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.
Extra! Extra! Exciting news alert!
We recently rolled out centers that offer dedicated, sports-specific care to athletes – centers of excellence.
Select Sports, our nationally recognized sports medicine program, is a comprehensive, industry-leading program that was developed to meet the physical demands of competitive and recreational athletes.
The Select Sports Center of Excellence (COE) designation conveys the highest quality in sports physical therapy.
These locations are provided with the opportunity to deliver superior sports medicine rehabilitation and performance enhancement to athletes of all ages and abilities.
As a Select Sports Center of Excellence, our centers went through a comprehensive application process to meet specific criteria and determine this exclusive designation. This includes:
- Having a sports medicine physical therapist on staff who has more than five years of experience and participates in ongoing monthly training.
- Offering the latest vetted technology for rehabilitation and athletic performance as well as safe, reliable equipment known to get the best outcomes.
- Partnering with key local sports medicine physicians.
- Showcasing a positive and motivated space to help athletes heal with like-minded individuals.
We understand an athlete’s mindset and physical demands and are committed to helping them heal, return to activity and meet – or exceed – goals.
If you, a loved one or a friend are competing at an elite level or simply want to retain an active lifestyle, trust our expert Select Sports Center of Excellence clinical team to treat the athlete you are today and help you become the athlete you want to be tomorrow.
Find a Select Sports COE near you and request an appointment today to begin progressing toward athletic excellence!
How to drive away aches and pains on your summer road trip or any long drive
Ah! Summer vacation.
Ugh! Summer vacation driving.
Destination driving vacations are a staple of American culture. But long hours spent crammed into a car can wreak havoc on your body before vacation even begins.
As the miles go by, an aching back, a crick in your neck or tense shoulders can put the brakes on feeling good by the time you arrive.
If you're shaking your head in agreement (or dread!), relax.
We’ve mapped out some quick tips to make your road trip more comfortable.
Plan stop-and-stretch breaks
You planned out your vacation, right? So it makes sense to plan breaks from the slog of driving or sitting for hours on end.
Stop hourly or every hour and a half – even if it’s just for five minutes. Park away from entrances to rest stops and eating places to get in some light walking. Before climbing back into the car, stretch your hamstrings.
Focus on your posture
Don't slouch. Use a rolled-up towel or foam roller and place it at your lumbar area (low back) between you and the seat for more comfort.
If you can spare a pool noodle, get creative and cut it in half. One for you and one for your passenger – two birds, one stone.
Set your car seat properly
This might sound trivial, but adjusting your seat reduces excess strain on the shoulders and neck. Here's how:
- Sit all the way back in your seat.
- Extend your forearm over the steering wheel.
- The wheel should be at about your wrist when positioned correctly.
Pay attention when unloading the car
When you finally arrive and begin unpacking, practice safe lifting, especially with items that have been unloaded on the ground.
- Don’t bend forward. Bend your hips and knees, like you’re doing a squat to pick up bulky items.
- Keep luggage and bulky items close to your body/mid-section, then straighten to lift.
- Distribute the weight evenly between both hands/arms to decrease stress on your neck, shoulders and back.
- Don't overdo it! An extra trip back to the car can prevent injury.
Bonus safety tips for driving!
While driving, don’t use mobile devices. The distraction of calls and texts isn't worth an accident.
If it is music you're craving, let one of your passengers play DJ to keep the tunes rolling while you roll along.
Stay alert. Roll down the windows now and then, even with the AC on, to get some fresh air and a breeze.
Safe driving, and enjoy your road trip or well-deserved vacation!
We’ll leave you with this parting line from Clark Griswold in the American classic National Lampoon’s Vacation. “Why aren't we flying? Because getting there is half the fun. You know that!”
By: Brett Sanders, M.S., OTR/L, CEAS, regional manager for Select Medical’s WorkStrategies Program. Brett is the ergonomics product manager and account manager for American Airlines. He has been an occupational therapist for more than 25 years specializing in reducing employers’ workers’ compensation injuries. WorkStrategies is a product of Select Medical’s Outpatient Division family of brands.
