASTM produces good results for large muscle groups as well as smaller, targeted areas.
Angle and pressure in using the instruments help your therapist work on a specific layer of soft tissue during treatment. Often, these are areas where prior injury or long-term overuse has contributed to a build-up of scar tissue that IASTM can help break down.
IASTM is a good choice for many who have soft tissue pain or injury contributing to movement restriction, including:
- Arthritis sufferers
- Workers who perform long-term repetitive tasks or whose job has them on their feet a lot
Read more to find out if you’d be a candidate for IASTM.
To request a consultation for any of our specialty services or ask us questions regarding treatment, fill out our short online form. A member of our team will connect with you directly.
If you’d rather speak with someone personally, call our toll-free scheduling line at (800) 779-6682.
Posted 12/8/2022 | 4 min. read
If you’ve never been to a physical therapist, you may not know some of it’s surprising benefits.
And if you have needed physical therapy (also known as PT) at some point, this article may still hold some surprising considerations.
But first things first. Like the not so subtle calendar to the right.
Yes, it’s that time again, when the old year is about ready to phase into a new one. For many of our readers, the little red circle at the end of the month sounds the alarm for just-oh-how-much still needs to get done.
But give us a few minutes and we’ll give you five reasons for the importance – and benefits – of fitting physical therapy into your end-of-the-year routine to jump start your healthy new year.
Take a minute to assess this past year.
If there’s one fact that we share it’s that we all got older.
Now, we’re not asking you to share your age, but just think about how you’re feeling overall.
Tired? A bit run-down?
Less energy, perhaps, or maybe just not feeling as healthy as you did at the beginning of the year.
As we age, we lose muscle mass and endurance. You may notice new aches and pains or popping – crunchy – noises in your joints. Physical therapy can address all these conditions, and our therapists (aka movement experts) can help with joint pain, arthritis, balance issues and teaching you how to make simple adjustments to your everyday movements to feel better and help prevent aches or an injury.
Physical therapy can be a great way to give your body a tune-up and move more easily.
It’s a big enough reason that there are organizations dedicated to its study. A 2022 “Stress in America” study shows the worsening effects of stress in the U.S. The end-of-the-year holidays can increase stress and anxiety.
Many of our patients come to us with tension in the neck, shoulders and back. These are three main areas where stress can set in and have you feeling unwell.
Physical therapy, especially manual (hands-on) therapy and instrument-guided soft tissue mobilization therapy, can help relieve stress by relaxing muscles and pinpointing treatment to the connective tissue around the muscles.
Our therapists can also give tips for exercise and simple stretches that can do wonders for reducing stress.
Never heard about prehab?
Well, then this may just surprise you. If you’re headed for surgery in the New Year, pre-surgical physical therapy can be a helpful way to prepare now (the “pre”), and help you recover more quickly afterward (the “rehab”).
We see many good results using this approach with joint replacement surgery.
Post-operative studies show prehab leads to better outcomes, including:
- Fewer days in the hospital
- More stamina for physical exercise after discharge
- Getting familiar with therapy equipment – before surgery – that will be used in your rehabilitation
Injury prevention is often a less talked about benefit of physical therapy.
But we place just as much value on learning how to help prevent injury as on how to recover from injury.
Depending on where you live, the change in weather can mean more cold, snow and ice. And that can mean more slips, trips and falls.
But slips, trips and falls can happen in the home too, especially if you’re at a higher risk for falling due to balance issues, like vertigo or dizziness. Or maybe you need help learning to use a new assistive device safely, like a walker.
Physical therapists are familiar with body anatomy and how the body moves – it’s why we call them movement experts.
Their knowledge of a wide range of body parts makes them an excellent source for helping you learn exercises to strengthen and stabilize your muscles. These exercises are meant to help you stay safe and reduce the risk of falling.
For an athlete, sports injury prevention is important, and physical therapy can help with that too. Our physical therapists understand the risks in playing a sport and ways to reduce the most common types of injuries, like stress fractures, ACL tears and concussion.
End-of-year insurance benefits.
For those with a Flexible Spending Account (FSA), this is money that needs to be spent by December 31 each year.
If you haven’t finished your full course of physical therapy sessions (usually between 6 and 10), don’t put it off. This is a great way to focus on your wellbeing during this busy time of year.
Flexible Spending Account (FSA) and Health Saving Account (HSA) monies can be used for physical therapy and co-pays. If you haven’t already been applying your funds toward co-pays, December is the time to start. If you’re unsure about your insurance billing, we can help answer your questions.
And a final bonus benefit!
