Dr. Boris Gilzon, PT

Park Sports Partners with Ivy Rehab Network

The winner is you, our patients!

Park Sports Physical Therapy is thrilled to announce a new strategic partnership with Ivy Rehab Network.

Ivy Rehab, an elite network of the nation’s top physical, occupational and speech and ABA therapists, will bring exciting benefits to Park Sports patients.

To symbolize this partnership, readers will have noticed a new logo, combining the well-known Park Sports neighborhood brand, with the logo of Ivy Rehab Network and its world-class resources.

The Ivy Rehab network has earned over 10,000 reviews online, with an average rating of 4.9 out of 5 stars. Park Sports continues its more than 20-year history as the preeminent physical therapy experience in Brooklyn.

Park Sports Physical Therapy services will still be provided by the same clinicians in the same patient-centered, community-oriented environment. Park Sports will always treat each of you, our Brooklyn neighbors, with individual attention and care, as we have for more than 24 years.

Now we are adding the superpower of enhanced delivery, world-class resources and advanced technology of Ivy Rehab.

How You Benefit

You can look forward to:

Streamlined appointment requests
Automation of front office procedures
Additional advanced, evidence-based clinical treatment options
A new methodology that measures the effectiveness of care
More educational opportunities for our clinicians

And much more…

Proud to partner

“We are proud to partner with the Ivy Rehab Network,” said Boris Gilzon, co-founder of Park Sports.

“We have a long history of being the provider of choice for so many individuals in Brooklyn. Now, joining Ivy will elevate our practice to the next level.

“This is an exciting time for our group, and we know that being partnered with Ivy Rehab Network will open up wonderful opportunities for our patients and our entire team.

“This partnership reaffirms our commitment to provide the highest quality of care to our patients and our community,” said Gilzon.

The Ivy Rehab welcome

The Ivy Rehab Network, with over 300 top quality clinics, now combines with Park Sports as it’s first set of clinics in New York City.

Said Troy Bage, Ivy Rehab’s Chief Operating Officer, “The team and culture that Boris and Svetlana have built is a wonderful fit for Ivy.

“This is a compassionate group of individuals, who are dedicated to both patient outcomes and unparalleled patient satisfaction. We are thrilled to enter into the greater New York City market with a market leading practice like Park Sports.”

Park Sports physical therapist cares for back pain

Park Sports Thriving Brooklyn Clinics

Park Sports Physical Therapy began in 1998 in a small, immaculate clinic with two therapists, its founders, Boris Gilzon and Svetlana Lazarev.

Its therapeutic expertise and compassionate, family-like atmosphere, soon became the talk of the Park Slope neighborhood where it began. Today, in 2022, it has grown to five thriving Brooklyn neighborhood locations.

With this new partnership, you can count on even more ways to get back faster to the things you love.

About Ivy Rehab

Founded in 2003, Ivy Rehab is a rapidly growing network of best-in-class outpatient physical, occupational, speech therapy, and ABA clinics located throughout the United States. The Ivy Rehab Network consists of multiple brands all dedicated to providing exceptional care and personalized treatment to get patients feeling better, faster. With the support of leading middle-market private equity firm Waud Capital Partners, Ivy Rehab will continue its strategic growth via the ongoing investment in new partners who embrace their mission, vision and values as well as a culture of being “All About the People.”

Blood Flow restrictions training what is it?

Originated in Japan where it was known as “kaatsu training” which means “training with added pressure”. A method of exercising the muscle by partially reducing arterial blood flow. A venous return is fully stopped in this method. It is achieved by partially occluding the vasculature above the muscle. This method essentially accelerates rehabilitation protocol by creating an environment that “fools” the muscle as if it is working harder and lifting much heavier loads than it actually does. The advantage over traditional weight training is that it reduces the load on the joint while achieving the same metabolic response. We all know that getting stronger requires working against resistance. The resistance is defined in terms of load and volume, but what do we do in cases when people cannot tolerate high loads, for example following surgery, injury or degenerative condition? Or simply do not have access to the high weights necessary to accomplish their goals?

Muscle weakness and why we are concerned about it.

Any injury or circumstances that require immobilization will lead to various degrees of weakness: sprained ankle, sprained back, knee surgery. Muscle weakness sets in quickly: Atrophy appears within days of disuse. And what relationship muscular strength has in the relationship of quality of life? It has been shown that strong muscle supporting the joint can delay or even prevent arthritis. For instance, greater quadriceps strength is linked to a lower risk of osteoarthritis. It is increasingly evident in non-injured healthy populations that loss of strength is a risk factor in developing osteoarthritis. With aging a decrease in some physical function occurs due to diminished muscle strength, vascular function, and bone mineral density.

Therefore, strength training is indispensable in the rehabilitation of musculoskeletal injuries: acute or chronic.

How Blood Flow Restriction Flow works.

A pneumatic tourniquet system applies an external pressure through the tourniquet cuff by applying the right amount of external pressure. There is a gradual mechanical compression created when the cuff is inflated resulting in the partial restriction of arterial flow and full restriction to the venous return. Compression of the vasculature above the muscle creates inadequate oxygen supply, thus changing physiological conditions under which muscle exercises. This causes greater fatigue, muscle activation, and also anabolic signaling pathways that lead to muscular adaptations compared to exercise without BFR. Thus it creates the same metabolic environment as if the muscle had been exercised in high-intensity resistance exercise without a restriction in the blood flow.

Is Blood Flow Restriction Training Safe?

The treatment is performed under the supervision of a licensed Physical Therapist who has additional training in the BFR technique and is following established safety protocols based on evidence and contemporary research. Blood Flow Restriction training It is an emerging clinical modality successfully implemented to achieve physiological adaptations for individuals who cannot safely tolerate high muscular tension. Continued research established parameters for safe application for widespread clinical adoption. Current evidence supports BFR training as a way to improve muscular strength and hypertrophy for individuals with musculoskeletal dysfunction.

Most commonly treated conditions by Blood Flow Restriction Method

Post-operative anterior cruciate ligament reconstruction,
Isolated muscle weakness
Pre-sarcopenia,
Knee osteoarthritis
Individuals with compromised bone mineral density
Neurological conditions; stroke, cerebral palsy
Cardiac rehabilitation.

