Occupational Therapist and Hand Specialist, Moussia shares her professional expertise in treating broken wrists.
I want you to close your eyes. Envision yourself walking down the street, admiring the surroundings, then suddenly you lose your footing. Instinctively, what do you do?
To brace yourself for the fall, most people intuitively stick out their hand. A full on outstretched hand often results in a Distal Radius Fracture (broken wrist).
So, what do those fancy words really mean? In your forearm, there are two bones, the radius, and the ulna. The distal end of the radius bone, meaning the part closest to your wrist, is most often fractured. Often, this requires a surgical procedure known as an open reduction internal fixation (“ORIF”) meaning plates and screws are inserted to secure the bone. Although the wrist is now more stable, the mobility is compromised.
That’s where I come in. This is actually one of the most common injuries we see in the clinic, and, if treated properly, rehabs beautifully. Usually, the greatest restrictions of movement are the extension of the wrist extension and supination of the forearm (bringing your palm back and face up). If a patient did undergo the ORIF surgical procedure, treatment will incorporate scar management, which is essential in improving the elongation of the soft tissue.
After any hand-related injury, strength will be diminished because if you “don’t use it you lose it.” But do not worry! Although this is very common cause for frustration among patients, it’s important to remember that as the motion improves, so will the strength.
As a clinician, this is one of the more rewarding diagnosis to treat because people progress rapidly and resume functional independence of most activities within a matter of weeks.
Have you recently broken your wrist? We can help. Schedule an appointment with any of our occupational therapists today.
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 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.
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.
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 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).
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 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.
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.
With the new year approaching, changes to your health insurance policy may occur. These changes may affect your current payment plan.
If you have an insurance plan with deductible policies – please be aware that your accumulations will reset for the new year. This means your deductibles will have to be met again before the health plan starts covering physical therapy sessions.
If you have questions regarding the costs of your physical therapy visits for the new year, please give us a call at (718) 230-1180, and we can give you an estimated dollar amount.
If you are switching to a new insurance – please give us a call with your new policy information. We can reach out to your insurance company to verify your benefits and coverage for your convenience.
If you decide to keep your current insurance provider – please be aware that although your insurance remains the same, coverage may differ for the new year.
Unfortunately, we are not able to verify your benefits with your insurance company until the new year begins. We want to assure you that we are working to ensure you with accurate benefit information.
We strongly encourage and recommend that you call your health insurance provider to obtain benefit information for additional information.
Please call us at (718) 230-1180 or email us at email@example.com if you have any questions about your insurance.
Times Fong & the Park Sports Physical Therapy Team
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.
Strengthening weak muscle group
Manual therapy and therapeutic modalities.
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.
You are probably watching the World Cup 2014. Did you notice that there are several elite players injuring their hamstring muscle in a seemingly innocuous situation? In fact, hamstring injuries are very common. It is a tear in a fleshy muscle behind the thigh. Depending on severity of a tear, the injury classified from mild to severe using a grading system. The tear is caused by sudden acceleration in sports like running, soccer, tennis. It can also happen in a routine situation as in trying to catch your toddler, or running after a bus. There is a sudden, sharp pain behind your leg and the person cannot straighten his knee without pain.
I noticed in the early morning on my way to my office in Clinton Hill, groups and individual runners from Fort Greene and Prospect Heights are dashing toward Prospect Park dodging traffic on Atlantic Avenue and Grand Army Plaza. Sudden accelerations and stopping probably is not the most ideal way to start your work out.
There is no foolproof way to completely avoid hamstring injuries. However, the risks can be minimized by paying attention to the principles of muscle strength and flexibility. Individual flexibility should be maximized by a regular stretching program as well as a period of warm-up and stretching before the intended athletic activity. Park Sports Physical Therapists are experts in designing such a program. Our Clinton Hill location has space and equipment for assessment and rehabilitation of sports related injuries like a hamstring pull. Carefully designed individualized stretching routine will address imbalances that may lead to a hamstring pull. Optimal individual hamstring strength is at least half of the strength of the quadriceps muscle (muscle of the front of the thigh). Also, there should be minimal imbalance in strength between the right and left legs (the injured hamstrings should be about 90% as strong as the uninjured hamstrings). If necessary, a weight-training program should be instituted to optimally achieve these goals. In an evaluation of an injured athlete, particular attention is paid to the relative flexibility of opposing muscle groups, not just the hamstrings and quadriceps pair.
An additional aspect of recovery is proper nutrition. A well-balanced diet and appropriate fluid intake are essential to avoid electrolyte imbalance. It is even more important when exercising in a hot weather. Dehydration can lead to muscle cramping, thereby increasing the chance of muscle injury. Overweight people have a higher risk of muscle injuries in the lower extremities. Some experts have also advocated the use of nutritional supplements, such as antioxidants. Unfortunately, despite the best efforts at prevention and treatment, hamstring injuries will continue to be a common bane of the high-performance athlete as well as the “weekend warrior.”
As a former competitive athlete, I sustained multiple ankle sprains. My personal experience and my knowledge acquired through my profession puts me in a good position to give an expert advice on ankle sprain. Ankle injuries has become one of the most common conditions we treat in our clinic.
Several factors contributed to such an occurrence. One of them is an increase in sports activities and sports participation. Ankle sprains in general by far the most common sports related injury.
In fact there are more than 30,000 ankle sprains in the US per day. Most of those sprains are mild GradeI type that will go away in 2-4 weeks. I am concerned about more severe sprains, approximately 25% of injured persons will go on to develop chronic ankle instability. Surgery may be appropriate in those cases.
There are several risk factors for developing ankle sprains. Probably the biggest factor is a history of a previous sprain. In an ankle that has been already sprained the ligaments are less taut, resulting in the ankle feeling less stable. A typical mechanism of an injury is "rolling" on the outer surface of the foot and causing quick and sudden stretch to the lateral ligaments. Other risk groups are people with stiff ankles, athletes in contact sports. Women are 25% more likely to sprain their ankle than man.
In more severe cases, Grade III sprains, the ligaments are completely torn. In some cases surgery is required. The person may have difficulties putting weight through their ankle, and in many instances this condition makes performing recreational activities impossible. It may lead to a development of premature arthritis, since the normal distribution of forces acting on the joint are disrupted, the articular cartilage wears out much faster.
MRI examination is the most useful tool in determining the degree of ligament injury.
For GradeI and GradeII sprains Physical Therapy is most helpful. The therapist cannot make your ligaments tighter, but he can teach you specific exercises to improve muscular support around the ankle joint, thus providing dynamic stability.
Physical Therapy for all ankle sprains will focus on balance training and proprioceptive control, that is an awareness of your ankle joint position in space.
Our goal is to decrease your chances of re-injury and return to your fun activities.