Treating Hip Pain for Brooklyn Athletes

Written by Boris Gilzon, PT, DPT, OCS, CHT & Alex Ariza

Physical Therapists play an essential role in the nonsurgical treatment of hip pain. Two of the most common conditions associated with hip pain are labral tears and hip impingement.

Labral Tears

Labral tears occur when the labrum, which is the cartilage that comes between the head of the femur – your thigh bone – and your pelvis – your hip bone, begins to wear down or experiences trauma. The most common cause of labral tears is repetitive stress on the hip joint, especially for athletes participating in running and skating sports.

Labral Tear - Hip Pain
Original Image Source:
http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=fabdfb4e-5fb5-4077-b341-df5d04a93605

Hip Impingement

Hip impingement, also known as femoroacetabular impingement (FAI), occurs when extra bone grows on either or both the head of the femur or the acetabulum (the part of the pelvis where the femur meets – the “socket”). The extra bone creates an irregular fit and can start to rub against the cartilage or bones in a way that can damage the joint causing hip pain.

There are 2 types of hip impingement. They can occur separately or together.

Hip Impingement Types
Original image source:
https://orthoinfo.aaos.org/en/diseases–conditions/femoroacetabular-impingement/

Cam-type Impingement

The head of the femur is shaped like a sphere. It acts as the “ball” for “ball and socket” joint in your the hips. In this deformity, an excessive bone growth around the head of the femur creates an irregular shape that makes it difficult to rotate in the acetabulum, your “socket”.

The misshapen overgrowth contacts the cartilage that lines the hip socket, the labrum, and can cause it to become worn and frayed. This can lead to hip instability and pain.

Pincer-type Impingement

Pincer impingement is when the acetabulum (hip socket) protrudes around the femur head, decreasing the space of the joint. Overtime with repetitive contact, hip flexion (bending over, sitting, walking) leads to tearing and inflammation of the cartilage that envelopes and protects the joint (labrum).

Symptoms

With either one of these conditions you may experience:

  • Increased pain with prolonged sitting and leaning forward in the sitting position.
  • Sharp pain during squatting, changing direction during running, pivoting and lateral motions./li>
  • Stiffness and deep aching in the front of the hip. Occasional groin pain.
  • Decrease ability to turn your thigh inward.

Treating Hip Pain with Physical Therapy

Kristin Treating Patient - Hip Mobility 2 | Park Sports Physical Therapy

Treatment of hip pain starts with a comprehensive evaluation of movement of your hip and surrounding joints.

Our therapists will test the strength of the muscles around your hip and observe your movements to properly diagnose the condition. During each session, our therapists will instruct and educate you about your body mechanics, the origin of your injury, and exercises you can perform to prevent future injury to the hip and strengthen the muscles around the hip and other parts of your body to stabilize and correct any imbalances.

Your orthopedic doctor may order X-rays and an MRI to confirm the diagnosis.

Hip impingement and labral tears may be concurrent with lower back pain and pelvic floor dysfunction.

Once your weaknesses and imbalances are identified, the goal of therapy is to restore normal force coupling and to develop strategies to compensate if your condition is chronic.

Strengthening of weak muscles and stretching tight muscles can help to avoid the progression of hip impingement. Manual therapy techniques may also be employed restore flexibility of the joint.

At Park Sports Physical Therapy, one of our therapists, Svetlana Lazarev, PT, is an advance hip specialist certified by the Hospital for Special Surgery (HSS).

Hip Arthroscopy Post Operative Rehabilitation

If you do end up having surgery for your hip pain, our therapists follow an established post-surgical protocol. Physical therapy is known to shorten recovery time and ensures that your body is healing properly. Our therapists help to promote safe healing by limiting the weight you put on the operated leg, exercises, stretching, and manual therapy.

The next stage of postoperative rehabilitation focuses on improving your range of motion and strength. During your treatment, our physical therapists can keep your doctor and orthopedic surgeon informed of your progress if you choose.

After 4 to 6 months of treatment following surgery, you’ll be able to return to your normal activities.

Do you currently suffer from hip pain? We can help.

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What We Can Learn From Angels Pitcher Shohei Ohtani’s Elbow Injury

Written by Boris Gilzon, PT, DPT, OCS, CHT and Alex Ariza

If you’re a fan of baseball you may have heard that New Los Angeles Angels pitcher, Shohei Ohtani, has a damaged Ulnar Collateral Ligament (UCL) in his pitching arm.

This is bad news for Ohtani, as his career relies heavily on the function his elbow. Although reports show that Ohtani only has a first-degree sprain, consistent use of his elbow can present serious problems down the line.

In the world of physical therapy, elbow pain does not get enough exposure and is often ignored. More often than not, people continue performing their daily activities that can exacerbate injury to the elbow and cause damage to the joint and ligaments.

Ulnar Collateral Ligament (UCL) Injury

As Physical Therapists, we see sports injuries in a different light, especially when they make the news. This post will share some of the intimate knowledge we possess from years of treating a number of injuries and conditions that athletes may face.

