Spinal Stabilization Exercises and Their Role in Alleviating Lower Back Pain

The Effectiveness of Spinal Stabilization Exercises for Back & Neck Pain

There is no standard approach treating chronic lower back and neck pain. Although this may be unfortunate for many patients to hear, the good news is that there are many conservative methods to alleviate pain.

While conditions like degenerative disk disease, spondylolesthesis, lumbar and cervical radiculopathy are rarely cured completely by conservative measures alone, physical therapy does offer a fair amount of pain relief in the long run.

By utilizing spine stabilization exercises, our physical therapists are able to help patients reduce back and neck pain. This is an active form of treatment requiring the patient to perform exercises to strengthen the muscles and improve the stability of the spine.

Patients suffering from chronic spinal pain should be leery of physical therapists who mainly offer passive modalities. Examples of passive modalities include heat, electrical stimulation, and massage. Patients should be aware that passive therapeutic modalities do not have sufficient evidence to support their use in chronic spinal conditions.

Spinal stabilization exercises offer the empowerment of the patient and have plenty of research and evidence to support their effectiveness.

Pilates offers an excellent variety of spine stabilization exercise.

Extensive benefits in treating the spine of those who suffer from lower back pain have been discussed extensively in medical literature. Physical Therapists specializing in the spinal disorders are trained in recognizing the factors that affect spinal stability.

Components Affecting Spinal Stability

The concept of spinal stability is relatively new with research beginning during the 1970’s.

There are three components that affect spinal stability.

The first component is the passive spinal element: the bone and ligamentous structures. Studies of the cadaver spine in which the bones and ligaments are intact but the muscles were removed showed to buckle under about 20 pounds.

Spinal Ligaments - Medical Illustration Originally Sourced from Kenhub.com — Ligaments of the thoracic spine: posterior (a), anterior (b), lateral (c) and posterior with vertebral arch removed (d). 1, anterior longitudinal ligament; 2, posterior longitudinal ligament; 3, intervertebral disc; 4, ligamentum flavum; 5, intertransverse ligament; 6, supra- and interspinal ligament; 7, radiate ligament; 8, costotransverse ligament.
Originally sourced from: https://musculoskeletalkey.com/anatomy-of-the-thorax-and-abdomen/

The second component of spinal stability are the muscles that surround the spine. The muscular component provides a necessary ‘stiffening” of the spinal segment. In a healthy spine, a very modest level of muscular activity can create a sufficiently stable joint. In a degenerative disk disease, for example, there is more demand on the surrounding musculature. More strength and endurance reserve is needed to overcome an injury and pain.

Deep Muscles of the Back. Medical Illustration originally sourced from: https://pulpbits.net/7-deep-muscles-of-back-anatomy/the-deeper-muscles-of-the-back/

The third component of spinal stability are the neural elements: the central nervous system and peripheral nerves. They are akin to an orchestra conductor, coordinating the performance of various muscles, making sure they are firing at the right time, at the right amount of force.

Spinal Cord Nerves Originally Sourced from Health Jade — Spinal Cord and Nerves – Medical Illustrations originally sourced from https://healthjade.com/spinal-cord/

Multiple studies have shown patients with lower back pain make a “repositioning error” in which their spine would resume to its original position causing pain after performing a certain movement more than patients with a healthy, stabilized spine.

In physical therapy language, we call it a poor postural control.

Specific physical therapy exercises and treatment has shown effectiveness in treating chronic spinal pain.

Lumbar stabilization exercises improve muscular function which can, in turn, compensate for the structural damage to the spinal segment. A thorough dynamic assessment of the spine helps identify postural deficits.

A thoughtful exercise program is designed for each individual by the physical therapist based on their initial testing and evaluation. The most tangible benefit of a lumbar stabilization is that it gives a patient the tools to control their pain.

Interventional Pain Management

Going beyond the scope of physical therapy, interventional pain management is another passive option for chronic spinal pain. This approach serves as a temporary source of relief for patients dealing with low or medium levels of lower back pain. These techniques include performing procedures directly at the level of your dysfunction.

A pain management physician gains access to the areas causing lower back or neck pain by penetrating the surface of the skin. There is a plethora of interventional pain management options for the diagnosis and treatment of the spinal pain.

Epidural steroids are the most common example of the interventional spine management. However, the accuracy and effectiveness of interventional methods in managing lower back pain are not always clear.

In the comprehensive review article published in Pain Physician, 2013 Apr:16, the authors conducted a systematic review of literature in order to collect evidence for the effectiveness of various interventional pain management techniques in the treatment of chronic spinal pain.

The author came to the conclusion that the evidence was fair to good in 52% of therapeutic interventions. The evidence for diagnostic value fared slightly better at 62%.