In summary, at ParkSports Ivy our clinicians are always striving to be at the forefront of clinical research and innovation. We work closely with referring physicians and collaborate on the best and most effective treatment approach to get you back on your feet faster and safer.

To schedule, an appointment with one of our clinicians call 718 230-1180

Gait Training With People With Amputation

Gait training is a type of physical therapy that can improve many people’s ability to stand and walk. Doctors will likely prescribe gait training to people suffering from an injury or illness that affects their ability to get around normally. Gait training is known to help strengthen muscle and joints, improve balance and posture, help develop muscle memory, build endurance, retrain legs for repetitive motion, and increase overall mobility.

Especially for those dealing with amputation of their lower limbs, it could also increase your risk of developing other illnesses like heart disease and osteoporosis. Whenever patients choose gait training over immobility, they are protecting and improving their health.

Physical therapists like those at Park Sports Physical Therapy work with lower limb amputees and believe that gait training plays a vital role in laying a solid foundation for the long-term success of their patients. Read on as we describe the positive impacts of gait training on people with amputation and what is involved in that training.

Here’s What You Need To Know About Gait Training For Amputees

Did you know that of the estimated 1.6 million people in the United States who suffer from limb loss, over 80% of those people have a lower-limb amputation? When these individuals fail to achieve prosthesis-assisted ambulation, or the ability to walk and move around on their own, they increase their risk for physical deterioration and several other health conditions. Without the help and guidance of a physical therapist, these amputees can develop characteristic gait asymmetries, including altered limb loading patterns, which can increase pain and metabolic costs. Over time, they’ll likely be prone to reduce their energy consumption, leading to health risks and immobility in general.

Let’s discuss why gait training is necessary and what can be expected with that type of training.

Why Is Gait Training Important?

Almost every lower-limb amputee is simply looking to walk “normally” again with their prosthesis. Though “normal” has several definitions, physical therapists define it as a symmetrical gait pattern that falls within the average range in terms of rate of speed, posture, limb positioning, step length, and more.

Generally, the higher the amputation level, the more gait deviations (also called limps) show up. Limps arise because with amputation, muscle, sensory receptors, and leverage are lost. Therefore, a person with a higher amputation level typically has a less stable and less energy-efficient gait pattern than others with a lower amputation level. Physical therapists across the world will agree that recent amputees will have the most to gain with gait training because using a prosthesis is a new challenge, and it’s important to establish healthy habits early on.

The best gait training programs will include aligning the prosthesis to ensure that all components of the equipment are positioned property to optimize the gait pattern. In addition, the prosthetist provides initial gait instructions to ensure that the person using it can stand and walk with stability and decrease the risk of falling.

Especially at these early stages, it is best to enlist the help of a physical therapist for regular gait training sessions. When consistent stability is established, other exercises can be taught to help encourage walking without support. Most physical therapists will agree that even amputees who have used a prosthesis for years can benefit from gait training. Whether patients are looking for a tune-up or learning a new skill, it’s important that amputees establish close communication with their physical therapists. This is especially critical considering how sophisticated today’s prosthetic components are, including their need for careful adjustments.

What Is Involved With Gait Training With People With Amputation?

Here are some of the things an amputee can expect when starting a gait training program:

Typically, it starts with pre-gait activities that are meant to help establish prerequisite skills that ultimately help prosthetic ambulation (the ability to walk without physical assistance). These include donning and removing the prosthesis, setting static standing balance, sit-to-stand transfers, and dynamic weight shifting.

Patients can also expect part-to-whole gait training, which consists of practicing the individual components and building up to the complete tasks. This practice allows physical therapists to identify deficiencies so that they can prioritize training and improvement in those areas.

Treadmill training is a very popular means to help new prosthesis users increase their stamina in a safe and controlled environment. Treadmills provide a consistent and level walking surface that is free from environmental obstacles. Additionally, it allows the therapist to focus on gait mechanics and provide live feedback.

A physical therapist who focuses on gait training with people with amputation might also use bodyweight-supported training as a variant of treadmill training. Typically, it involves using an overhead harness so that patients can practice walking using only a small percentage of their body weight. This allows individuals to learn and practice proper gait mechanics using less weight that can progressively increase as they develop strength and confidence.

Gait training might also employ psychological awareness training which encourages the patient to be mindful of certain gait variables. This could include step and stride lengths, side-to-side movement symmetry, pelvic rotation, and more. Again, the purpose is to help patients consciously monitor their performance with respect to their goals.

Let Park Sports PT Help You Today

At Park Sports Physical Therapy, we are introducing gait training programs for people with lower-limb amputation and including Prosthetists in our team at the Clinton Hill Clinic. The key to a successful prosthetic training program is to instill good habits early on and focus on quality movements that our patients can practice on their own. This includes ensuring each of our patients:

Can correctly put on and remove their prosthesis,
Establishes a proper center of balance and posture (which minimizes compensations)
Shows prosthetic stance control with single-leg activities
Has undergone thorough pre-gait training to help break down improper gait training and improve motor control
Can handle functional training
And more!

Our goal is to help our patients understand the fundamentals and establish meaningful goals so that we can work together to create a more normalized gait pattern. We’ll help minimize gait deviations and focus on one thing at a time so that our patients can master higher-level activities over time. Our mission is to help you get comfortable in your own environment and get back to doing the things you love.

Get in touch with our experts today, and let’s discuss your goals.

Back Pain From Cycling – Causes and Prevention Tips

Are you feeling back pain from cycling? Given how hard your legs work when you’re on your bike, it’s natural to assume that your knees would be most vulnerable to a cycling injury. However, research suggests that the biggest culprit is not knee pain but lower back pain!

Let’s discuss why cyclists are suffering from back pain and how you might prevent it.

How to Prevent Back Pain From Cycling

You might be surprised at the number of people who are afflicted with back pain from cycling, given that it is a low-impact sport and is often recommended for those who suffer from back pain. Why is lower back pain so common among cyclists? It might be your bike setup.