If you have a spending account balance remaining, you might consider using it to buy products that you use in our centers for your home exercise sessions. Check out the items we have on selectmedical.performancehealth.com and stay healthy and strong into the New Year.
Posted 11/3/2022 | 5 min. read
If you google physical therapy definition you’ll find this short explanation. You’ll even be able to hear how to pronounce it.
the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.
While that’s pretty straight-forward, unpacking this definition reveals much more about this medical practice than a simple definition.
It may surprise you to learn that physical therapy isn’t a new thing. In fact, the roots of modern-day physical therapy go back in time…
Back to ancient Greece and Rome and the early practice of water therapy and massage to help improve movement. Water therapy and massage are still widely used as part of physical therapy treatments.
As its name suggests, physical therapy (PT) had its beginnings in physical, hands-on treatment.
Today’s physical therapy, also called physiotherapy, is still a hands-on practice. But it also includes technology in care delivery, like telerehab care. This lets people work with a therapist over the internet for in-home physical therapy.
Whether hands-on/in-person or web-based, physical therapy is a way to treat movement and mobility issues, without the risk of surgery, and is drug-free.
Physical therapy’s scope and purpose
In practice, physical therapy covers a broad scope of treatment for:
- Joint motion
- Spinal misalignment
- Bone malformation and breaks
- Muscle weakness
- Respiratory dysfunction and endurance
- Joint inflammation and pain
- Limb loss and limb difference
- Cardio-vascular function
- Nerve damage
- Pelvic and bladder dysfunction
- Inner ear disorders
Physical therapy, at its core, treats impairment and functional limitation. Therapists are medical professionals and highly skilled in understanding anatomy and body function. They are also licensed to perform treatment.
Before delivering any services, a therapist will take a thorough history of your condition to understand its severity. Depending on your symptoms, they may also gauge:
- Standing and walking ability
- Skin and muscle tone
- Comfort and fit of orthotics and prosthetics
This consultation helps determine the kind of care and treatment techniques that may be of benefit for healing and recovery.
If physical therapy can help, this is the best time to ask questions and learn more about what your treatment will include.
What might physical therapy treatment look like for you?
Everyone’s body structure is different. As we age, our bodies change.
Pain and discomfort may become less tolerable. Healing may take longer.
Between any two people, pain, discomfort and healing ability are different too.
At RUSH Physical Therapy, we take all of that into consideration. After an initial consult, a treatment plan will be tailored for you. The treatment plan is the guide for what, when and how treatment happens. This is a key factor in the success of your physical therapy experience.
To begin, there’s a time element for physical therapy and getting the best results.
Typically, therapy sessions last from 30-90 minutes.
Sessions are scheduled two to three times per week. Your first session may start right after the initial consult or be scheduled for a different date.
At each session your therapist will assess your progress based on your treatment plan.
Sessions involve physical activity, so it’s important to dress comfortably.
Tip: Wear loose clothing. If you choose to wear exercise gear, be sure that you can roll up your pant legs and sleeves (or wear shorts/t-shirt). This allows your therapist to easily work on your arms and legs.
Your treatment may include the use of a variety of therapy exercise equipment to get the best experience in your sessions:
- Training stairs
- Balance stabilizers
- Recumbent bikes
- Free weights
- Therapy bands
- Parallel bars
- Posture mirrors
Some of these may be unfamiliar at first, but therapists are your partners in learning. They will teach you what the equipment is and what it’s for. They will also explain proper use and the results you can expect.
Some therapy aspects are more familiar like water, ice and heat.
Others may be specialized therapies delivered by therapists with advanced training. Some of the leading techniques:
- Dry needling for pain relief
- IASTM treatment using specialized instruments
- Cupping for relieving soft tissue pain
Your physical therapist may recommend doing some exercises at home. These will be prescribed by your therapist so that they are consistent with your treatment plan. The goal is to keep moving and improving in between one-on-one sessions.
A proactive benefit of physical therapy
Physical therapy is most often done for corrective and rehabilitative reasons.
But physical therapy is moving beyond being just for recovery. It’s now also a preventive practice to help avoid injury.
Athletes and individuals who are active in hobby or league sports may benefit from therapy designed for athletic health.
While a physical therapist may work with athletes, treatment can also be given by certified athletic trainers working with the newest techniques for treating athletes.
A primary focus of athletic health is education on injury prevention. It’s designed to optimize athletic performance, specifically to avoid injury or re-injury.
Preventive therapy crosses into other functional areas. This includes working with people who engage in active, physical or repetitive activities.
