Runner’s Injury Prevention Workshop Recap

We want to give a big thank you to all of you who came out to the Runner’s Injury Prevention Workshop. Boris and Julie really enjoyed presenting and getting to know more about your running goals.

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Recap

Whether you run recreationally, competitively, or for fitness, the information we shared last night is 100% applicable to you. We covered a lot of material, so we wrote up a brief recap for you and those who couldn’t make it out to our event.

Biomechanics of the Foot

foot pronation and supination chart

Boris and Julie discussed what pronation and supination is and how it can affect your foot if there is a mechanical abnormality. They mentioned individuals’ variations in the foot and ankle structure and how it is connected to the rest of your leg higher up. Other variables play a part in how fast, how long, and efficiently you run. They touched on proper running mechanics and emphasized the form over the speed and distance.

When you run your body experiences impact many times your body weight on each stride. It’s important to understand how your feet land to make the appropriate adjustments. A physical therapist or personal trainer specializing in gait analysis can help in this regard.

The Importance of Core Strength

core muscles

One cannot overstate the importance of core strength in any physical activity and this includes running. Your core ensures your body’s stability, balance, proper posture, and control. Strengthening your core comes with many benefits including injury prevention. In regards to running, when your core muscles – your pelvis, abdominal, hips, and back – all work in sync, you are able to remain solid as your foot strikes the ground. If you are a long distance runner, you know how important maintaining proper posture is. A strong core will improve your running time, endurance, stamina, and help reduce the chances of injury.

Strengthening Your Glutes

Glutes Breakdown

Your glutes are made up of the gluteus maximus, gluteus medius, and gluteus minimus. They all play an important role during your run. We want to make sure that each of these muscles is strong so that other parts of your body aren’t overcompensating for their lack of engagement.

Your gluteus medius and minimus are abductors and help move your legs away from your body. The gluteus maximus is used for hip extension.

Julie mentioned that too much sitting can lead to weak glutes since they are not activated in that position. On the opposite end, your hip flexors shorten since sitting keeps them in a contracted position. Both Boris and Julie recommend that you do the following exercises:

  • Glute Bridge
  • Lunges
  • Squats
  • Clamshells

Dynamic Stretching

Dynamic Stretching

Although recent research has shown that stretching before a run does not help to prevent injury, there are some benefits to stretchings.

Both Boris and Julie encourage dynamic stretching in which your body is moving while you stretch. This ensures that your muscles are warmed up and ready to go.

Common Tight Spots for Runners

We suggest that you keep a close eye on these parts of the body before, during, and after your run.

  • ITB
  • Achilles
  • Hip Flexors
  • Hamstrings

Plantar Fasciitis

plantar fascitiis

Some of you had concerns about plantar fasciitis. Your plantar fascia is a thin ligament that lies on the bottom of your foot. It connects from the heel all the way to the front of your foot. It helps to support the arch of your foot and plays an important role in walking and running mechanics. If you suffer from heel pain after a run, chances are high that you suffer from plantar fasciitis which is the inflammation of this ligament. Symptoms are described as a shooting pain near the heel. The pain is usually worse in the morning or after long periods of rest.

When you run there is a lot of pressure and force pushed on the plantar fascia. This can cause inflammation and tightness.

There are many factors that can contribute to plantar fasciitis. Tight calf muscles or having a high arch can both play a role in plantar fasciitis. Seeing a physical therapist can help identify these issues and provide a treatment plan to manage pain or prevent pain altogether.

Are you currently experiencing pain from running? Participating in races anytime soon? Our highly trained physical therapists can help.

Running can put a lot of strain and stress on your body. Seeing a physical therapist can help you address any biomechanical issues such as muscle imbalances, gait, or tightness to prevent injury, improve your performance, and keep you running for life.

Fill out the form below to get started.

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Want to learn more about the AlterG Anti-Gravity Treadmill and give it a try at our Clinton Hill location on Fulton Street? Schedule your first run here.

Brooklyn Half Marathon Crash Course Recap

We had a blast last night hosting the Crown Heights Running Club at our Clinton Hill location for our Brooklyn Half Marathon Crash Course.

The presenters included physical therapist and owner of Park Sports Physical Therapy, Boris Gilzon, PT, DPT, OCS, CHT, Certified Coach for the Road Runner Clubs of America, Nate Turner, and nutritionist, Tara Mardigan, MS, MPH, RD, AKA “The Plate Coach.”