Start With Correct Bike Set-Up

Though lower back pain often occurs because of muscle weakness or improper movement as a result of fatigue, one thing we recommend is to assess your bike fit, too, as this can also be a contributing factor. You want to choose a bike frame with the proper geometry to ensure the correct riding position, which can help minimize the pain on not only your lower back but your knees, shoulders, and even your neck.

When you’ve found a frame that suits you, the next step is to set up on it correctly. There are a few key elements to look at. First, the saddle height should be positioned so that when the pedal is at the bottom of the stroke, and the ball of your foot is on the pedal, your knees are slightly bent. Hips shouldn’t move sideways during crank rotation, and you shouldn’t have to stretch at the bottom of the pedal stroke.

Saddle angle is also critical. It should be in a horizontal position, parallel with the floor (sometimes a very slight downwards tilt can be helpful for those who experience pressure in the perineum area).

Handlebars should be adjusted as well. You should adjust them so that you don’t have to stretch to reach them, but they shouldn’t be too close to your body either. You want your arm position to be comfortable when you reach for them in an upright position, and your elbows should be slightly bent.

Work Your Core

A significant factor that plays into back pain is muscle fatigue and the resulting poor posture to accommodate. Some studies suggest that when cyclists are pedaling to exhaustion, their hamstrings and calf muscles became tired, resulting in undesirable changes in muscle movement patterns. The degree to which you bend forward in the lumbar region and how far your knees are splayed out affects your back. Basically, the more tired you become in your legs, the worse your spinal posture gets.

The evidence points to the fact that to avoid muscle fatigue and strengthen your lower back to prevent pain due to impaired movement patterns, you must work on your core. Your core is your foundation, so if your core is weak, then your lower back muscles will likely try to compensate, leading to overworking, stress on the joints and ligaments within your spine, stiffness, and pain.

A certified therapist like those at Park Sports Physical Therapy in Brooklyn can give you some outpatient therapy and equip you with a plan of safe exercises to practice based on your functional strength and pain symptoms.

Stretch Before and After Riding

Several things can lead to lower back pain. Tight hamstrings are common for cyclists as they pull the pelvis down and cause the lower back to curve more than it should. Tight hip flexors, quadriceps, piriformis, and other muscles can lead to back pain as well. The more flexible you are, the more efficient your cycling will be, and the less likely you’ll experience pain from improper positioning.

There are lots of stretches you should do before and after you ride. Reach out to our team for a complete list of great stretches for cycling. Yoga and pilates, in general, will help you stay limber.

Contact Park Sports PT If You’re Suffering With Back Pain From Cycling

Lower back pain in cyclists is a very common injury. Some studies suggest that more than half of all cyclists have experienced lower back pain in this year alone. The two main reasons why back pain from cycling happens are incorrect bike geometry or muscular insufficiency, and sometimes both! If you’re a cyclist or are planning to spend more time on your bike this summer, make sure that your bike is properly fitted. Bike shops can be a huge help here.

Muscular insufficiency can be addressed in physical therapy. We know that sitting in the saddle for a long time causes the muscles in your calves, hamstrings, and behind your back to naturally shorten. This position changes the length-tension ratio of the muscles and creates multiple issues that could lead to pain. Additionally, prolonged pedaling causes fatigue, which leads to undesirable muscle movement patterns in the legs and spine. It affects your bike by altering the spinal posture. Physical therapists usually associate excessive lumbar spine flexion with lower back pain in cyclists. Excessive lumbar spine flexion is associated with the reduced activity of a key back muscle, multifidus, a stabilizing muscle located in the deep layer of your back.

At Park Sports, we’ll build you a comprehensive lower extremity stretching program and a core stabilization program for cyclists suffering from back pain. We think that back pain from cycling can be avoided, it just comes down to understanding the basic principles of biking mechanics and building up your core so that you can get back to the things you love, pain-free!

When you need us, the physical therapists at Park Sports know all the ins and outs of the mechanical aspect of cycling. We are passionate about sports and athletics, and some of our team members are advanced-level multi-sport athletes that include cycling. Our office is located at Prospect Park, a major cycling venue in Brooklyn. Give us a call to schedule a consultation or a meeting; we would love to help!

Why Strength Training For Triathletes Is Essential

Triathletes are great at many things, but after all the time they spend running, riding, and swimming, they might forget something important – strength training. Strength training for triathletes can be a significant advantage for several reasons. In addition to its performance benefits, we think that strength training also plays an active role in keeping athletes healthy and injury-free. While adding another activity to your exercise routine might sound daunting, you can become an all-around better athlete with a simple plan that doesn’t have to take more than half an hour a week. Building your strength will make you faster and keep you feeling stronger as you make your way to the finish line.

Read on as we describe why strength training for triathletes is important.

The Importance of Strength Training For Triathletes

Successful triathlon training should include strength training. It helps improve muscular endurance to help prepare the body for the demands of training and racing. This kind of exercise helps to increase your power output and also prevent injury.

Any athlete with a well-balanced strength training plan has the ability to efficiently transfer power from their body into their run, their swim, and their pedaling. On the other hand, an athlete who lacks strength throughout their body might experience a lack of power due to poor postural control, reducing the amount of force they can produce during the triathlon.

Postural strength is crucial when it comes to injury prevention. As your workouts get more challenging, your body requires the proper support from your muscles to maintain good form for all three areas of the race. When your form is weak, you become more susceptible to injury. You’ve already heard that you need good core strength, and it’s because core strength creates a stable base for all the activities you do on a daily basis.

When you ask a physical therapist, they’ll tell you it’s imperative to work on the lateral and rotational musculature of the hips and core. These muscles are used to help you move side to side and help prevent any unwanted twisting motions of the pelvis, trunk, or legs when running and biking. When these muscles are strong, your workout will be much more efficient and keep you from straining unnecessarily. Since running and biking is a straight-forward motion, you’ll naturally be working the muscles in the front and back of the hips and legs. Therefore, adding a strength program that includes strengthening the lateral muscles will help you improve stability.

