Treating hand, wrist, arm, elbow and shoulder injuries in athletes
When you've got an injured athlete, what's your move to get them back in the game?
For some sports organizations, athletic trainers and team doctors are on deck to treat most sports injuries. But there's a variety of health professionals who help players get their pitch, swing or throw back.
Did you know that occupational therapists play key roles in athletic injury treatment? With all the throwing, lobbing, pitching and twisting that comes with playing sports, the need for therapy is big.
Upper extremity injuries in athletes are common, sidelining them from play. As many as one in four injuries are to the hand or wrist.
Occupational therapists (OTs) specialize in these types of injuries and more. Their goal is to help the athlete recover and safely return to play.
How occupational therapists help athletes
Occupational therapists (OTs) work with all kinds of individuals to overcome physical setbacks from illness or injury. For athletes, this is key for a return to play after injury.
Just as athletes are unique in their play with their sport, injuries are unique to them. For example, athletic injuries can occur in all ages, from Little Leaguers to Silver Sneakers. Treating a specific type of injury, like a broken arm, will be different for a patient who's 7 and another who's 70.
An OT's role is to assess the impact of injury and the limitations it causes.
Therapy is then based on the skills the individual needs to recover to overcome those limitations.
OTs are specialists in assessing the impact of injury on many parts of the body's framework such as:
The level of an injury can vary from acute to chronic.
For example, an acute injury is sudden, like breaking a wrist.
A chronic injury is one that happens over time, like tendonitis of the wrist. Tendonitis builds up after long periods of overuse, doing the same movements over and over, like serving a tennis ball.
Whatever the injury, OTs are highly-skilled in treating a variety of injuries.
For the weekend warrior or a pro athlete, your path to recovery from a sports injury will be unique. And just like the role you play on the court, the track or the field, you'll play a major league role in your healing process.
Here's some inside baseball on what that will look like.
Expect your doctor and OT to talk with you about your goals for recovery. This is key for planning your way back to play and any restrictions you'll need to follow.
Your local physical therapy center will be your home base for therapy sessions. This is to ensure your safety during treatment.
Your therapist will guide you in proper movement and the use of any equipment to make sure you are doing each exercise right. This helps improve your range of motion and stay on track for healing.
Your therapy may include strength training with resistance bands or weights to improve dexterity and build strength.
If your therapy includes doing exercise at home between scheduled appointments, you may benefit from having your OT take a look at your personal equipment and how you use it. They can spot if it's appropriate for your use and goals for healing. They can also see if you're using it right and, if not, help you to correct it.
Each step of your treatment is planned to help you heal from the injury and get back to your goals.
Brace yourself for orthotic devices
For serious injury or bad breaks that take you out of play, your OT may want to restrict the motion or movement of your injury to help with healing.
The terms – splint, brace, wrap or cast – are pretty common, so, it's likely you've heard them before. In medical terms, though, you might hear your therapist refer to them as an orthotic device or orthosis.
The bottom line, whatever the device looks like, is that it will be fairly rigid or stiff to keep a joint or broken bone in place as it heals.
Orthotics can be made and fitted for:
For a less serious level of injury, there are a host of orthoses we can provide to support and protect to keep you in the game, no matter your game!
These upper extremity orthoses can be fit for thumb, fingers, hand, wrist, forearm and shoulder.
These are custom-fitted and made onsite at our center so you can leave your appointment with what you need.
Your therapist will ensure it fits right for comfort, support and protection.
At the ‘core’ of your injury
Your core is a complex series of muscles extending far beyond your abs. So if you’re thinking “six-pack” or “washboard” abs, think bigger!
The core is made up of 20-plus muscles at the center of the body. It includes major and minor muscles of the stomach, hips and low back. They all work in tandem, making the core part of nearly every movement we make.
Having a strong core (diaphragm, abs, glute and pelvic muscles) and good dynamic balance plays a large part in athletic activities. Weakness in either of these areas may be flagged by your therapist for you to get a movement screen assessment.
The core helps:
- Stabilize movement
- Transfer force from one extremity to another
- Initiate movement
If your core strength is weak, the strength and coordination of your upper extremity isn't at full potential.
Occupational therapists who work with patients on upper extremity recovery consider the whole body during treatment. Your OT will work on improving core strength as well as leg and hip strength as it applies to your sport.
The power of occupational therapy
Getting back to a well-loved sport or activity is important to anyone who's sidelined by injury.
It doesn't matter if you’re competing at an elite level or just want to retain an active lifestyle to get the benefits of occupational therapy. Our OTs know how to create a rehabilitation plan to meet your goals.
Our occupational and hand therapists can help you:
- Avoid injury
- Perform better
- Recover from injuries quickly and safely
We're here for you. Our proven therapies, along with compassionate care, offer the best outcome for your injury.