Called prehab in some medical circles, here, again, the emphasis is on the proactive side of preventing injury. Prehab uses education and preventive techniques with patients to strengthen muscles and joints used on a regular basis.
Prehab can be especially effective in on-the-job safety to manage work injury risks and with performing artists to help prevent common injuries in their art form.
Physical therapy and its specialty areas have the goal of restoring movement and improving impairment for better quality of life.
This is our goal. If physical therapy sounds right for you, fill out our online Request an appointment form. A member of our team will connect with you to confirm your visit.
Busting the myth that nothing can be done to treat hand and thumb arthritis
- 58+ million adults are affected by arthritis (1 in 4)
- 57% of working adults (18-64 years old) are affected by arthritis
- Arthritis is the leading cause of work disability in the U.S.
- Osteoarthritis (OA) is the most common type of arthritis
As someone who provides care for people with osteoarthritis, my heart sinks at those numbers from the CDC. The sheer number of people impacted by arthritis is disheartening.
And as a hand therapist, I often have people tell me that they are having issues but “know there is nothing that can be done about it.”
Osteoarthritis of the thumb affects the base of the thumb, where the thumb meets the bones at the wrist. Over time, and as we age, the cartilage in this joint breaks down.
Sometimes called "wear and tear" arthritis, OA was once thought of as something that we just have to deal with.
Well, I can say that's no longer the case.
While we can’t change the wear and tear on our cartilage, we can reduce the resulting symptoms.
What are the symptoms of hand and thumb osteoarthritis and what can help?
- Loss of motion
- Loss of function
With a lot of research in recent years, we now understand that OA is more than just cartilage breakdown.
OA also involves the fluid in the joint, as well as the ligaments and the muscles that support the joint.
Age, gender and genetics all play a part in the onset of osteoarthritis. And while there's not much we can do about those, the good news is there are things we can do. These include:
- Reducing extra stress placed on our joints
- Eating healthier
- Doing gentle movement
- Retraining muscles
An easy way to remember what helps reduce arthritis symptoms is a phrase often used by therapists, “Motion is Lotion."
How do I know it's time to do something about my thumb OA?
Because thumb OA usually is a gradual process and the changes are subtle, early symptoms can go unnoticed until you begin having pain or weakness. Increased stress on your joints adds to the factors contributing to what you experience as pain and swelling.
The base of the thumb is a unique joint. It gives us the ability to twist, pinch and grip. With OA, you may have stiffness that prevents pulling your thumb away from your palm.
On the other hand (no pun intended!), weakness causes your thumb to collapse. This makes it hard to twist off a lid, turn on a faucet or pinch buds in the garden.
If you're experiencing limitations in everyday movement, it's probably time to seek expert help.
A therapy program that treats the full spectrum of your symptoms can move you from saying, “Nothing can be done,” to saying, “How come I never knew therapy could be so helpful?”
Hand therapists are specially-trained in treating conditions of the upper limb. This includes the hand and thumb.
This advanced training makes therapists great partners in helping reduce your pain and restore lost function.
What can I expect in working with a hand therapist?
Your first therapy appointment will begin with a thorough evaluation of your hand and abilities.
With that evaluation, you therapist can help you see what's triggering your symptoms and coming up with a treatment plan. The plan will be unique to you and your specific issues.
Thumb arthritis is different for each person, and your treatment plan will reflect that.
Treatments and techniques can include:
- Retraining your muscles to provide stability when you pinch
- Hands-on techniques to improve motion and reduce pain
- Changing how you do what you do – modifying behavior
This last one can be one of the more challenging aspects of managing your OA. But it’s critical in reducing stress on your involved joints.
Everything you and your therapist do has the goal of getting back as much natural range of motion as possible.
Therapy for thumb OA is designed to help you “work smarter, not harder.”
Therapists may introduce adaptive equipment or assistive devices into your care as well.
While those words may sound a bit "techy," the items themselves are quite simple but can lend a helping hand (again with the puns!) with your day-to-day tasks.
Some everyday items to make things easier include:
- Using a wider pen for easier gripping
- Using a jar opener instead of your hands
- Using a coffee mug with a wide handle so all four fingers fit under the handle.
I’ve found that changing the tools used for gardening helps protect my joints but still lets me enjoy digging in the dirt.
Spring handled shears reduce stress on the hand.
Ergonomic gardening tools reduce stress on larger joints.
You may benefit, too, from the short-term use of orthoses (braces or splints) in treating your thumb arthritis. This will keep the thumb in a neutral position and ease pressure on the joint while doing tasks that may trigger pain or discomfort.