Better Performance

Many of the best triathlon coaches will tell you that strength training for triathletes is a vital part of any multisport training program. With triathlons, there is both upper body and lower body training involved.

Research supports the idea that strength training and improved endurance performance are linked. The Journal of Strength and Conditioning Research looked at several studies and concluded that the analysis showed a 4.6% improvement in running overall among those trained along with their regular endurance training.

Additionally, another study looked at both runners and cyclists. After a ten-week resistance training program, participants showed an increase in leg strength by 30%, a 13% improved running time, and cyclists could ride for 14 more minutes than they could initially.

Reducing Injuries

While performance benefits might appeal more to triathletes, as physical therapists, we encourage strength training as a way to prevent injuries. Injuries are often caused by muscle imbalances and chronic weaknesses in certain areas of our bodies. A basic strength training program is the best way to increase your muscle tissue strength and connective tissue, too, like tendons and ligaments. As your tissue is strengthened, you’ll be able to put in more training without injury, which leads to better and faster performances.

Break Your Training Into Phases

Just like with all triathlon and marathon training, strength training should be periodized throughout the year. You should start with the general strengthening and preparation phase, which lines up with the offseason and helps you build triathlon training phases. This period is when you increase your overall base strength. The offseason is when you should also take a break from the main activities in a triathlon. Hitting the weights will be a nice change of pace from the hardcore training you might be used to. We might even suggest that you increase your resistance in this phase, as you don’t necessarily need to worry about soreness or fatigue for your next run, bike, or swim workout. In particular, heavy-resistance training has been shown to enhance both short and long duration endurance capacity in high-level endurance athletes, like those who participate in triathlons. The healthier you are, the better you will be able to handle increases in workout intensity as the season progresses.

After the offseason and build phases, then comes the pre-racing stage. The pre-racing phase will require that your strength training become more specific and focused on building power and speed. This is where plyometrics comes in. Plyometrics, also known as jump training, are exercises in which muscles exert maximum force in short intervals, the goal being to increase both speed and strength.

During the competitive phase, the idea is to maintain the strength you’ve built throughout the season. Resistance training is reduced, and you can continue focusing on training and practicing for your races.

Once the season is over, take some time off to rest and recover. During this time, strength training is low and shouldn’t be done more than a couple of times a week. You want to let your muscles rest, but you also don’t want to lose the fitness you’ve earned before the next cycle.

Consult A Physical Therapist

If you are new to strength training or new to triathlons in general, you should definitely consult a physical therapist to help guide you. They’ll show you the proper technique and help you focus your strength training sessions on your specific needs.

Even if you’re an experienced triathlete, it’s never a bad idea to have a functional assessment and evaluation from a licensed therapist to learn what you need to work on so you have an injury-free and successful season.

The experts at Park Sports Physical Therapy would love to set up a consultation to see how we can help you maintain your health and wellness so that you can continue to do the things you love.

Overpronation and Orthotics for Runners

In this post I will discuss Overpronation and Orthotic for runners.

During my 30 years of practice as a sports physical therapist, I encountered many runners with afflictions that they attributed to overpronation or flat feet: plantar fasciitis, shin splints, tendinitis, and knee pain, to name a few. A question that is commonly asked: are orthotics good for plantar fasciitis, shin splints? What if you are a runner and developed those symptoms due to your activity? I do not have a straight answer to that. The foot is the final link of a lower extremity kinetic chain. Treating solely pronation without assessing the knee, the hip, and the spine, may not necessarily solve the underlying problem. Clinicians occasionally make a pre-judgment error in mistakenly recognizing something they already know and are familiar with as the main cause for a symptom. Overpronation is a well-known abnormality not only to physical therapists and other clinicians but to trainers, running coaches, and running shoe salespeople in a local sporting good store. Running analysis set up in the shoe store often lacks scientific standards. Well-intended advice for a particular running shoe or orthotic may not lead to the desired benefit.

What running experts say about orthotics.

Said Aouita, a famous Moroccan-born runner, who won the 50000-meter race in the 1984 Summer Olympics and set many world records in shorter distances admitted to the French newspaper L’Equipe that fallen arches have been an issue during his entire career. “My only problem is that I have flat feet, which promotes tendinitis”. Aouita had specially created custom shoes that provided the additional support he needed. Supplementing fallen arches with orthotics insoles can better support adjoining ligaments and tendons, one piece of advice Aouita gives to the runners.

Ethiopian athlete Haile Gebreselassie is considered one of the greatest long-distance runner of all times. He set 27 world records, winning two Olympic Gold medals and the Berlin Marathon 4 times in a row. Running experts had been studying his overpronation and were baffled by it. They recognized his overpronation as a postural deformity. He found a different solution to the same problem that Aouuita experienced: barefoot running.

What is pronation?

Pronation is a shock-absorbing adaptation. Lowering your arch to the ground by inward rolling of your foot. It allows for the distribution of an impact across your foot and stores the elastic energy released during the push-off.

In overpronation, the foot arch drops downward and the ankle rolls inward too much. It continues to roll when the toes should be starting to push off. As a result, you cannot effectively push off.

Do I under or overpronate?

Overpronation and flat feet are often used synonymously, but they are not the same thing. In fact, you can be overpronating, but not have flat feet.

Underpronation is when there is too little inward and downward movement of the foot. Overpronation is more common in runners. Both conditions distribute impact unevenly and may lead to shin splints, stress fractures, plantar fasciitis, Metatarsalgia, and Achilles tendinitis.

How do I stop overpronation when running?

Do you really need to? Overpronation as a cause for foot pain cannot be considered in isolation. Without assessing the running style, joint flexibility, and bone structure of the entire lower extremity, we cannot determine that overpronation is the sole reason for pain. A thoughtful physical therapist should not start fixing pronation. Each runner develops their unique running style. Changing it may take away a useful adaptation. It may force the runner in an unnatural movement pattern. It will lead to higher energy expenditure and undue stress in other parts of the body. Further in this article, I will discuss a recently developed ” habitual motion path theory” that supports an argument against treating overpronation by orthotics for runners.

What are the foot orthotics and do they really help?