They shared a lot of great information with us. This post will serve as a brief recap of some of the material that was reviewed.

Dynamic Stretching VS Static Stretching

Dynamic stretching is preferred over static stretching. You will want to focus on “warming up” your muscles before a run or undertaking any form of exercise. This can be in the form of jumping jacks, lunges, or any other full body movement. Core exercises are strongly encouraged.

There is no correlation between stretching and preventing injury, but stretching is still very beneficial in other ways. Boris recommends holding a stretch for twenty seconds or more for the muscles to get the full benefit of the stretch.

Tara recommends staying properly hydrated as that also plays a role in the performance and flexibility of your muscles.

Anywhere from 7-10 minutes of dynamic stretching will be enough to get you warmed up.

Cross Training

Cross training is useful, but depending on your goals, whether they be increasing mileage, speed, or endurance, nothing can replace running.

Boris and Nate both recommend strategic planning in terms of setting up a schedule for training to achieve your goals. The example given was a six-month training schedule. Boris recommends starting off with a light workout and running schedule at the very beginning and then increasing the intensity of theworkoutss as time progresses. This allows the body to adapt.

According to Nate, you should plan ahead and find ways to stimulate the climate of the actual race. For instance, if you are training during the colder seasons for a race that takes place during warmer seasons, you should try running in warmer temperatures some days. This could be done on a treadmill indoors with higher heat. Don’t forget to stay hydrated during these experiments!

Identifying Pre-Existing Structural Issues to Avoid Injury

Having a pre-existing injury or structural issue can lead to more serious injuries down the line. Both Nate and Boris strongly advise against working through the pain during training. Structural issues can be evaluated by a medical professional, physical therapist, or even an athletic trainer trained in identifying imbalances in the body.

A physical therapist will be able to assess your body’s strengths and weaknesses and will be able to offer valuable insight as to how you can improve your odds to avoiding injury, whether they be through strengthening exercises, modifying certain movements, correcting postural issues, or stretching and manual therapy.

If you are interested in getting a movement evaluation done by one of our physical therapists, schedule your appointment here.

Increasing Mileage Safely

Boris and Nate mentioned when training for a half marathon or even a full marathon, it’s best to work your way up to running that distance.

Instead of flat-out running thirteen miles, you could distribute a certain amount of miles each day that adds up to the full thirteen miles.

For example, on Monday you run four miles, Wednesday you run four miles, and Friday you run five miles. You can slowly increase your mileage safely in this manner instead of just deciding to run ten miles one day.

Nutrition for Runners

Tara put together an excellent handout reviewing some excellent advice in terms of nutrition, rest periods, and more. Here’s a PDF of the handout for those of you who couldn’t make it last night.

Wrapping Up

To those of you running the Brooklyn Half Marathon, we wish you the best of luck. You have trained hard and whether you aim to break a new personal record, finish the race, or have a set time that you would like to finish, we are here to help.

Want to learn more about Park Sports Physical Therapy and get started? Fill out this form here.

AlterG Anti-Gravity Treadmill

We are offering a 20% discount to Crown Heights Running Club’s members interested in trying out the AlterG Anti-Gravity Treadmill.

Schedule your first run today! Call 718.230.1180

Learn more about the AlterG treadmill and our rates here.

Injury Prevention for Youth Soccer Athletes Workshop Recap

On March, 28th 2018, physical therapists, Igor Kozlov, DPT, and Aaron Lentz, SPT, gave their first presentation at the new Park Slope United Club House, which just opened up their doors on March, 24th 2018 in Bedford Stuyvesant.

A lot of great material was covered including common injuries that soccer players face during training and games, the FIFA 11+ warm-up, proper footwear for different kinds of turf, and the benefits of the Movement Assessment.

Here’s a brief recap.

What is the Movement Assessment?

A Movement Assessment is an evaluation of your child’s body’s movement. Our therapists will assess your child’s body’s posture and core strength, search for any muscle imbalances, test their flexibility, analyze their gait, and test for balance.

This creates a baseline for them to improve upon. A Movement Assessment is useful for catching any inefficiencies in the body early on that can lead to injury. This assessment has proven to be an invaluable tool for many of the athletes we see at our practice.

Imagine your child being able to run with greater efficiency and producing less strain on their muscles and joints, or having the knowledge to jump, land, and pivot with a lower chance of injury.

Our therapists can help your child gain greater insight and control over their body, which will lead to greater athletic performance.