Structurally, the thumb is designed like a column and under pressure if the muscles are not strong your thumb will “collapse."
A collapsing thumb reduces the strength to do pinching movements.
Just as we learn to use our core muscles when lifting, we can re-learn how to use muscles that stabilize the thumb column to perform grip and pinch motions.
Thumb collapse during pinch due to weakness and too much joint mobility.
Motor retraining can help correct the collapse.
Relearning how to use your muscles results in a stable strong pinch.
As you progress in therapy you will relearn how to use your muscles in a stable way.
The more you know, the faster you can dismiss the myth that there's nothing to be done about treating OA.
Admittedly, I initially thought this 15 years ago when I developed early signs of thumb arthritis.
Thankfully, we stand on the shoulders of giants who have done research to show the effectiveness of therapy.
I now use joint protection strategies and adaptive equipment. I use my “feel good” exercises when needed and my brace regularly. It has allowed me to continue the things in life I so love – cooking, gardening, mountain biking and working as a hand therapist.
Arthritis is a common condition.
While it's not preventable, you can take steps to help protect your joints to reduce the risk of further injury and discomfort.
Take a quick assessment of the following:
- Change in the appearance of your thumbs
- Pain or aching at base of thumb
- Loss of motion, stiffness or weakness while doing activities, especially when you pinch
If you notice a change in any of these, know that there is treatment to help you.
Talk with your doctor or click the blue button above to request a consultation with one of our therapists. Ask about our arthritis program and get started with your personalized treatment plan.
Article courtesy of Molly Hudson, O.T., CHT, COMT-UE, Hand Therapy Program Coordinator Houston, TX.
Posted on: 9/20/2022
How to easily fix bad habits and ace backpack injuries prevention
If you're old enough to remember book bags, you know they've long been replaced by backpacks.
From the littles to the not-so, each category of kid wears their backpack like another piece of clothing. Color, creativity and the right amount of cool factor all go into making the choice, whether for school, sports or sleepovers.
But that choice can also create risks to kids' health and safety, if not done with some thought.
Things to keep in mind:
- The width of the pack should be about the same as the wearer.
- Length should be no longer than the torso (central part of the body) and not hang more than four inches below the waist.
- The weight of what gets loaded into backpacks increases as books, sports equipment and the number and types of electronic devices increase.
If you've seen your child twist and contort as they hoist or sling a backpack over their shoulder racing out the door, the following shouldn't surprise you.
Each year, an estimated 14,000 children need treatment for backpack-related injuries... while from 2019-2020 an estimated 1,200 kids ended up in the ER for the same.
Here's where that statistic gets interesting and why backpack safety is so important.
There’s growing awareness on this topic over the last few years that’s making a positive impact. The result is that numbers for backpack ER visits have gone down.
From the same source noted above, in 2013 the annual average for kids under 19 being seen in the ER was 5,000.
Going from 5,000 to 1,200 is a big deal (cue happy dance music!).
So, let’s keep it going.
Here's a basic three-step guide to follow for any age backpack wearer. Watch our video for a quick summary to see it in action. Then see the steps below for more information.
Since the objective is to keep the backpack light, choose one that has sturdy compartments but is lightweight.
As you load, distribute by weight, the right way. Put heavy items on the bottom and in the rear compartment (the side that will be against the back) and lighter items in the front compartment. This helps keep weight off the shoulders.
Like unloading luggage after a road trip, proper lifting is key to backpack safety.
Bend at the knees before lifting -- both knees. Then grab the pack with both hands before lifting it to the shoulders.
Once lifted, both straps should be worn. No single-shoulder slinging!
Using just one strap causes a lean to the side and may cause the spine to curve.
Check the bag as your child grows, especially for those in growth spurts.
Whatever your child's age or size, teach them how to wear a backpack correctly and to know their carry limit.
A loaded backpack should not be more than 10-15% of their body weight. For example, if a child weighs 50 pounds, the backpack should not weigh more than 7.5 pounds.
These tips can help fix bad habits and prevent backpack injuries. But if your child has shoulder soreness, pain or tingling in arms, hands or fingers, we can help. Physical therapy can help strengthen muscles used for lifting and carrying and relieve symptoms.
Click the blue "Request an appointment" button. Most states do not require a doctor's prescription for physical therapy.
For a deeper dive into backpack safety, other considerations when choosing a backpack and creating a "shoulder shadow," check out these safety tips by Anne Marie Muto, OTR/L, CHT.
Originally posted on 4/19/2021; updated 9/16/2022
Why they happen and what to do about it
Compared to many sports, baseball is known for its slower pace and long duration.