Basketball is one of the most popular sports in America, especially among kids and young adults.
From March Madness to the NBA finals, people love watching and playing basketball.
The love for playing the game doesn’t come without the risk of injury, though.
Whether played recreationally or in an organized league, injuries happen, even with the pros.
2022 saw the beginning of the end of careers for several powerhouse players. Injury and overuse forced them off the court and into retirement.Some injuries, like knee injuries, are more common than others. They typically involve the lower body.
Here we’ve ranked the five most common types in basketball:
Nearly half of all basketball-related injuries involve the ankle and foot. From “rolling” an ankle, to landing awkwardly, to getting stepped on, playing basketball leaves athletes open to injury.
A standard treatment for ankle injuries, specifically ankle sprains, often centers around a method remembered by the acronym RICE:
Most injuries can be treated without a trip to the doctor’s office with this practice. But if you have the following symptoms, a trip to urgent care might be better:
- Pain directly on top of the outside bone of your foot
- Inability to walk a couple steps
Physical therapy could be helpful, too, depending on the severity of the sprain.
Typically, with the right rehab plan, an athlete can be back in their sport in two-to-six weeks.
Getting a knee to the thigh can be one of the worst pains for a basketball player.
Because of this, more athletes are wearing compression garments with thigh padding. If hit hard enough in the thigh by an opposing player, the muscle can tighten up and bruise.
Typically, an athlete can play through bruising. But some deep tissue massage by a licensed therapist is helpful to loosen up the muscle.
Treatments for a thigh bruise might include:
- ICE: ice, compression and elevation
If you watch or play basketball with any regularity, this one is not surprise.
The three biggies include:
- Anterior cruciate ligament (ACL): ACL injuries are the most talked about of the knee injuries. The ACL is one of the bands of ligaments connecting the thigh bone to the shin bone at the knee.
Injury can range from a tiny tear to a significant tear. A bad tear, separating from the bone, generally requires surgery and months of physical therapy for return to play.
Go in-depth with our article on three ways to prevent ACL injury.
- Meniscus: The meniscus is the little brother of the ACL. Every knee has two, and often they are injured along with the ACL.
A meniscus is one of two rubber-like wedge-shaped cushions for each knee joint. Without them, the thigh bones would sit directly on top of the lower leg bones. Over time, this bone on bone condition causes pain as th bones rub together.
Treatment for meniscus injuries depends on the level of injury. It can vary from ICE, which we talked about above, to surgery and physical therapy, to just physical therapy.
- Patella tendon: Patella tendonitis – jumper’s knee – is a result of inflammation of the patella tendon which connects your kneecap to your shin bone.
Jumper’s knee can often be healed with customized exercise guided by a physical therapist. Here, too, the RICE method, with emphasis on the “R”, is quite effective.
Jammed fingers are exceptionally common (and painful!). They often occur when the finger, fully extended, hits the ball “head on” without bending.
This kind of finger jam can lead to immediate pain then swelling.
Although uncomfortable, this injury isn’t considered serious.
Jammed fingers typically heal without medical intervention or the need for a trip to the emergency room.
Buddy taping (taping the finger to the finger next to it) and icing can help you heal in as little as a week.
But if pain or swelling persists, a consult with your doctor or a physical therapist can determine if there’s something else in play.
Concussions make up about 15% of all sport-related injuries, not just basketball.
A concussion is a brain injury that occurs with a physical impact to the head or neck, like whiplash.
Most sports-related concussions can be managed by either an athletic trainer individual or in tandem with a physical therapist. Athletic trainers may also work in combination with a doctor and other health care professionals.
In basketball, a few examples of when concussion can occur:
- An athlete hits their head on the hard gym floor
- Head-to-head contact between two players
- Head-to-elbow contact
- Head-to-shoulder contact
- Any collision involving the head
When concussion is diagnosed, the athlete is unable to return to play for a period of time. This can be a 5- or 7-day waiting period, or until the treating health professional gives approval.