One significant drawback of all passive techniques is that they do not require a participation of the patient. Without an active engagement of the patient, there is a limited self-control and independence in managing their own condition.

Do you suffer from chronic neck or back pain? Our therapists can help. Schedule your appointment today.

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How Physical Therapy Works To Eliminate Knee Pain

By Boris Gilzon, PT, DPT, OCS, CHT

In a 2006 health survey conducted by the National Health Interview Survey (NHIS), knee pain was reported as the second most common cause of chronic pain in America.

Another surprising statistic comes from the Society for Academic Emergency Medicine. They reported that “the knee is the most commonly injured joint by adolescent athletes with an estimated 2.5 million sports-related injuries presenting to [Emergency Departments] annually.”

Some studies even show us that there has been an increase in the amount of knee replacement procedures over the last few years. Researchers say this is caused by two major factors: the first being the obesity epidemic and the second being that we are living longer lives. While living longer is great, it also puts more years of wear and tear on our bodies which can lead to osteoarthritis.

So what can you do to prevent knee pain or if you already suffer from knee pain, how can you better manage it and get out of pain?

The knee joint can only move in one plane, like a door hinge, and does not accommodate well to external stress that falls outside of its natural axis. For example, imagine being pushed from the side while your feet are firmly planted. This is the most common mechanism leading to a knee injury. Anterior Cruciate Ligament (ACL) injuries, as well as meniscus tears, normally occur this way.

The knee joints bear multiples of your body weight in running and jumping. Climbing up the stairs, for example, loads your knee joint 2.5 times your body weight.

The knee is considered a biomechanical link between the hip and the ankle/foot complex. Dysfunction in any of these joints can negatively affect the others in the chain. Repeated abnormal stress can take a toll on the knee joint.

Knee pain is one of the most common conditions our therapists treat in our clinics. Our therapists know how to take care of a variety of injuries and conditions for people of all ages. Early intervention of knee pain will improve your quality of life, mobility, and prevent loss of muscle strength and instability.

Types of Knee Injuries

There are two categories that a knee injury can fall into: 1) acute/traumatic and 2) chronic/repetitive stress. Acute injuries are when the incidents occur immediately, like a fall, car accident, landing in a strange way, twisting/pivoting quickly, etc. Many sports injuries, especially sprains and strains, fall under this category.

Chronic injuries are caused by repetitive stress over a long period time. Poor posture and/or body mechanics can play a major role in chronic conditions. Physical therapy can be very beneficial in correcting these issues.

Osteoarthritis

Knee pain can be caused by degenerative changes in osteoarthritis. Arthritis is when the cartilage cushioning the bones wear down leading to swelling, stiffness, and pain.

Unfortunately, in the cases of the knee pain due to severe osteoarthritis, Physical therapy intervention is limited and one should consult with an orthopedic doctor to assess whether a total knee replacement is appropriate.

Knee pain is more commonly seen in people who do not yet have visible arthritic changes on radiographic examination. Those people are engaged in various physical activities while struggling with the knee pain during and after the activity.

Anterior Knee Pain aka Runner’s Knee

knee medical illustration patella — The patella “floats” between the thighbone and shinbone in the trochlear groove. Medical illustration original source: https://orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-arthritis/

Anterior knee pain or the “Runner’s Knee” is related to an abnormal motion of the kneecap in the trochlear groove. It causes an irritation and eventual wearing out of the cartilage on the back of your kneecap. The knee pain gets worse when you first stand up, run and going downstairs. The knee pain worsens while performing your physical activity.

Patellar Tendonitis aka Jumper’s Knee

Patellar tendonitis, also known as “Jumper’s Knee,” is another activity related condition that is caused by repetitive motion. The knee pain, in this case, originates in the patellar tendon. A structure that connects your quadriceps muscle to the lower leg through the kneecap. When your quadriceps muscle is overloaded it causes an inflammation of the tendon, thus contributing to the knee pain. The symptoms are usually more pronounced when you are at rest and when you initiate your activity. In more severe and chronic cases the knee pain prevents you from participating in sports.

Knee Pain Rehabilitation and Treatment

The key in the rehabilitation of the knee pain is a correct biomechanical analysis of your kinetic chain. An exercise regimen performed at the proper angles and positions. Prescribed activities help to avoid further irritation of the joint and yet strengthening the weak elements. If you suffer from the knee pain, it does not mean that you need to halt your physical activities. Physical Therapist at Park Sports have the tools and knowledge to get you ‘back in the game”.

Do you currently suffer from knee pain? We can help. Get started by filling out the form below.