Despite the less than hard-hitting action of a football game, baseball can place a lot of strain on the body.
And although typically a low-intensity sport, the repetitive movement in playing baseball can lead to annoying at best and critical at worst overuse injuries.
These days an MLB pitcher, for example, throws about 95 pitches per game. In comparison, an official Little League pitch count for ages 9-10 is 75 pitches.
That’s a lot of pitches in a year!
Position players, too, get their share of high volume throwing, plus hitting and base running. Game after game, this adds up to lots of repetition.
So, despite its slower pace, baseball takes a toll on the body – upper and lower body.
Let's take a look at some of the most common baseball injuries due to overuse.
Rotator cuff tears
Rotator cuff tears are prevalent in baseball, especially with players who do a lot of high-speed throwing, like pitchers.
The rotator cuff is made up of four muscles that work together to help rotate your shoulder and arm away from and toward the body. Think of a hinge. The cuff is the part that sits at the top of the shoulder.
The act of pitching over and over, game after game, season after season can wear down the tendons that attach the muscles. This leads to a breakdown in the shoulder's movement, which can lead to muscle tearing.
If diagnosed before a tear, this injury can be helped with physical therapy. But if the muscle is fully torn, surgery will likely be needed.
There's a ligament on the inside of the elbow called the ulnar collateral ligament, UCL for short. This is a stabilizing ligament and the one most commonly injured of the various elbow ligaments.
Known in sports circles as the Tommy John ligament, this little ligament can take a beating with the stress that throwing places on it. And there’s an alarming number of young athletes we’re treating for UCL injuries.
Inner elbow pain is one of the tell-tale symptoms that something's not right. It may have a "pins and needles" type of feeling in the ring and pinky fingers, which can impact an athlete's grip on the ball.
Most cases can be fixed with rest and physical therapy.
However, full and partial tears of the UCL may require reconstructive surgery (Tommy John Surgery), as for pitching namesake Tommy John.
This is another injury that impacts the shoulder.
The labrum is a rubbery, flexible tissue that helps keep the shoulder socket tight. Picture a gasket that seals the space between two adjoining items. But because it is a soft tissue, it can tear.
In baseball, this type of tear can be caused by the overuse with repeated motion. This injury typically presents with the shoulder joint locking up or weakness of the shoulder.
A labral tear is typically confirmed by a doctor. Depending on severity, it can be either repaired surgically or helped with professional physical therapy and time off the field to recover.
Although less common than with higher-intensity sports, like basketball and football, knee injuries are part of baseball.
They happen most with base running. The sudden stopping, sliding and quick pivots in direction can cause a player's knee to give out.
Sprains and tears of the ligaments supporting the knee are painful.
One of the most devastating lower body injuries is an ACL tear. Injury to this ligament typically happens with sudden, excruciating pain and the sensation of popping or cracking in the knee.
Similar to UCL injuries, an ACL injury can sometimes be healed with specialized physical therapy and rest. But in cases of a fully torn ACL, surgery will likely sideline play for a few months.
Muscle sprains and strains
Like the other baseball injuries we've covered here, muscle sprains and strains are a biggie.
These types of injuries are common in the legs, arms and back.
Symptoms will vary based on the player and the seriousness of the injury, but typical symptoms include:
- muscle spasms
They may also include bruising and swelling.
It's rare for these to require surgery. Professional physical therapy and the RICE method (rest, ice, compression, elevation) are effective.
With sports injuries like we've covered here, a common theme is that working with a physical therapist can help with healing.
Physical therapy can also help with pre- and post-surgical intervention if necessary.
If you have an injury, you can get an injury screening at one of our centers. A personalized treatment and exercise plan with a licensed physical therapist will help get you back to your sport. Click the Contact Us button below to find a location and request an appointment.
Posted on 9/14/2022
RUSH Physical Therapy’s Joshua James, DPT, CSCS, recently joined Dr. Brian Cole, orthopedic sports medicine surgeon, and Steve Kashul, host of Chicago Bulls Basketball, on Sports Medicine Weekly to discuss high ankle sprains, including how they are diagnosed and the best treatments to help athletes recover. Check it out!
More information can also be found at sportsmedicineweekly.com.
Posted on 9/9/2022
One of the myths about concussion is that it takes a big blow to the head to get one.
A second is that getting your “bell rung” or “seeing stars” isn’t a big deal.
They’re just that. Myths.
The fact is any impact to the head, neck or body has the potential to cause a concussion. In turn that can temporarily shift the neurological function of the brain.
While a hit to the head during a high-intensity football game or from a car accident can result in concussion, less intense trauma can do the same.