The Ulnar Collateral Ligament, located in the elbow, is a complex structure consisting of three bands. It is challenged more when the elbow is in flexion. During full elbow extension, the bony congruity provides additional stability.

Ulnar Collateral Ligament Anatomy

Ulnar Collateral Ligament injury is common in many overhead sports. The forces that can lead to injury on the elbow are generated when the elbow goes from flexion to extension at a high velocity. In Ohtani’s case, this would be frequently pitching at a consistent speed of 100 mph.

This injury occurs from repetitive valgus (a condition in which the bone segment distal to a joint is angled outward) stress on the medial (inner aspect) of the elbow. This kind of elbow sprain commonly occurs in baseball pitchers. It is less frequent in racket sports, volleyball, and hockey, but can still occur in athletes playing those sports.

Damage to the ligament can be caused by sudden trauma or a gradual stress. The most typical sign is a pain in the inner elbow while performing a physical activity. Patients commonly describe an elbow sprain as a twinge or sharp pain when pushing up, such as getting up from the chair.

If a ligament is compromised a patient may develop:

  • A sense of looseness or instability in the elbow.
  • Irritation of the ulnar nerve (aka the “funny bone”): This is felt as a tingling sensation or numbness in the small finger and ring finger.
  • Decreased ability to throw a baseball or other object overhead.

Treatment for Ulnar Collateral Ligament Injury

Ulnar Collateral Ligament injury can happen to anyone at any age. Parents and coaches should be aware of the issue and be alert if the child complains of the pain in the elbow.

Physical Therapy is the best first line of defense following this diagnosis. At Park Sports Physical Therapy, our Physical Therapists are skilled and experienced in treating elbow instability and ulnar collateral ligaments tears.

The treatment approach is based on thorough examination and biomechanical analysis of the activity that caused the condition.

It includes:

  • Strengthening weak muscle group
  • Activity modification.
  • Manual therapy and therapeutic modalities.

Post-Surgical Recovery

In cases of severe damage and instability, the ligament is reconstructed in what is commonly known as a Tommy Johns procedure. Physical Therapy treatment in this case follows an established post-surgical protocol. Our therapists work closely with an Orthopedic Surgeon to optimize post-surgical recovery and achieving the highest functional outcomes.

Do you suffer from Ulnar Collateral Ligament Injury? Take the first step to get out of pain by scheduling your appointment.

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Post Surgical Rehabilitation in Brooklyn

If you just had an operation for a muscle or joint problem, then you need want to experienced clinicians that provide some of the best post surgical rehabilitation in Brooklyn.

A Park Sports Physical Therapy treatment program will help shorten the road to recovery after surgery.

After an injury occurs, the first thing most people think about is recovering as quickly as possible and getting back to doing what they love.  For most injuries, physical therapy is considered the best possible option to help accomplish this goal.  Physical therapists are experts at diagnosing injuries and creating treatment programs that are personalized for each patient based on their particular condition.  The treatments they provide are also supported by countless research studies that continue to come out.

Sometimes You Need a Surgeon…then Great Post Operative Rehabilitation in Brooklyn

Not all injuries can be treated with physical therapy alone.  In some cases, a person’s injury might be too severe, or they may have already tried physical therapy and it failed to bring about any major improvements.  In these cases, surgery may be recommended as the next option.

Patients with severe osteoarthritis of the hip or knee, chronic low back pain, tears of the meniscus, ACL or Achilles tendon and many other injuries may consider surgery if their condition doesn’t improve trying after physical therapy.  These patients should carefully weigh the benefits and risks of surgery, since there is no guarantee that it will lead to a successful outcome.  If the patient decides to go through with surgery, it’s also important to realize that it may take some time to completely recover.

Once again, this is where our physical therapists can help.  One of the best possible ways to ensure a positive outcome and shorten the road to recovery is by participating in a physical therapy program after undergoing surgery.  Depending on the surgical procedure, physical therapy can begin right away or soon afterwards, and it will focus on bringing the patient back to full strength as quickly as possible.  Treatment usually includes a variety of modalities including:

  • Neuromuscular reeducation,
  • Post-tetanic stretching,
  • Hands-on mobilization,
  • Progressive strengthening exercises,
  • Functional training with a walking device if one is being used, and
  • Education on how to return to activities with a minimal risk for future injuries.

The benefits of having post-surgical physical therapy can be seen in the results of this recent study:

The study showed that patients who received both outpatient physical therapy and a home-exercise program improved in range of motion, the 6-minute walking test, and health-related quality of life. Patients who received outpatient physical therapy also had significantly fewer days from the date of surgery to physical therapy discharge.
Reference: https://www.ncbi.nlm.nih.gov/pubmed/27851675

Nobody wants to have surgery, but it may be necessary if your injury or condition is too severe.  If you find yourself in this predicament, the best way to ensure a fast and successful recovery is to follow a physical therapy program that’s created specifically for you.

We have four physical therapy clinics here in Brooklyn.  Click here for contact information.