Concussion recovery can go slowly if symptoms linger. When this occurs, supervision by the health care provider is key for successful healing.
Working with a licensed physical therapist can help with the recovery of nearly all of these injuries.
Think you may have one of these, or another type of sports injury? Click the blue Request An Appointment button to find a physical therapy center near you.
We offer complimentary consultations so you can get back on the court.
By: Wyneisha Mason, MAT, ATC. ‘Neisha is an athletic trainer with RUSH Physical Therapy in Chicago, Illinois.
RUSH and RUSH Physical Therapy are part of the Select Medical Outpatient Division family of brands.
Running can be a real rush – a bit euphoric, even!
The health benefits of a good run – long-distance or short runs – do the heart and mind good. That rush – a “runner’s high” – can give you a boost in mood and sense of accomplishment
For race runners, nothing beats that “mission accomplished” feeling after putting in the work and crossing the finish line.
If you run for health or sport, race running might seem like a lofty goal or dream. You can see the finish line banner in your head but then…
But with the right planning and commitment, it’s totally doable!
Our work with runners of all athletic levels gives us a competitive edge in helping keep them safe and running. We can help you, too.
It starts with some basic but important need-to-knows.
In this article we break them down into a series of four S’s of safe marathon training:
- Stress injury prevention
- Standards of progress
- Strength training
- Shoe (yes, shoes!)
If you’ve been thinking about pushing to a next level and running your first half-marathon, read on!
Stress injuries that can stop you in your tracks
Injuries to feet, ankles and legs are common for runners.
If you run on a regular basis, it’s likely you’ll have an injury at some point.
The most common are repetitive stress injuries (RSIs). They’re also called repetitive overuse injuries or repetitive strain injuries.
80% of running injuries are overuse, repetitive stress injuries.
~ PubMed Central (PMC), Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences
These happen with movement that’s repeated over and over.
Think about the act of running and your feet hitting the ground.
The constant slap-slapping of shoes on pavement or other hard surfaces. Muscles pulling on bone to propel you forward. All of this works together to make our bones and tendons stronger.
Now add to that any increases in your running distance as you train. This pushes your body past the point of comfort; each bit more adding more stress to tendons and bones. The intensity stimulates collagen growth – the protein that helps joints flex and absorb impact.
But add too much stress and the body can’t adapt quickly enough. The force of running and the extra miles is too much for the bones, tendons and joints and you can end up with micro-fractures or tears.
RSIs include other injuries too, some higher in the Ouch! factor than others. But any of them can all take a runner off course.
Not surprisingly, the knees, legs and feet take the top positions for injury to body parts from running.
Looking at the injuries themselves, RSIs include:
- Sprains - overstretched ligament with pain, swelling or bruising
- Stress fractures - hairline cracks in bone with bruising or tenderness
- Shin splints - pain in front of inner part of lower leg near shin bone
- Plantar fasciitis - pain under heel or bottom of foot
- Achilles tendinitis - inflammation of the tendon connecting calf muscle to heel
These injuries can take weeks of rest to heal, bringing your training runs to a screeching halt.
So slow your training down a bit. Giving yourself a few more weeks to train before adding to your weekly mileage can be the difference to successfully reaching your goal.
Let’s talk about how to do that.
Stress injury prevention that keeps you in running shape
Let’s look at a study.
Okay, maybe a study doesn’t sound fun…
But stick with us here.
We use them because the research helps us be better care providers. Research finds new ways to treat and prevent injury. That means we can better support your training or treat your condition or injury.
A study of risk factors of lower extremity running injuries (van Gent et al.) estimated that 60% of running injuries were attributed to preventable training mistakes. In half these cases, the mistake was excessive mileage.
Breaking that down a bit and it’s all about your training.
That may have you asking, How should I progress my mileage?
Standard of progress for safely increasing you running distance
There’s a rule for how to increase your running distance (we like rules!).
The 10% rule is the most cited standard to progress running distance.