 

The FIFA 11+ Warm-up

The FIFA 11+

Aaron and Igor mentioned the importance of stretching and warming up before training and playing in any matches. The FIFA 11+ warm-up routine was created as an injury prevention program. Coaches and parents should be mindful and remind their young athletes to do a proper warm-up.

Recent studies have shown that the most common injuries in youth soccer players are torn ACL’s, Hamstring strains/tears, and ankle injuries.

Research has shown that implementing the FIFA 11/11+ warm up statistically decreases the number of injuries during soccer. The warm-up can be implemented before a game, practice or just kicking the ball around with friends.

The FIFA 11 is a series of warm-up exercises that are broken up into three parts.

Part 1 includes all running exercises, there are a series of 6 activities to be performed in part 1.

Part 2 is all about exercises that utilize plyometrics, balance training, and strength training. Part 2 includes another 6 exercises which can be changed to a more challenging level as the athlete improves.

Part 3 is the last section where there is just one exercise that again focuses on running. In part 3 the level of difficulty can be changed based on the ease of completion of the athlete performing the warm-up.

Download the FIFA 11+ warm-up sheet here.

 

Osgood-Schlatter Knee Pain
Medical Illustration originally sourced from https://orthoinfo.aaos.org/en/diseases–conditions/osgood-schlatter-disease-knee-pain/

Osgood-Schlatters (Knee Pain)

Osgood-Schlatters is an overuse injury that is more common among boys from the age of 9-15 and during growth spurts. The presentation and symptoms are a pronounced bump below the knee cap, that is painful with activity, but the pain decreases with rest. The details of the injury affect the patellar tendon at its insertion point on the tibia and may affect the growth plate. Osgood-Schlatters can be diagnosed with a radiograph. This injury is caused by a lot of running and jumping activities.

Read more about Osgood-Schlatters here.

Proper Footwear

The last topic that was discussed was proper footwear for playing soccer. The shoe should fit snug with just a little room for the toes to move. Proper soccer shoes should be worn while playing soccer, not running shoes or cross trainers or basketball shoes. This cannot be stressed enough!

For indoor play, there are specific indoor soccer shoes that should be worn. When playing on artificial turf there are specific turf cleats that aren’t as long and have more cleats on the bottom of the shoes.

When playing in wet or long grass that is softer the cleats should be a little longer to provide more grip while playing.

Schedule Your Child’s Movement Assessment with Our Expert Physical Therapists Today.

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Brooklyn Half Marathon Crash Course w/ Crown Heights Running Club

Monday, April 9th, 2018 @ 7:00 PM

Park Sports Physical Therapy – Clinton Hill
973 Fulton Street
Brooklyn, NY 11238

Register for the Brooklyn Half Marathon Crash Course

The presentation will be given by Boris Gilzon, PT, DPT, OCS, CHT the owner of Park Sports Physical Therapy and an avid runner and triathlete, Nathon Turner, Certified Coach, Road Runner Clubs of America, and Nutritionist Tara Mardigan, MS, MPH, RD, AKA “The Plate Coach”.

Are you a runner looking to build speed, improve your endurance, and increase mileage safely to prep for the Brooklyn Half Marathon?

Park Sports Physical Therapy would like to invite the members of the Crown Heights Running Club to a free crash course to help improve performance and prevent injury.

The topics being covered include:

  • How to prevent failure in critical joints and avoid structural imbalances.
  • Muscle efficiency – making sure opposing muscle groups are performing in harmony.
  • Proper running form and how to spot deficiencies.
  • Benefits of training with the AlterG Anti Gravity Treadmill.
  • Nutrition for runners.
  • Reviewing your current training plan.

We’ll have a short Q&A section at the end the presentation.

Space is limited to 25 people. Reserve your spot today!

Register for the Brooklyn Half Marathon Crash Course

Questions? Email us at info@parksportspt.com or call 718.230.1180.

Crown Heights Running Club

Learn more about Crown Heights Running Club

 

Injury Prevention Workshop for Youth Soccer Athletes

Presentation by Aaron Lentz, SPT & Igor Kozlov, PT, DPT of Park Sports Physical Therapy

Wednesday, March 28th, 2018 @ 7PM

Park Slope United
260 Jefferson Avenue, 2nd Floor
Brooklyn, NY 11216

RSVP to the Workshop Here

Join us for our very first injury prevention workshop at Park Slope United’s clubhouse presented by one of our physical therapists from Park Sports Physical Therapy.