In my years of practice, I’ve seen people with significant concussion symptoms from a slip and fall on ice. And from accidental encounters with a cabinet door to taking an elbow to the head.
And from luggage falling out of the overhead bin. There’s a reason for those cautionary announcements when the plane lands.
I see patients suffering from motor vehicle collisions who never even hit their head, and I see athletes who can’t pinpoint a specific hit. Yet they showed concussion symptoms after the accident or game.
A third common myth: concussion requires a loss of consciousness.
A loss of consciousness is not the norm. Losing consciousness happens in less than 10% of concussion cases.
Concussion: an invisible condition
What makes concussion more complicated is its invisible nature.
Unlike a cut or broken bone where you can see physical trauma, concussion can often go unseen.
So you need to look for common symptoms:
- Foggy or difficulty thinking
- Blurred or double vision
- Sensitivity to light or sound
- Changes in sleep patterns
- Increases in anxiety and irritability
Any of these symptoms can significantly impact your ability to function. They could also indicate a deeper type of trauma.
It’s critical that if you experience one or more of them, tell someone and get checked out by a medical professional.
Concussion PT: return to sport and return to life
As physical therapy specialists, our job is to promote awareness and education across the many types of health conditions our patients come to us for.
Patients sometimes come to us for physical therapy from a doctor’s recommendation after medical treatment. Or they may come to us of their own accord.
In either case, we’ve seen that starting physical therapy early can be hugely beneficial in a successful recovery.
An important first step is recognizing any of the symptoms listed above that could be connected to a physical impact, even if it seemed like “just a bump” on the head.
Despite how or when someone sustained a concussion, the current recommendation to help is an active treatment and rehabilitation program. Our concussion rehabilitation clinicians will do an assessment to develop a care plan unique to each person and case.
In the past, the primary treatment for concussion was total rest, sometimes called “cocooning.”
More recent findings show that after an initial 24-48 hours of rest, a combination of carefully prescribed physical and mental activity is better than total rest. That doesn’t mean, though, that you should go full force into your previous activities.
Rather, as long as you have lingering symptoms post-concussion, the care plan set for you can help guide your activity until fully healthy, safe and ready to safely return to your sport or normal symptom-free life.
So, what are some common concussion rehabilitation treatments?
Visual exercises can help when symptoms are due, in part, to the eyes not communicating well with each other and the brain. These exercises can help increase visual clarity due to the eyes working inefficiently. This may involve doing simple eye movements or complicated tasks of watching a busy scene with many moving items.
Vestibular rehabilitation is used when the inner ears are involved. The inner ears control balance and keep us oriented to the space around us. Treatment can be varied but typically involves head or body movement activities. You may initially feel dizzier with these exercises, but they are effective in eliminating symptoms in the end.
Neck treatments can address any neck pain or the many symptoms that can impact the neck after concussion. Sometimes after an injury, the nerves in the neck stop communicating well with the brain. This can lead to a sense of fogginess, dizziness, unbalance or headaches. Specific exercises can retrain these nerves and, in turn, clear up remaining symptoms.
Sub-symptom exertion training is frequently recommended post-concussion. This training is designed specifically based on a heart rate that would increase your symptoms. In basic terms, it’s a way to set a safe exercise program to help gradually return you to pre-concussion activity levels. For athletes, this can be one of the first steps of a Return to Play protocol.
Balance and functional training may be part of your full rehabilitation program. This training is used to restore/maintain strength, balance and walking safety.
Concussion prevention and one last myth
Unfortunately, there’s not a lot to be done in preventing concussion.
Protective equipment, such as helmets or mouth guards, may protect against other serious injuries but can’t prevent a concussion.
They are important in preventing skull or jaw fractures or cerebral bleeding, but their limitation in concussion protection is an all too common misconception.
In fact, using equipment can lend a false sense in thinking it can prevent concussion.
The best approach is being vigilant about injuries and any post-injury symptoms.
Early recognition of concussion can lead to faster recovery. Knowing what to look for and awareness of the myths surrounding concussion can help protect against a delayed recovery. A concussion isn’t less impactful just because it didn’t knock you out or have you seeing stars.
Lastly, always take the important steps for recovery. Many people will recover on their own. But if you or someone you know have lingering symptoms, we can help.
You can quickly find a center near you or request an appointment by clicking the buttons below.