It allows for increasing distance at a rate that gives your body time to adapt to the added stress.
Runners can do this two ways:
- Increase weekly mileage
- Increase total minutes by 10% week over week
Here’s how it looks.
Week 1: Distance - Run three 3-mile runs (a total of 9 miles). Week 2 run two 3-mile runs and one 4-mile run (a total of 10 miles).
Here’s an example using minutes.
Week 1: Time - Start with run/walk interval training. Run 20 minutes out of a 30-minute workout. Week 2 increase to 22 out of the 30 minutes.
That said, we work with runners individually. We want to learn about their experience and where they are in their running program and training.
It’s a partnership we build with you to reach your ideal parameters for getting to your distance goals. That includes injury prevention.
While it may not be as simple as applying the 10% rule to all runners, it’s a good place to start for an experienced runner.
We’ve created this chart for training with your sports medicine specialist or physical therapist. Click to download a copy of the training chart.
10-Week Half Marathon Training Program:
Sun Mon Tues Wed Thurs Fri Sat Total Miles Week 1 Rest 3 Strength 3 Strength Rest 3 9 Week 2 Rest 3 Strength 3 Strength Rest 4 10 Week 3 Rest 3 Strength 3 Strength Rest 5 11 Week 4 Rest 4 Strength 3 Strength Rest 6 13 Week 5 Rest 4 Strength 3 Strength Rest 7 14 Week 6 Rest 5 Strength 4 Strength Rest 6 15 Week 7 Rest 5 Strength 3 Strength Rest 8 16 Week 8 Rest 4 Strength 3 Strength Rest 10 17 Week 9 Rest 4 Strength 4 Strength Rest 11 19 Week 10 Rest 3 Strength 3 Strength Rest Race day (13.1) 19.1
This 10-week schedule roughly follows the 10% rule. It’s a good plan for the runner who can already run a 5k distance at the start of training.
Scheduling rest days in your training gives your bones, muscles and tendons time to recover.
How should I focus my strength training?
Runners only have one foot on the ground at any time. That means you are constantly having to balance on one leg.
This is important for how the ankles and hips work while running. These body parts need to make quick adjustments to maintain balance and have both legs share the shift in your weight evenly.
Your training plan will benefit from working with your therapist’s single-leg balance and strengthening exercises in your workouts.
- Single-leg heel raises
- Single-leg squats
- Single-leg bridges
- Single-leg Romanian deadlifts
If the shoe fits
You’ve heard the phrase. But for the runner, the wrong size and fit can start all sorts of problems.
The running community has lots to say about footwear, and which type is best for preventing injury.
Some advocate for shoes with cushion and support. Others for barefoot running.
There’s research on both.
One study had Marines in basic training wear different shoes based on the arches of their feet. Each arch type – low, medium, high – got a different type of shoe.
The results, when compared to a control group who wore only one type of shoe, regardless of their arch type, showed no difference in injury between the groups. Now, if you like research, like we do, check out the full article on the Marine Corps shoe study.
The concept of barefoot running is based on the theory that, well…barefoot is best. The jury is still out on this one.
There’s also the argument that wearing shoes changes the way we run. Barefoot enthusiasts say that the human foot evolved to handle the forces of running without the need for the support of shoes.
But running on hard surfaces, like concrete or asphalt, barefoot may cause a higher amount of stress fractures.
With either choice, the best option is to choose what’s right for your run – what feels best to you and what keeps you safe.
If choosing a shoe, go a half size bigger than your walking or dress shoe. This will give room for your midfoot and toes to spread out as you push off. There’s also room if your feet swell a bit on longer runs.
Running shoes should be replaced every 300-500 miles or every six months to a year based on how much they are used.
Write the date on the inside tongue of your new shoes to track how long you’ve used them.
You might consider a gait analysis when you’re looking to buy running shoes. This can identify any movement patterns or bad running habits that could result in injury. You can schedule an analysis from one of our outpatient physical therapy centers or a local running store.
There you have it!
Four steps to build a training plan that helps you avoid injury, build up your strength and distance, choose your shoes and get out there and run toward race day.