Although we focus on orthotics’ usefulness in runners, they are used widely for static corrections. The vast majority of the custom made orthotics are prescribed by the clinician to correct the foot deformity.

An orthotic is a shoe insert that supports the abnormal movement of the foot. It claims to properly align your feet and avoid imbalances by adjusting the angles at which your foot strikes the ground. According to the recently published issue of the American Foot and Ankle Society’s journal https://www.aofas.org/, there was no significant change in incidences of foot problems between the users of custom orthotics and those who wore over-the-counter ones.

Are foot orthotics prescribed too often?

Over the counter, orthotic insole value in North America is $1.2 billion. The price of the shell orthotics is $10-120. This number does not include custom-made or prescription orthotics that can range from $300 to-500. A clinician makes a cast of your foot and sends it to the lab, where the insole is created. Some insurances cover the cost.

Running is a high impact sport. There is repetitive stress on biological tissues that are often associated with cumulative trauma. Foot and ankle is just a part of a mechanical chain. It follows the path set up by the joints above it. The Habitual Motion Path Theory states that humans instinctively “choose” an optimal path of lower extremity joint movement. The neural control regulates our movement and directs our motion in the path of least resistance. How we walk and how we run is specific to each individual’s anatomy, soft tissue mechanical properties. In other words, our bodies will find a way to minimize the loading on our lower extremities joints during running.

What is a habitual motion path theory?

According to the habitual motion path theory, https://www.nature.com/articles/s41598-020-58352-5the runner must generate amplified lower extremity joint movement in order to optimize the load distribution to regions in your lower extremities. Any deviation from the Habitual Motion Path leads to loading to less adopted structures leading to a risk of injury. Neural control of running is adjusted to avoid irreversible injuries such as osteoarthritis. Such a theory is supported by scientific evidence. It was put to test in a recent study performed in Germany in the institute of Biomechanics and Orthopedics. The purpose of this study was to examine how deviation from a natural running path can negatively affect your knees. The subjects had to run for 75 minutes under 3 running conditions in their natural state and with inserts in their shoes either on the inside or outside of the border of the insole. Thus the subjects were forced to run in conditions that deviated from their natural path. Then the MRI of cartilage volume measured after the exercise demonstrated a statistically significant decrease in the knee cartilage volume in the runners who ran with inserts in their shoes.

Physical Therapy for the runner’s injury in Brooklyn

Although orthotics have their value for correcting foot deformity, I would use caution in prescribing one for the runner who was diagnosed with overpronation. If you were diagnosed with foot pain, plantar fasciitis, shin splint, or tendinitis the first step in your treatment at Park Sports https://parksportspt.com/staff/would be a thorough functional evaluation that may include a detailed running analysis https://parksportspt.com/running-analysis-how-you-run-and-walk-matter-a-lot/. Orthotic services are available at our Williamsburg location, and are offered only to those patients who are most likely would benefit from them. In conclusion: overpronation cannot be diagnosed by simple observation. Many other clinical factors must be taken into consideration. Please visit our services website for more information.

Boris Gilzon, PT, DPT, OCS, CHT

Common Injuries In Runners & How To Treat & Prevent Them

Running is one of the most popular ways to improve and maintain fitness, and more than 40 million Americans run on a regular basis to stay in shape. Though running is a great way to keep active, runners across the country deal with an injury at some point in time. Many running injuries are caused by repetitive stress, but other injuries like sprained ankles and torn muscles can happen suddenly.

Keep reading to learn a little more about the most common injuries in runners and how they are typically treated.

How To Treat the Most Common Injuries In Runners At Home

Before we begin, it’s important to note that there is no substitute for a highly-qualified physical therapist, even though some running injuries can be treated at home. Here is a brief list of some of the common injuries in runners and some basic prevention and treatment options.

Runner’s Knee (Patellofemoral Syndrome)

Patellofemoral Syndrome, commonly known as runner’s knee, refers to the pain that resides in front of your knee or around your kneecap. This is a common injury in sports caused by overuse from running or jumping.

Runner’s knee usually causes pain that is dull and can be felt in one or both knees. Typically the pain ranges from mild to extreme and worsens with prolonged sitting or exercise like jumping, climbing stairs, or squatting.

This type of injury may also include cracking or popping sounds after being stationary for prolonged periods. You might be at higher risk of developing runner’s knee if you have weakness in your hips or the muscles around your knee.

A doctor can usually diagnose a runner’s knee with a physical exam, but they might recommend an X-ray to rule out anything else. A physical therapist like the ones at Park Sports will give you a specific treatment plan to treat runner’s knee and other common injuries in runners.

IT band syndrome

Your IT band, or iliotibial band, is a long piece of connective tissue that runs from your outer hip to your knee. It helps stabilize your knee as you’re walking or running.

Repetitive friction of the IT band rubbing against your leg bone is the typical cause of IT band syndrome. Runners have tight IT bands, which is why this is a common injury in runners. Other things that may also contribute to this condition are weak gluteal muscles, abdominals, or hips.

Runner’s experiencing IT band syndrome feel a sharp pain on the outer side of your leg, just above the knee. The IT band might also be tender to the touch, and the problem gets worse when the knee is bent.

Plantar Fasciitis

One of the most common foot injuries is plantar fasciitis. It entails irritation or degeneration of the fascia, the thick layer of tissue on the bottom of your foot. This tissue layer acts like a spring when you’re walking or running. You can put your fascia under increased stress by increasing your running volume too quickly. Weaknesses in your calves and muscle tightness can also increase your risk of plantar fasciitis.

Some symptoms include gradually developing pain, a burning sensation on the bottom of your foot, pain that resides under your heel or midfoot, and pain after prolonged activity.

Hamstring Injuries

During your running cycle, your hamstrings help decelerate your lower leg during the swing phase, so if your hamstrings are tight, weak, or tired, they might be prone to injury. Distance runners rarely experience sudden hamstring tears like sprinters might. Most of the time, distance runners experience hamstring strains that come on slowly. They are usually caused by repetitive small tears in the fibers and connective tissue of the hamstring muscle.