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Now Offering Pay-As-You-Go Rates for the AlterG Antigravity Treadmill in Clinton Hill

Twitter post of Sean “P. Diddy” Combs using the AlterG AntiGravity Treadmill

The Perfect Solution for Recovering Athletes

If you’re a Brooklyn athlete and recently sustained an injury or underwent surgery on your lower body we have the perfect solution to get you running sooner. The AlterG Anti Gravity Treadmill uses NASA’s patented Differential Air Pressure Technology to “unweight” you, making it possible to run at a fraction of your body weight. You’ll be able to improve your aerobic conditioning and put less stress on your joints – hips, knees, and ankles – while maintaining strength and endurance.

Not Just for Athletes

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Senior Citizens looking to stay active
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Want more information? Fill out the form below.

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Shoulder Impingement Syndrome Treatment

Written by Nicole Liquori, DPT
Edited by Alex Ariza

In this article, we take a look at the process of one of our sports rehabilitation therapists, Nicole Liquori, DPT. From the initial evaluation to the treatment plan to the patient’s progress throughout, we will get to see and understand the physical therapist’s perspective. On the flip side, we’ll also get to see the patient’s point of view.

Conrad arrived at our facility with complaints of pain and loss of range of motion in his right shoulder. In early 2017, Conrad had been in a swimming accident which left him with transient paralysis. He regained full function of his arms and legs within a few weeks of the accident but was left with the residual weakness of both upper and lower extremities.

Upon evaluation, Conrad demonstrated signs and symptoms consistent with a diagnosis of shoulder impingement syndrome. Conrad presented with rounded shoulders and weakness of his postural and rotator cuff musculature which can strongly affect the mechanical relationship of all joints associated with shoulder mobility.

Conrad’s symptoms included pain and restricted motion when lifting his arm above head and reaching behind his back.

Our treatment initially focused on restoring his normal shoulder and scapular range of motion (as compared to his left shoulder) using mobilization, soft tissue work and passive/active assistive range of motion. Once we were able to establish the normal glenohumeral rhythm – the coordinated motion of the scapula and humerus experienced during shoulder movement – we moved into scapular and rotator cuff strengthening and stabilization activities.

We focused on functional movements that would translate into his activities of daily living (i.e., reaching for a cup in a high cabinet), as well as recreational activities (i.e., throwing a ball, swimming, etc.).

Conrad’s treatment was cut short secondary to surgery on his spine, but prior to discharge, Conrad had returned to performing most everyday tasks, as well as throwing a ball overhand without pain.

In Conrad’s Own Words

I highly recommend Nicole Liquori at Park Sports PT. After a serious accident, I was unable to raise my arm over my head. I couldn’t throw a ball or swim with an overhand stroke. Nicole changed that in the space of two months. A combination of deep massage, passive movement and guided exercises brought back pain-free use of my shoulder. Her knowledge is apparent in her explanations of the functional basis for the exercises. Her skill is demonstrated in her wonderful touch. She confidently employs just the right amount of force in the right places. On top of that, Nicole is sympathetic and encouraging. She has all the qualities of a first-rate therapist and she helped me immensely.

Conrad L.

Do you currently suffer from Shoulder Impingement Syndrome? We can help. Schedule your appointment today.

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Couples that do Physical Therapy Together…

Married couple, Michael and Lila R., are longtime patients of Park Sports Physical Therapy. Michael is a lifelong athlete having run 26 marathons during his lifetime. He has also been a member of the Prospect Park Track Club, a local running club in Park Slope, Brooklyn. Michael has over 30 years of running under his belt. That’s a whole lot of miles!

His wife Lila, also an athlete, has spent most of her life swimming and running.

Lila’s first experience at Park Sports started back in 2011. She came in with a rotator cuff condition. One of our therapists treated her and got her back to swimming fairly quickly. Lila recommended her husband, Michael also get treated at Park Sports after her positive experience.

Michael suffered from arthritis in both his knees. It was when he tripped and injured his iliotibial band that he came in for treatment. He was feeling a snapping sensation whenever he would walk up and down stairs.

Kristin Romeo, DPT became both Michael’s and Lila’s therapist, often times seeing them at the same time for treatment. For Michael, Kristin used manual therapy, stretching, strengthening exercises, and worked on improving his balance on the injured leg.

During the interview, Michael and Lila spoke very highly of Kristin, saying “Kristin is attentive, listens to your needs, and makes sure that the problem area is getting the right treatment.”

“The sessions hold me accountable,” Michael mentioned. The exercises have helped him greatly throughout his treatment. He’s progressed to the point where he no longer feels any snapping sensation walking down the stairs.

Lila similarly was very pleased with her progress.

Michael and Lila, being older in age, both realize the importance of maintaining balance to avoid falls. Physical therapy has proven to be quite useful in that regard.