Article research courtesy of Jasmine Fisk, P.T., DPT
Treating hand, wrist, arm, elbow and shoulder injuries in athletes
When you've got an injured athlete, what's your move to get them back in the game?
For some sports organizations, athletic trainers and team doctors are on deck to treat most sports injuries. But there's a variety of health professionals who help players get their pitch, swing or throw back.
Did you know that occupational therapists play key roles in athletic injury treatment? With all the throwing, lobbing, pitching and twisting that comes with playing sports, the need for therapy is big.
Upper extremity injuries in athletes are common, sidelining them from play. As many as one in four injuries are to the hand or wrist.
Occupational therapists (OTs) specialize in these types of injuries and more. Their goal is to help the athlete recover and safely return to play.
How occupational therapists help athletes
Occupational therapists (OTs) work with all kinds of individuals to overcome physical setbacks from illness or injury. For athletes, this is key for a return to play after injury.
Just as athletes are unique in their play with their sport, injuries are unique to them. For example, athletic injuries can occur in all ages, from Little Leaguers to Silver Sneakers. Treating a specific type of injury, like a broken arm, will be different for a patient who's 7 and another who's 70.
An OT's role is to assess the impact of injury and the limitations it causes.
Therapy is then based on the skills the individual needs to recover to overcome those limitations.
OTs are specialists in assessing the impact of injury on many parts of the body's framework such as:
The level of an injury can vary from acute to chronic.
For example, an acute injury is sudden, like breaking a wrist.
A chronic injury is one that happens over time, like tendonitis of the wrist. Tendonitis builds up after long periods of overuse, doing the same movements over and over, like serving a tennis ball.
Whatever the injury, OTs are highly-skilled in treating a variety of injuries.
For the weekend warrior or a pro athlete, your path to recovery from a sports injury will be unique. And just like the role you play on the court, the track or the field, you'll play a major league role in your healing process.
Here's some inside baseball on what that will look like.
Expect your doctor and OT to talk with you about your goals for recovery. This is key for planning your way back to play and any restrictions you'll need to follow.
Your local physical therapy center will be your home base for therapy sessions. This is to ensure your safety during treatment.
Your therapist will guide you in proper movement and the use of any equipment to make sure you are doing each exercise right. This helps improve your range of motion and stay on track for healing.
Your therapy may include strength training with resistance bands or weights to improve dexterity and build strength.
If your therapy includes doing exercise at home between scheduled appointments, you may benefit from having your OT take a look at your personal equipment and how you use it. They can spot if it's appropriate for your use and goals for healing. They can also see if you're using it right and, if not, help you to correct it.
Each step of your treatment is planned to help you heal from the injury and get back to your goals.
Brace yourself for orthotic devices
For serious injury or bad breaks that take you out of play, your OT may want to restrict the motion or movement of your injury to help with healing.
The terms – splint, brace, wrap or cast – are pretty common, so, it's likely you've heard them before. In medical terms, though, you might hear your therapist refer to them as an orthotic device or orthosis.
The bottom line, whatever the device looks like, is that it will be fairly rigid or stiff to keep a joint or broken bone in place as it heals.
Orthotics can be made and fitted for:
For a less serious level of injury, there are a host of orthoses we can provide to support and protect to keep you in the game, no matter your game!
These upper extremity orthoses can be fit for thumb, fingers, hand, wrist, forearm and shoulder.
These are custom-fitted and made onsite at our center so you can leave your appointment with what you need.
Your therapist will ensure it fits right for comfort, support and protection.
At the ‘core’ of your injury
Your core is a complex series of muscles extending far beyond your abs. So if you’re thinking “six-pack” or “washboard” abs, think bigger!
The core is made up of 20-plus muscles at the center of the body. It includes major and minor muscles of the stomach, hips and low back. They all work in tandem, making the core part of nearly every movement we make.