Hamstring injuries usually cause dull pain in the back of your upper leg, muscles that are tender to the touch, or general weakness and stiffness in your hamstring.

Treatment Options For Running Injuries

Follow up with your doctor or physical therapist if you’re experiencing any kind of pain or discomfort or find it hard to run so that you can get a proper diagnosis and rule out any underlying conditions.

For many common injuries in running, treatment often includes specific exercises assigned by physical therapists, following the RICE protocol (rest, ice, compression, elevation), cutting back on your running time, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen.

Specifically for runner’s knee, you should try strengthening your quadriceps and hip muscles while making sure to stretch quads and calves often. It might also help to wear orthotic shoes. With IT band syndrome, daily stretching, and strength training for your hip muscles can decrease pain. If you’re experiencing hamstring injuries, then you should work on strengthening your glutes, stretching your hamstrings often, and changing your running technique. If you’re experiencing plantar fasciitis, then stretching and strengthening your calves can help ease discomfort.

Prevention Tips For Common Injuries In Runners

Running injuries can happen to anyone, but you can minimize the risk of injury in a few of the following ways:

First, warm up! Warming up before you go on your regular run by starting with an easy job or dynamic mobility stretches for 5 to 10 minutes. Another tip is to increase your running volume slowly. Consider the 10% rule, where you don’t increase your weekly volume of running by more than 10 percent at a time.

A lot of physical therapists recommend preventing further injuries to take care of the small ones as they come up. If you already have a nagging pain in your knee or leg, rest! You don’t want them to develop into more severe issues. A physical therapist will give you a proper diagnosis and provide you with a customized treatment plan.

Include stability exercises in your training program to help strengthen your hips. Try glute bridges or single-leg squats to help you protect your knees and ankles. You might also consider cross-training to improve your aerobic fitness, which gives your joints a break from the repetitive impact of running. Add some low-impact workouts into your schedule, such as swimming or cycling.

You should also work on your running technique. Especially if you’re just getting into running, it’s important to note that poor technique can increase the amount of stress on your muscles and joints. Work with a running coach or film yourself running to help yourself improve.

Lastly, run on softer surfaces. Grass, rubber tracks, sand, or even gravel is easier on your joints than running on pavement. Especially if you’re experiencing nagging injuries, try switching up your run and stay on softer surfaces until your pain subsides.

Conclusion

Many runners will deal with an injury at some point, and the most common areas that sustain injuries include knees, legs, and feet. If you’re a runner and experience any kind of pain or discomfort when running, it’s essential to reach out to your physical therapist or doctor to get a proper diagnosis and to rule out other conditions.

A targeted plan made by a physical therapist can go a long way into helping you properly recover when you’re injured so that you can get back to doing what you love. When you need help or advice, give us a call today. We’d love to schedule a consultation with you to see how we can help you alleviate pain and keep you healthy and safe.

7 Winter Exercise Tips That Will Help You Stay Active This Season

We know that staying fit over the winter means you’re more likely to spend time exercising in the gym or at home than outside. However, there are benefits to exercising outdoors in the winter that the gym can’t provide – and with the pandemic still not under control, the gym might not be an option. Being outside exposes you to the sun, which will help boost your mood, increase your vitamin D levels, and enhance your immune system. Plus, with the variety that outdoor exercise can provide, you might even burn more calories. Let’s dive right in with winter exercise tips to help you stay active and in shape this winter.

Embrace Winter With These Winter Exercise Tips

Though it’s often tough to head outside on rainy and snowy days, we’ve got some winter exercise tips to help you stay warm and injury-free in the colder weather.

Wear The Right Clothing

Wearing the right clothing might be the most crucial winter exercise tip we can give. The quickest way to lose body heat is to get wet. Water is an efficient heat conductor, which means it moves heat away from your body to the cold air outside, quickly leaving you cold and miserable. Being cold and wet is a surefire way to cut your workout short and also increase the risk of hypothermia and even frostbite.

To avoid wet fabric leaving you chilled, skip any activewear made from cotton. Cotton soaks up sweat and rain and holds in moisture. Opt instead for synthetic fibers like polyester, nylon, and polypropylene that is designed to dry quickly.

Something else we should mention is not to dress too warmly either. Exercise already generates a considerable amount of heat, which makes you feel warmer than you are. But the evaporation of sweat pulls heat away from your body, which will make you feel cold. The solution is to dress in layers that you can remove as you sweat and put back on as needed. Start with a thin layer of synthetic material to keep sweat off of your body. Then add a layer of fleece or wool for proper insulation. Top it off with a waterproof and breathable outer layer.

Of course, you might need to experiment to find the right combination of clothing styles to match your workout intensity. A heavier person might not need as much insulation as a lean person. Keep in mind that stop-and-go interval activities like a mix of walking and running might make you more vulnerable to the cold. Especially if you’re working up a sweat and then cooling down quickly, you might not have as much fun with your outdoor workout routine.

Protect Your Skin

You probably already know that fingers, noses, toes, and ears are the most affected most by chilly temperatures. Blood is sent to the core of the body when it’s cold out, leaving less blood and heat available to hands and feet. To help avoid freezing your extremities, we suggest wearing a hat or a headband, and also gloves or mittens. You can always take them off if you’re getting warm and tuck them into your pocket or a fanny pack. Thick socks are also a good idea. As we mentioned above, any add-ons you use to protect your skin should be synthetic rather than cotton.

It might also be a good idea to consider the design of your shoes. Running shoes are often designed to let heat escape, but during winter, the cold is coming in. You might want to invest in shoe covers to help keep the cold out. Exercise and sport equipment stores will give you some advice on what shoes are best to withstand the elements.

Another way to protect your skin is to drink lots of water. The winter air is dry as well as cold, and so drinking lots of water will help. Use moisturizing cream or lotion and maybe even use Vaseline to sensitive areas like your nostrils, tip of the nose, and ears for additional protection. Face coverings will also protect your face from the elements.