Melissa Bloom, P.T., DPT, NCS, is a board-certified specialist in neurologic physical therapy. She is Select Medical’s Outpatient Division's national coordinator of concussion and vestibular services and treats patients at NovaCare Rehabilitation in Baltimore, MD. Melissa has served as a board member on the American Physical Therapy Association's Vestibular Specialist Interest Group and as the Chair of the Georgia Neurologic Special Interest Group. She specializes in vestibular and concussion rehabilitation and has lectured nationally on both topics.
NovaCare Rehabilitation and RUSH Physical Therapy are part of the Select Medical Outpatient Division family of brands.
Posted on 8/15/2021
How tearing my ACL made me better on and off the field
As an avid soccer player and athlete, I’m intrigued by sports stats. Like this one:
Each year in the U.S., between 20,000 to 80,000 female athletes sustain an ACL injury. Most of them in playing soccer and basketball.
To me, that’s a scary statistic.
But it was the last thing on my mind as a 15-year-old competitive soccer player in 2017.
Back then, I only cared about getting to play college soccer at the highest level.
I had a plan!
- Get recruited.
- Play soccer at a high level
- Figure out everything else later.
I didn’t care where the school was or what I studied, because I had a plan – my Plan A. My plan told me I didn’t need to worry about anything else. If it was outside of playing soccer, it fell into the category of “figure out everything else later.”
I felt good about my plan.
Nothing could get in the way of me and Plan A.
That was the sound that came from my knee during a high school game that year.
I got hit while dribbling down the field.
All of a sudden I became one of those statistics. And I was in the worst pain I’ve ever been in.
In an instant, everything changed.
ACL spells agony… and (eventually) accomplishment
I tore my ACL completely.
I needed surgery, to be followed by physical therapy… for nine months.
No soccer for nine months? In my mind, my life had just ended.
I had surgery a few weeks later and wondered if I would be the same player as before my injury.
There’s a reason they say ‘never Google your injury or illness.’ My brain was filled with more statistics and stories of players who never returned and players who experience an ACL re-tear soon after returning to their sport.
After looking online, I wasn’t hopeful.
ACL rehab took the place of soccer. I went two and three times a week.
Without practice, I had extra time on my hands. I filled it with thoughts about how much my life sucked. I was in a dark space mentally and emotionally and didn’t know how to get out of it. A good friend noticed and invited me to go to yearbook club with her. With nothing else to do, I went.
It opened my eyes to the possibility of enjoying something unrelated to sports.
I saw fellow students writing stories and designing pages for the yearbook. I heard the buzz of enthusiasm as they worked as a team. Each person doing their part to create a representation of our school.
I realized for the first time since I tore my ACL that I wasn’t thinking about it. I wasn’t thinking about soccer, either. I was happy.
I went again the next week.
For months, as I continued to heal from my ACL injury, I was an honorary member of the yearbook team. I was also working hard at physical therapy.
One of my teachers, and yearbook advisor, saw my work and recommended Communications as a possible college major. I put my focus into that.
Without realizing it, I’d found my Plan B:
- Study Communications in college.
- Find a school I liked (location, size and culture).
- Figure out everything else later.
Finally, the nine months were over.
I was released from physical therapy with no restrictions.
But I still had a lot of emotions going on. Many less-than-confident thoughts in my head.
It was time to play soccer again.
I was terrified to step on the field.
Coming back was not easy.
It took me another six months to feel comfortable in the game. I was out of shape, and my knee hurt every day.
I stuck it through and with hard work – just like I did in PT – (and muscle memory), things did start to come back.
While my teammates were getting recruited, I was still trying to fall back in love with soccer. Things had changed a bit. I was comfortable with my Plan B.
I found a school that checked all my Plan B boxes. I set my sights on going there, with or without soccer. Because, in Plan B, soccer now fell into the category of “figure out everything else later.”
Turns out the school also had a pretty good women’s soccer team, and they were doing an identification camp (an opportunity to get recruited).
Jeena working the ball in the United Soccer League game.
I went to camp, but with a different mindset than previous camps.
The old soccer me had gone into camps feeling nauseous and panicked by stress. This time I was pretty chill.
It was one of my best performances at a camp.
Fast forward, now five years later, and I am a rising junior, studying Communications at Thomas Jefferson University. I’ve won two conference championships and made a National Collegiate Athletic Association tournament appearance.
I’m one of three captains, and looking to win my third championship and the team’s fourth consecutive title.
I also completed my first season in the United Soccer League (USLW), a pre-professional women’s soccer league.
I’m currently living out what I now call my Plan A/B:
- Playing soccer at a high level.
- Studying Communications at a school I love.
- Figuring out everything else… later.
Before surgery, I wondered if I’d be the same player after. I don’t have to wonder anymore. I am not the same player I was before I tore my ACL.