This workshop is designed to inform parents of children playing soccer about some of the common injuries that can occur on the field during training or matches and what to do in the event of those injuries occurring. We’ll also review the most common injuries among soccer players, how to self-treat, what to look out for more serious injuries, and more.

Here are some other topics that we’ll be covering during the workshop:

 

  • Proper stretching before and after training and games.
  • Post-injury signs.
  • Common knee and ankle injuries.
  • Concussion symptoms.
  • Purchasing proper footwear for both indoor and outdoor soccer.
  • Landing and cutting mechanics.
  • Flexibility vs. Hypermobility.

 

To RSVP call 347-301-9613 or email  team@parkslopeunited.com or sign up on Eventbrite.

 

About Park Sports Physical Therapy

Park Sports Physical Therapy & Hand Therapy has been treating patients of all ages for over 20 years in Brooklyn. With three locations – two in Park Slope and one in Clinton Hill, patients have access to sports rehabilitation, vestibular rehabilitation, pelvic floor therapy, pre & post operative rehabilitation, Scoliosis Treatment / Schroth Therapy, and pediatric physical therapy.

About the Presenter

Igor Kozlov, PT, DPT - Physical Therapist

Igor Kozlov, PT, DPT

Physical Therapist

  • Received his Doctorate of Physical Therapy from Hunter College
  • Attended courses focused on manual therapy at the Institute of Physical Art (IPA) and Maitland Australian Physiotherapy Seminars (MAPS)
  • Pre and Post Operative Rehabilitation

Read Igor’s Full Bio

What Is A Total Ankle Replacement Surgery?

By: Allison Benson, Physical Therapy student at Hunter College, graduating in May 2018
Worked with Kristin Romeo, PT, DPT

With injury and with age, the joints of your body can be damaged by osteoarthritis, causing painful, aching joints. This pain can follow you throughout the day. You may feel stiff waking up, feel a dull ache when taking your dog for a walk, or feel a painful grinding as you stand up from sitting or as you climb the stairs.

Osteoarthritis (OA) is the most common joint disorder in the United States and is more common in women than men, according to an article published by Zhang & Jordan (2010). In healthy joints, where two or more bones meet and rub together, the bone surfaces are covered by a slippery substance called hyaline cartilage. This cartilage helps make your joints move smoothly and painlessly. With OA, this cartilage has broken down, leaving the bones exposed to each other, creating a grating or “bone on bone” feeling.

When a joint with OA becomes very painful, surgeons often recommend a total joint replacement—you probably know someone who has had a total knee or total hip replacement due to OA. Hips and knees are common sites for OA to develop, both because they move a lot, and because they carry the weight of the body.

You may not have heard of a total ankle replacement, though. Although ankles are also weight-bearing and mobile, they develop OA much less common; only about 1% of the population develops ankle OA (Valderrabano et al., 2009). This means many fewer people have ankle surgeries related to OA.

Another reason you may not have heard about ankle replacement is that it was a relatively unpopular surgery until recently. Total ankle replacements are complicated because there are a lot of important structures packed into a small area at the ankle. They also were associated with a very high failure rate, with surgeons needing to go back in and complete additional surgeries to replace, remove, or adjust the hardware they had placed.

That said, the popularity and success rate of total ankle replacements are on the rise.

In this surgery, a round metal ball is implanted into the talus, which is an important bone in your ankle. A metal implant is also implanted into the bottom of your tibia, which is the big bone in your calf. A plastic spacer is placed between these two pieces, which allows the tibia to slide smoothly on the talus, just like it does in healthy ankles.

After surgery, a patient will typically be in a surgical boot for 8-10 weeks, and cannot put weight on that foot for 4-6 weeks (Devries, Scharer, & Sigl, 2015). Patients may be referred to physical therapy prior to, or immediately following the procedure for prehab or rehab of the ankle.

Immediately after the surgery, therapists help with gentle work to reduce swelling and pain and prevent tissues from binding down as scar tissue forms. As time passes, therapists help patients regain their strength and range of motion, restoring their ankle to full use. Healing from an ankle surgery is a long process, and requires months of physical therapy, but can be a good option when faced with debilitating ankle OA.

Did you recently have a Total Ankle Replacement surgery? We can help. Schedule your appointment today.

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SOURCES

Devries, Scharer, & Sigl. (2015). Total Ankle Arthroplasty Rehab Protocol. BayCare Clinic; Foot & Ankle Center.