Both Michael and Lila recommend the services at Park Sports highly saying, “almost all our friends in the neighborhood go to Park Sports for physical therapy. This is a great place that offers excellent care. The therapists that work here are excellent. We couldn’t be happier with Kristin’s care.”

Frozen Shoulder Treatment – Regaining Mobility Through Physical Therapy

Written by Edward Umheiser, PT, DPT
Edited by Alex Ariza

Injuries to the shoulder are fairly common in everyday life. Strains and sprains resulting from repetitive activities such as throwing a ball or twisting your arm while reaching behind your car seat happen all the time, and usually heal on their own in only a few days. But what happens if your shoulder suddenly starts to lose its normal range of motion for an unexplained reason?

In this article, I would like to talk about the diagnosis known as adhesive capsulitis, more commonly referred to as frozen shoulder.

What is Frozen Shoulder?

Frozen shoulder is a fairly common diagnosis, but is not well understood and does not always have a known cause. Many people develop frozen shoulder following a surgical procedure to the shoulder, or after an injury that results in the shoulder needing to be immobilized for a short period of time. However, in some cases, some people develop symptoms with no known trigger.

The symptoms are fairly clear-cut – a marked loss of normal range of motion and stiffness of the shoulder joint that may or may not be accompanied by pain.

This shoulder stiffness affects motion in all directions such as reaching up in the air or trying to place the hand behind the back or behind the head. Adhesive capsulitis begins as an inflammatory process within the shoulder and leads to scar tissue formation which can restrict shoulder motion.

For some people, this scar tissue formation can lead to pain in the shoulder joint, especially with movement and during the evening hours while trying to sleep.

The Stages of Frozen Shoulder

Physical Therapist, Edward Umheiser, DPT treating patient with frozen shoulder. — *Physical Therapist, Edward Umheiser, DPT treating a patient with frozen shoulder.*

There are several stages of frozen shoulder each with their own unique characteristics:

Inflammatory Stage

The inflammatory stage lasts approximately three months and is characterized by pain with shoulder movement in most directions. Pain is often sharp with movement at the end of the range, and there is an ache at rest. Pain is also commonly felt at night, making it difficult to fall asleep. The range of motion may still be normal at this early stage.

Freezing Stage

Edward Umheiser, DPT measures the shoulder's range of motion. — *Edward Umheiser, DPT measures the shoulder’s range of motion.*

The freezing stage typically lasts 3-9 months. This is when flexibility of the shoulder begins to reduce due to pain. At this time, people often begin to notice difficulty reaching overhead, or reaching behind their back. This stage, known as the frozen stage, is when the stiffness is most severe. The inflammatory process inside the shoulder joint is starting to decrease at this stage so pain is lessened or non-existent. Over the past several months a thick layer of scar tissue has formed around the shoulder capsule, which makes it difficult to move. This is the stage when most people are diagnosed with frozen shoulder.

Thawing Stage

*Edward Umheiser, DPT treating a patient with frozen shoulder. With consistent physical therapy sessions, a patient can begin seeing an increased range of motion.*

Finally, the thawing stage is when shoulder motion gradually starts to return to normal. This stage can last anywhere from 9 months to two years and may leave some minor limitations in shoulder range of motion afterward.

Treating A Frozen Shoulder

*Edward Umheiser, DPT teaching the patient shoulder exercises.*

Physical therapy along with treatment provided by your doctor such as cortisone injections are the first line of defense in reducing the time a patient may experience the symptoms related to a frozen shoulder.

A doctor will typically take some images of the shoulder to rule out other possible structural involvement such as the rotator cuff or the labrum.

At that point, physical therapy treatment 2-3x a week is generally recommended where manual shoulder stretching, massage, mobilization, and exercises are performed to keep the shoulder as pain-free as possible, and to help increase the range of motion.

It is also important to continue to perform the prescribed stretching exercises at home under the guidance of a physical therapist. Generally, the time it takes for a frozen shoulder to “thaw” can be halved under physical therapy treatment. Most patients do not need surgical intervention to correct this diagnosis.

Steps to Take If You Suspect Having a Frozen Shoulder

If you have noticed that you have a lot more difficulty with overhead shoulder motion following a shoulder injury, let your doctor know. If this has persisted for several months, it may be a sign of adhesive capsulitis. An orthopedist can help you make that diagnosis, and physical therapy can help you get onto the road to recovery.

Schedule Your Physical Therapy Appointment Today To Begin Frozen Shoulder Treatment

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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:
https://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

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 clinician 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.

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.

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.
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:

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.
Stretch before and after training and rock climbing. It is important that you keep your muscles loose and mobile.
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 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).