Don’t forget about the sun! Even in the winter, you are still susceptible to sunburns. Plus, snow reflects up to 80 percent of UV rays, so if you’re out while it’s snowing, you can be hit double by sun rays. This is important to consider if you’re skiing or snowboarding, where not only are you exposed to because of the snow reflection, but being higher up also increases your UV exposure.

Protect your skin by using sunscreen and wear UV-blocking sunglasses.

Don’t Skip The Warm-Up

We’ve mentioned warm-ups before, and we’ll say it again – no matter the weather, your body needs a good warm-up. However, it’s especially essential to warm-up when preparing for cold-weather workouts. A dynamic warm-up can increase blood flow and temperature in the muscles to decrease the risk of injuries.

Working out in colder temperatures increases your risk for sprains and strains. A cold rubber band snaps quickly when stretched, but a warm one is more pliable. Your muscles work similarly. The best warm-up will depend on the workout you’re doing, but at the end of the day, all warm-ups should include low-intensity movements that mimic the exercise you’re about to do.

A warm-up is not static, stretch-and-hold movements. Those types of stretches are best at the end of your workout, during the cool-down. Ask your physical therapist what exercises will be best for your cold-weather exercise routine.

Focus On Your Breathing

The last thing we want to mention is your breathing. If you’ve ever worked out in colder weather, then you know that it feels different than exercising in warm weather. Frequently it can hurt to breathe because of how your body is reacting to cold, dry air. In colder temperatures, your airway passages tend to narrow, which means that inhalation is more difficult. Breathing in through your nose can help warm and humidify the air you’re breathing, but it’s not always feasible.

We suggest wrapping a bandanna or scarf around your mouth or another sports mask to help trap water vapor in when you breathe out so that the air is moister and more comfortable to breathe as you continue your workout. Luckily, with COVID-19, we’re all getting used to wearing masks outside, and more companies are developing breathable masks that also filter out potentially harmful contaminants. It’s easier than ever to find masks and scarves that work great for a winter run.

Conclusion

It’s not for everyone, but exercising outside can invigorate you and give you a connection with nature you might have never had before. Without the right preparation and proper attire, cold-weather exercise can be uncomfortable and even dangerous. Start by making a plan and investing in suitable clothing. Avoid extreme or icy conditions and get back outside.

Outdoor exercise can be an enjoyable experience, even when the temperature drops. Ask your doctor or physical therapist for more tips on adjusting your workout for colder weather to make sure you avoid injuries. Do you have a nagging injury that is currently preventing you from getting outside? Make an appointment with us! A physical therapist’s goal is to get you moving and back to doing the things you love, even in the winter. We’d love to answer your questions and see how we can alleviate your pain.

Your Go-To Tips When Training For A Marathon

Autumn is usually a time when runners start training for marathon season. Training can be an arduous process, and it requires participants to be in top shape to complete the entire race. With the pandemic still affecting our daily lives, especially in more prominent and populous areas, athletic events like the New York City Marathon are being postponed. Additionally, many people find that the more time they spend cooped up at home, the more aches and pain they experience from lack of movement. If you’re feeling discouraged as a runner, we have some tips to help you continue training for a marathon and hopefully help you get your spirits up.

Read on as we discuss some tips to help you safely get back into the running game.

Training For A Marathon? Here Are The Tips You’re Looking For

We know that a lot of you were itching to cross “running a marathon” off your bucket list for 2020, but the global pandemic has thrown a wrench in your plans. You’re not alone! COVID-19 has simply made runners a bit more creative in achieving their mileage and speed goals. Now you can participate in virtual races and other online challenges to help you fill your time as we adjust to this new normal.

Don’t give up, though! One day you will be able to participate in a real-life marathon with your fellow runners, and when that day comes, you’ll want to be ready for it. Here we’ve laid out a few timeless tips to help you start training for a marathon no matter what shape you’re in right now.

Carefully Map Out Your Course

The first thing you should do is map out your final course and try to start incorporating your training runs on the same topography as the actual marathon. If you’re running in New York City, then you’ll want to practice running up and down hills. Chicago runners, however, need to get used to several hours of flat terrain. Though a flat course might seem like a breeze for those used to the up and down, a flat course means you’re using the same muscles the whole race with no variation, and you’ll want to prepare your body for that.

Drastic times call for drastic measures, and you might have to prepare for runs on a treadmill or even just stairways and steps, especially if you live in an area where the terrain is different from the race you’re signed up for. For example, if you live in a flat area but need to train for a hilly run, you might try to alter the incline throughout your treadmill run.

On the actual race day, map out your course and consider leaving supplies for yourself along the way. These supplies might include water bottles, Vaseline, energy chews, and fresh masks at different points. Several sportswear companies make masks that are breathable and comfortable and can stand up to the condensation that comes from heavy breathing.

Listen To Your Body

An important tip we like to give to runners, novice or experienced, is to listen to your body. Though aches and pains are bound to happen, especially if you’re just getting back into the running routine, pay attention to what your body is trying to tell you. Runnings who are training for a marathon tend to see a body break down usually 2-4 weeks before the race day. Overuse aches and injuries can include shin splints, Achilles and hip flexor tendonitis, and runner’s knee (known to us as patellofemoral pain).

Make sure you’re resting when you need to rest and ask your physical therapist for more exercises you can do to ease these aches and pain.

Cross-Training Is Important When Training For A Marathon

It’s also essential to implement cross-training into your training plan. Incorporate short runs with dynamic warm-ups to help keep your muscles fluid. Cross-training and building up your entire body is just as beneficial as getting in those long runs.

Don’t Forget About Mobility and Flexibility

One of the best ways to prevent those aches and injuries we mentioned above from sneaking up on you is to make the most out of your recovery days. On the days you’re not running, incorporate icing into your routine, self-massage, and don’t forget to focus on stretching and mobility. Stiff muscles won’t be able to make it the full 26 miles on race days. If you’re feeling actual pain, though, make sure you’re taking full days off too to let your body rest and heal.

Warm Up And Cool Down

Here at Park Sports, we think that the warming up and cooling down portions of your workout are essential parts of every run, and you definitely should not skip them. Proper warm-ups and cool-downs are vital in preventing injuries and helping you get the most out of your race.

