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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Treating Tendonitis for Rock Climbers

Written by Alex Ariza
Reviewed by Moussia Krinsky-Raskin, OTR/L

Sports injuries can occur from many different kinds of physical activities. This post will focus on how our occupational and physical therapists approach treating tendonitis, specifically for rock climbers feeling elbow, forearm, and finger pain.

Rock climbing is a very demanding sport requiring a lot of strength from your entire body. Grip strength is one of the most important factors in tackling new levels of difficulty in climbing. Working on strengthening your hands and forearms can prove to be challenging to develop without leading to injury.

Even professionals with many years of experience and skill can suffer from overworked flexors in their forearms and fingers.

When your flexors become inflamed from overuse – usually from your hands gripping tightly for prolonged periods of time – it can cause pain that can be felt from your fingers all the way to your elbow. This condition is called tendonitis.

Forearm Muscles - Flexors and Extensors

So what do you do if you suffer from tendonitis? The first step is rest. For many athletes, this can be very difficult to do, especially if they are training for a competition. Some may even be tempted to continue to train, creating more inflammation and a bigger problem to deal with.

Exercises that require gripping should be avoided for a brief period time. Each case is very specific to the individual, so this will vary from person to person.

Simultaneously, to counteract the inflammation, direct application of ice or a cold pack to the affected area is recommended, especially if swelling is visible. After the inflammation has subsided, light stretching can be followed as tolerated.

To help with stretching, our certified hand therapists recommend using heat prior to stretching or exercise to allow the muscles and tendons to loosen up.

You can use a warm towel or heating pad to do this.

Below is one recommendation from one of our occupational therapists, Moussia Krinsky-Raskin, for stretching. Remember, you do not want to stretch to the point when you are feeling pain. There should be some discomfort, but never pain.

  1. Straighten your arm in front of you as much as you can, bend your wrist towards your chest, palm facing you and hold for 5-10 seconds, or as much as you can handle it. This will stretch your extensors.
  2. Straighten your arm in front of you, palm facing outward, gently pull the back of your hand towards your chest and hold for 5-10 seconds. This will stretch your flexors.

Recovering from tendonitis requires patience. Remember to listen to your body. Don’t ignore pain. Continue to push through the pain following the “no pain no gain” mantra can cause far more damage than good – regardless of mind over matter. A badly injured tendon rarely recovers to its full strength afterward. If pain continues for more than a few weeks, it is strongly advised that you see a medical professional.

Here are some tips on how you can prevent tendonitis in the future:

  1. Take breaks often when training. Remember to treat rock climbing as if you were lifting heavy weights. There should be moments of rest between each “set” or climb that you attempt.
  2. Stretch before and after training and rock climbing. It is important that you keep your muscles loose and mobile.
  3. If you feel pain begin to creep up during your climb, stop. We understand that most people will disregard this piece of advice and want to continue training through the pain, but this will ensure longevity and maximum performance of your body in the long run. Don’t work yourself until you are out of commission!

Our physical therapists and occupational therapist are all sports rehabilitation specialists. They will work closely with you to help you recover quickly and teach you how to prevent injury in the future.

If you are just beginning to climb, we strongly encourage you to undergo a strength training program to help prep your body and prevent injury.

Do you currently suffer an injury from rock climbing? Our therapists 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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Sports Medicine Treatment in Brooklyn

Our Physical therapists are sports medicine specialists capable of effectively treating any sports-related injury.

If you’re an athlete and you experience an injury while playing your sport, you’re probably looking for sports medicine treatment in Brooklyn. Regardless of the type of injury or the sport in which it occurred, though, the best option in every case is to see a physical therapist as soon as possible. This is because physical therapists are sports medicine specialists who are experts at diagnosing and treating any and all sports-related injuries.

Sports medicine is a branch of health care that deals with the physical fitness of both amateur and professional athletes.  Sports therapy specialists focus on helping these athletes improve their athletic performance, and most importantly, treating their injuries and reducing the risk for future injuries that can be prevented.

Physical Therapists Play a Central Role in Sports Medicine Treatment

A sports medicine team includes physical therapists, physicians, surgeons, athletic trainers, coaches and athletes, who all work together to keep injury risk at a minimum and to effectively treat injuries when they do occur. Physical therapists play a central role in this team by being the most commonly used method to rehabilitate the majority of injuries in just about every sport.

For this reason, physical therapists are well versed in which types of injuries occur most frequently in each sport, and they are experienced in identifying and properly treating a vast range of sport-specific injuries.  For example, they know to look for the following injuries in each of these sports:

  • Basketball: ankle sprains, jumper’s knee, ACL injuries
  • Baseball: shoulder and elbow injuries, especially damage and tears of the ulnar collateral ligament
  • Football: concussions, ACL and meniscus injuries, ankle sprains
  • Tennis: tennis elbow, rotator cuff and other shoulder injuries
  • Running: runner’s knee, jumper’s knee, plantar fasciitis, Achilles tendinitis

So when an athlete sees a physical therapist with an injury, the therapist will know exactly what to look for in order to accurately diagnose the problem. From there, they will develop a personalized and sport-specific treatment program that takes into consideration the demands of the sport in order to reach the best possible outcome.

To highlight the effectiveness of physical therapists as sports medicine specialists, this recent study shows how physical therapy is better than injections for tennis elbow:

Physiotherapy was a cost-effective treatment for lateral epicondylalgia. Corticosteroid injection was associated with greater variability, and a lower probability of being cost-effective if a willingness to pay threshold of $A50 000 is assumed. A combination of corticosteroid injection and physiotherapy was ineffective and cost-ineffective. Physiotherapy, not corticosteroid injection, should be considered as a first-line intervention for lateral epicondylalgia.

So if you’re dealing with any type of sports injury, remember that physical therapy should always be your first choice for treatment, and the sooner you see a therapist, the greater the chances of a positive outcome. Click here to see where we are located (we have 4 locations to serve you).