Zhang, Y., & Jordan, J. M. (2010). Epidemiology of Osteoarthritis. Clinics in Geriatric Medicine, 26(3), 355–369. http://doi.org/10.1016/j.cger.2010.03.001. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920533/

Valderrabano, V., Horisberger, M., Russell, I., Dougall, H., & Hintermann, B. (2009). Etiology of Ankle Osteoarthritis. Clinical Orthopaedics and Related Research, 467(7), 1800–1806. http://doi.org/10.1007/s11999-008-0543-6

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

osteoarthritis knee joint
Osteoarthritis of the knee joint. Medical illustration original source: http://drcolinmacleod.com/platelet-rich-plasma-arthritis

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
Patellar Tendonitis Medical Illustration Original Source: https://www.vivehealth.com/blogs/resources/patellar-tendonitis

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

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

The AlterG can also benefit:

  • Senior Citizens looking to stay active
  • People with obesity looking workout and lose weight
  • Anyone with past injuries or arthritis looking to workout with less impact and stress on their joints

Rates & Monthly Memberships

Your first 30-minute trial run is only $20.00 (normally $25.00). Call 718.230.1180 to schedule your first run!

 

Time Price
Under 30 Minutes  $1.00/minute
30 Minutes $25.00
30 Minutes – Three Scheduled Sessions $50.00
Monthly Memberships Price
Up to 45 minutes – Three Scheduled Sessions Per Week $100.00
Up to 90 minutes – Three Scheduled Sessions Per Week $200.00

Want more information? Fill out the form below.

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What is the Schroth Method?

Written by Kristin Romeo, DPT
Edited by Alex Ariza

What is Scoliosis?

curvature scoliosis diagram

Scoliosis is a three-dimensional abnormal curvature of the spine. Everyone’s spine has a natural curvature to it, however, if that curvature progresses beyond a certain degree it can be classified as scoliosis. Scoliosis occurs equally among genders but girls seem to be more likely to have scoliosis that has progressed to a level that requires treatment. There are an array of health issues that can accompany scoliosis such as abnormal breathing patterns, visible prominences and poor posture due to muscular imbalances.

What causes Scoliosis?

Scoliosis X-Ray
X-ray image of a person with Scoliosis. Original Image Source: https://www.orthobullets.com/spine/2053/adolescent-idiopathic-scoliosis

There are several different types of scoliosis, however, the majority of scoliosis cases are idiopathic, meaning it has an unknown origin. Idiopathic scoliosis typically begins at a young age and becomes more pronounced during periods of rapid growth.

What are the symptoms of scoliosis?

Pain does not always accompany scoliosis. Scoliosis can present in a variety ways such as abnormal trunk lean, uneven rib cage/shoulders or even back pain. If you suspect scoliosis contact your primary care provider to address your concerns. Prior to Schroth treatment, an x-ray is needed as scoliosis can present differently externally due to overlying musculature and does not give us the full picture. Knowing the bony anatomy allows us to monitor your progress and tailor your treatment to your specific curvature.

rib cage scoliosis cross section diagram

What is the Schroth Method?

Kristin Romeo, DPT Treating Patient with Schroth Exercise 5 | Park Sports Physical Therapy

The Schroth Method is a conservative form of scoliosis treatment designed to target the flexible, postural component of scoliosis. The method was created in Germany in the 1920’s by Katharina Schroth as a way to treat her own scoliosis. Since then the method has made its way across the globe, only recently in the US. Scoliosis specific exercises are targeted specifically to each patient’s curvature through the use of five principles of correction. Subtle postural corrections, spinal distraction and isometric tension help to increase muscle activation and strength in a neutral spinal alignment.

What can I expect during a session of Schroth method physical therapy?

On your first visit, you will be fully evaluated. We will take a look at your posture, your muscular imbalances, address any goals or concerns you may have and take a variety of measurements. You will be sent home the first day with the beginnings of a home exercise program. During your follow-up treatment sessions, we will be utilizing a variety of equipment such as a Schroth wall ladder, physioball, rice bags and Therabands. You will learn about the five principles of correction (1. Auto-elongation (detorsion); 2. Deflection; 3. Derotation; 4. Rotational breathing; and 5. Stabilization) and how to implement them into your home exercise program. We will discuss safe ways to lift, sit and postural corrections to integrate into your daily routine.

Do you or your child suffer from Scoliosis or Kyphosis? We can help. Schedule your evaluation today.

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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.
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.
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.

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