I am a better one.
Faster, smarter and better on the ball.
The ACL recovery process is a long and painful one. It can be overwhelming.
But if injury recovery is ever in your path, you have more control than you might think.
I learned things about myself I never would have known if I didn’t take time away from soccer.
My ACL tear gave me more than it took from me because I refused to let that happen.
Our individual experiences will be different, for sure. What I can tell you from my experience, though, is that no one else can do it for you. Your physical therapy will be a critical part of recovery. You’ll be part of a team – working with professional therapists who will be rooting for you.
You don’t have to give up on your Plan A… you might just need to adjust it.
Jeena Pressley completed her 2022 summer intern program with Select Medical in the Communications and Branding Department. She is a student-athlete at Thomas Jefferson University studying Communications. Her return to campus as a junior captain for her soccer team will see her on the field looking to defend her team’s CACC Champion title.
Originally posted on 7/22/2021; updated 8/1/2022
You've heard the phrase, “You are what you eat.” That to be healthy, you need to feed your body well.
A similar idea for golfers might be, “You are how you train.”
In golf, the way you move is important. Not just for being able to hit the ball, but in how your body functions when you do.
In particular, golfers undergo some of the quickest changes in body movement of any sport.
Precision is key.
Golfers are in the category of “rotational athletes” – those who need to twist the torso in playing their sport.
Rotational athletes move their bodies through high velocity motions. These motions put increased stress on the body’s major joints, in particular the spine, and through the hips.
This stress puts increased strain on the entire body.
Being aware in how to rotate correctly can help decrease your chances of injury during play.
Hooray! More tee times!
But it can also benefit you off the course so you can move in a pain-free manner in your daily activities.
Anatomy of golf
Our bodies are comprised of a system of joints. There are two types – stable and mobile. Each plays a role in body movement; each has levels of stability and mobility. In the golf swing, certain joints should have a core function, either stability or mobility, but not both.
In a high-velocity movement, like a golf swing, you need both types of joints to be tip-top in performance. If either is subpar, the other must compensate. And that’s when injuries can happen.
For golfers, lower back injuries are a biggie.
In this case, the stable joint is the lower back (lumbar spine). Without the right preparation to open the core to support the lumbar spine and increase spine/hip movement before cranking that backswing, you risk playing badly at best and hurting yourself at worst.
The good news is that you can prevent both by taking the time to stretch.
Stretching is a key component in any sport, but it is often overlooked or disregarded. Stretching key muscle groups can improve movement and your game.
We’ve put together a list of stretches that work from the top of your head to the tips of your toes.
Read on. Then take the time for a good overall stretch before your next round of golf to lessen neck strains, shoulder injuries and back spasms.
Neck flexes and rotations
To loosen up, increase range of motion and help keep your eye on the ball during your swing.
- Curl your chin to your chest until you feel a slight stretch in the back of your neck.
- Slowly rotate your head side-to-side in small motions.
To loosen up and get more fluid in your backswing and follow through.
- Put your club behind your shoulders, resting your hands at both ends.
- Crouch in a golf stance.
- Slowly turn your shoulders back and forth 8 – 10 times
Two-part lumbar spine stretch
To help your body more fully rotate and increase mobility of the upper and middle part of the back to improve your swing and prevent injury.
This is a super effective stretch! But we get it if you choose to do it at home before loading the clubs in the car.
- Start by laying on your side and stack your hips with knees bent.
- Extend one hand toward the ceiling. Use your other hand to hold your knees if you feel like they're coming off the ground.
- Slowly lower your arm and turn your neck to look toward it.
- Try to bring your shoulder to the floor.
- Breathe through the stretch – feel it in the middle of your back. Repeat on the opposite side.
To help your hips move freely and efficiently in the backswing and follow-through. To increase hip movement so you don’t put too much weight on the back leg at impact and pull off early, hooking the ball.
- Stand and, with a straight leg, make several small circles in a clockwise motion.
- Do the same with a counter-clockwise motion.
- Repeat with other leg.
Golf is an amazing sport, but to play or compete pain-free you need to learn (or relearn!) how to move correctly.
Good movement helps decrease stress on your body, avoid injuries and enjoy the game more.
Just remember to stretch first, then swing.
Who knows? Adding regular stretching before you hit the driving range or the greens may even add a few more yards to your drive, and without that wicked slice.
If you’re having pain when you play or recovering from a golf injury, come talk with one of our physical therapists.
We offer a complimentary consultation to assess your condition and can do an assessment of your readiness to return to play. Click below to find a nearby location or request an appointment.