Having a strong core (diaphragm, abs, glute and pelvic muscles) and good dynamic balance plays a large part in athletic activities. Weakness in either of these areas may be flagged by your therapist for you to get a movement screen assessment.
The core helps:
- Stabilize movement
- Transfer force from one extremity to another
- Initiate movement
If your core strength is weak, the strength and coordination of your upper extremity isn't at full potential.
Occupational therapists who work with patients on upper extremity recovery consider the whole body during treatment. Your OT will work on improving core strength as well as leg and hip strength as it applies to your sport.
The power of occupational therapy
Getting back to a well-loved sport or activity is important to anyone who's sidelined by injury.
It doesn't matter if you’re competing at an elite level or just want to retain an active lifestyle to get the benefits of occupational therapy. Our OTs know how to create a rehabilitation plan to meet your goals.
Our occupational and hand therapists can help you:
- Avoid injury
- Perform better
- Recover from injuries quickly and safely
We're here for you. Our proven therapies, along with compassionate care, offer the best outcome for your injury.
Take a look at all the sports medicine and injury prevention services we offer. Then click on any of our pages' blue Request an appointment buttons and come see us!
Posted on 3/9/2021
PODCAST: The Best Treatment for Patellar Tendonitis
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 the best ways to manage and treat patellar tendonitis, more commonly known as jumper’s knee. Check it out!
More information can also be found at sportsmedicineweekly.com.
How to stay in play and on the court
What is pickleball? And why are people raving about it?
Pickleball is an improvisation of badminton and ping-pong. The game is played on a court using a softball-sized, hard-plastic ball with holes - like a wiffle ball - and paddles similar to table-tennis paddles.
Conceived in 1965 as a game that families could play together, pickleball grew in popularity. By 1972, a corporation was founded for the sport.
While there is debate around the origin of its name, there is none about how fun, fast, competitive and entertaining the game is.
With a smaller court size than its cousin sport of tennis, it’s an ideal way to stay active and fit for just about anyone.
And pickleball has taken the country by storm.
The first pickleball tournament was held in 1976 in Washington State. And while not what’s called an overnight sensation, the explosive growth of the game in the years since has led to pickleball courts popping up everywhere, and the formation of amateur and professional leagues.
There’s even a professional pickleball tour.
When injury puts you in a pickle
With the rise in popularity of pickleball, physical therapists throughout the country are seeing an increase in injuries that are similar to those found in other racquet sports.
New pickleball players sustain approximately 50% of injuries during their first year of play.
The most common pickleball injuries include:
- Pickleball elbow
- Ankle sprains
- Knee sprains
- Shoulder sprains
- Achilles tendonitis
- Wrist fractures
- Concussions from falls
In the case of older players, many are predisposed to injury, often due to prior injury, limited flexibility and range of motion and deterioration of balance, or have recurrent injuries.
So if you are looking to start playing the game … or stay in the game … keep these prevention tips in mind to reduce your risk and avoid injury:
Warm up Pickleball is a fast-paced game, and the excitement starts right away. So it's important that you warm up before you get on the court. Try a light 5-minute jog, a slow walk with high knees or some side shuffles to loosen up.
Stretch As part of your warm-up, make sure to stretch. Shoulder stretches, calf stretches, hamstring/quad stretches and wrist and neck stretches are all important to incorporate into your routine.
Choose proper footwear Pickleball requires moving side to side and back and forth. Choose a good fitting athletic shoe for this type of movement.
Pivot Similar to tennis and other racquet sports, you will be executing groundstrokes, volleys and serves. Remember to pivot your hips and shoulders as you face the approaching ball.
If you are injured, stop playing!
Don’t try to tough it out, especially if it is a head injury.
Contact a physical therapist to help you heal and recover before you return to play.
Pickleball is as fun as it sounds, and you’ll want to play for years to come.
If you’re in a pickle with pain or injury of any sort, click now to request an appointment to find one of our centers near you.
NovaCare and RUSH Physical Therapy are part of the Select Medical Outpatient Division family of brands.
Select Medical is proud to be the official physical therapy partner of the PPA Tour.