When you perform a proper warm-up, you’re gradually preparing your heart, lungs, muscles, and tendons to exert each training run. It can last anywhere from five minutes to one hour. It should include gentle loosening exercises, some light jogging, static stretching, and maybe even event-specific activities like jumping over hurdles, sprinting, or running at race speed.

Once your workout is finished, you’ll want to begin your cool down, which helps your body recover and helps prepare it for tomorrow’s workout. A cool-down can include roughly 10 minutes of easy running or jogging, which encourages your heart and lungs to return to their regular rates slowly. This is also an excellent time for stretching and massage, as your muscles will be warm and loose. Stretching will help your muscles for the next day’s workout. Hold your stretch for 15 to 20 seconds, and repeat a few times per muscle group.

Try A Dress Rehearsal Run

We suggest doing a dress rehearsal run if you have the time. Four or five days before the marathon, do a three-mile run at marathon-pace in your marathon outfit and shoes. If you can, run at the same time of day as the start of your marathon so you can get your body’s rhythm in sync for race day. The more times you can do this before race day, the better.

While you’re doing short “dress rehearsal” runs, picture yourself on race day. Are you strong and relaxed? Mentally preparing for the day will help boost your confidence, and these practice runs will provide the last boost of conditioning to lock in your race pace on marathon day.

Mindset Is Everything

Though it’s important to train hard for your marathon, you should spend time working on a positive mindset as you prepare for your race. Whether it’s first thing in the morning or as you’re getting dressed for every run, start to visualize yourself crossing the finish line as the clock shows your personal best time. Start willing your positive experience into existence, and see how much better you feel on race day.

You’ve heard the saying when the going gets tough; the tough get going. Runners already have the determination and perseverance that long races need, so we suggest adding a smile to your face and start believing in yourself. You can accomplish anything – and have fun doing it!

Reach Out To Park Sports Physical Therapy

If there’s any pain or lack of movement you’re experiencing that keeps you from participating in a marathon or even a half marathon, reach out to us. The physical therapists at Park Sports PT might be able to help you get back to doing the things you love and help relieve the pain that is holding you back.

Everyone is different when it comes to their training methods and their pain. But at Park Sports, everyone gets the same elite, top-quality, neighborhood care. To us, it’s personal, and we want to help you feel healthy, strong, and able to do the things you love. Call us today, and let’s discuss your goals.

Common Cycling Injuries

Common Cycling Injuries Can Be Avoided.

Most common cycling injuries can be avoided. Unfortunately, we do not have full control of sudden impact injuries; accidents happen. Covid-19 changed our transportation habits. With more cyclists on the road, there are more chances of car-to-bike accidents and bike crashes. The lowest cost and the simplest way to prevent the most common injury ( head trauma) is to wear a helmet. This post is focusing on the conditions which we can control.

Hand and Wrist Pain in Cyclists.

The weight distribution on the bike should be such that 60 percent of the weight is positioned on the rear of the bike. If the seat post is too high or the handlebar is too low, then your arm and wrist take undue pressure. This results in too much weight at the front of your body. If the handlebar angle is not set correctly it may force the wrist joint into an abnormal position. This may result in ulnar nerve neuropathy. The ulnar nerve at the wrist level is vulnerable to repetitive injury. The anatomical structure at the wrist level where the ulnar nerve is passing is called the Guyon canal. It is in a unique location where the ulnar nerve is susceptible to compressive injury. Tingling in your Pinky and Ring finger is a sign of ulnar nerve compression. Wrist joint pain is another common condition in cyclists. The low position of the handlebar forces the wrist joint into more extension which in turn accelerates wear and tear of the small carpal bones that evolutionarily are not adopted for weight-bearing.

Spine: Neck and Lower Back Pain in Cyclists

The low position of the handlebar forces the rider to hyperextend their neck to look up in order to see what is ahead. It causes compression in the cervical spine and creates muscle imbalance between the muscles in the front and the back of the neck. One possible solution to alleviate pressure on your arms is to opt for a compact or shallow handlebar. You can also adjust your handlebar position by loosening the stem bolts and rotating the stem bar upwards. This will reduce your arm’s reach.

Lower back pain in cyclists is the most common injury. A recent study has found that 58 percent of all cyclists experienced lower back pain in the previous 12 months. Because cycling is a low impact sport, it is surprising as to why the lower back pain is so common among cyclists. There are 2 possible reasons: incorrect bike geometry and muscular insufficiency. If you are planning a long time in the saddle make sure that your bike is properly fitted. There are professional services that can perform this job. Your bike is not at fault.

Muscular insufficiency can be addressed in physical therapy. Sitting in the saddle for a long time causes the muscles behind your back, hamstrings, and calves to naturally shorten. It changes the length-tension ratio of the muscles and creates multiple issues affecting your lower back. Prolonged pedaling causes fatigue and produces undesirable muscle movement patterns in the legs and spine. It affects your back by altering the spinal posture. Lower back pain in cyclists is associated with excessive lumbar spine flexion, which in turn is associated with the reduced activity of a key stabilizer back muscle- multifidus, located in the deep layer of your back. A comprehensive lower extremity stretching program and a core stabilization program for cyclists are of paramount significance in preventing lower back dysfunction.

Knee Pain and Possible Quick Fixes.

Before you consult a medical provider for the knee pain from cycling, check your bike fit.

Pain in the front of your knee is a result of a powerful and continuous force that your quadriceps muscles exert on your knee cap. The force could be detrimental if it is applied at the wrong angle and direction. Bike fitting issues like saddle height, saddle fore, and crank length affect the pressure on your knee cap by producing an abnormal force. If the saddle is not properly adjusted in the vertical and horizontal direction the force is increased, causing more irritation. All those issues could be avoided. Understanding the basic principles of biking mechanics can save your time looking for remedies and let you enjoy the things you love to do!

But if you need us, Physical Therapists at Park Sports have a unique understanding of the mechanical aspect of cycling. We are passionate about cycling and some of our team members are advanced level multi-sport athletes that include cycling. Our office is located at Prospect Park, a major cycling venue in Brooklyn. We are here to help!