Take a look at all the sports medicine and injury prevention services we offer. Then click on any of our pages' blue Request an appointment buttons and come see us!
How the ravages of history launched two profound professions
When a doctor recommends occupational therapy (OT), rather than physical therapy (PT), many people don't at first realize there are two kinds of therapies.
It might also not be understood that there's a difference between them, or why a doctor prescribes one over the other.
As therapists, we get this question a lot.
For sure, there's a difference between the therapies and how they're used in healing and recovery. And the story is more interesting than you might imagine…
A short history of modern therapy
Movement and manual therapies can be traced back to ancient Asia, Greece and Rome. Those early practices included massage and hydrotherapy (water therapy).
In the 1920s and ‘30s, Franklin D. Roosevelt found relief with hydrotherapy. FDR receiving physical therapy or exercising with assistance in an indoor pool at Warm Springs, GA, 1928. Courtesy of Franklin D. Roosevelt Presidential Library and Museum.
Fast-forward to modern-day therapy which began in 18th century Sweden with the practice of orthopedics — the medical focus on bones and muscles.
A bit later, Hanrik Ling, developed the Swedish Gymnastic System (also known as the Swedish Movement Cure). His motivation? Having experienced the benefit of improved body movement through his practice of fencing.
At its core, Ling's system emphasized physical conditioning for its ability to improve health and body function. It combined lesser intensive floor-style of gymnastics with manual therapy. Ling's approach brought wide acceptance of his methods.
In 1813, the Swedish government appointed Ling to start the Royal Central Institute of Gymnastics (RCIG).
Ling's system became wider spread as graduates of the RCIG adopted its four core components:
- physical education
- massage, physical therapy, physiotherapy
- dance performance
One more fast-forward to the 1920s. The polio epidemic was raging in the United States, especially among children.
During the epidemic, two schools of thought emerged.
One used the practice of immobilizing the limbs of patients believing limb movement and stretching would impair muscle recovery and cause more deformity.
A second practice re-introduced the Roman practice of hydrotherapy. Here therapists used exercise in heated pools to improve a patient's muscle recovery and movement.
Polio paralysis spurred working with patients to improve balance and regain muscle strength. The benefit of warm water was helpful as well as buoyancy – water supports body weight and reduces stress on the joints.
The practice – active polio therapy – helped grow a population of physical therapy (PT) specialists who became instrumental in treating polio paralysis.
These early PTs developed methods for assessing and strengthening muscles – methods still used today.
This piece of history gave the push to establishing the profession of physical therapy in the U.S.
Turning now to the topic of occupational therapy (OT), its history doesn't stretch back as far as those of physical therapy.
But its roots in America began to grown in the late 1800s. This happened primarily as a way to help individuals with mental illness by engaging them in meaningful tasks. Examples include gardening, painting and arts and crafts creation.
The U.S. military also began recognizing the importance of mental health services for wounded and traumatized soldiers to help them resume daily living.
This marked an entry for OT services in the treatment of individuals with mental and physical needs.
Three movements of thought were significant in the development of OT:
- The consensus that mental health patients should be treated and not put in asylums or prisons.
- The reemergence of the value of manual occupation and vocational skills over mass production.
- The rise of thought that working with your hands to produce items of value can be beneficial to a person’s overall health.
During this time, mental health asylums changed to reflect these new ideas. They were ideas of humane rehabilitation and included craft and recreational activities to help patients return to society through their contributions.
These ideas were foundational for developing OT.
About 1915, a social worker named Eleanor Clark Slagle started the first formal OT education program at John Hopkins University in Baltimore.
Dubbed the "mother of occupational therapy" she trained more than 4,000 therapists and promoted OT within the medical community.
While PT and OT therapies were in their infancy on the two sides of the Atlantic, it was America's entry into the Great War in 1917 where they came together.
To summarize some of the above timeframes, it's worth a look at how it happened.
World War I and its transformation of therapy
World War I transformed medicine and contributed to the development of today's scope of medical care.
The total number of military and civilian casualties in World War I was about 40 million.. and about 23 million wounded military personnel.
With the staggering number of wounded worldwide, orthopedics and therapists rapidly advanced to meet the need.
The course of thought was that society had a moral responsibility to help these soldiers return to a normal and purposeful life. Thus, medical specialties developed to fill this need.
The U.S. military hired a small group of women, calling them "reconstruction aides." In their roles they provided treatment by teaching occupation skills to the wounded.
The initial 18 aides were trained in the latest European physiotherapy practices at the time. Aides were chosen from civilian women and women from the newly established profession of OT.
Both therapy groups expanded rapidly to help the soldiers with recovery.
Of the original 18 Aides, 16 went on to form the American Women's Physical Therapeutic Association. This later became the American Physical Therapy Association with McMillan as president.
– The U.S. World War One Centennial Commission.
Soldiers recovering from severe wounds learn basket weaving as a form of occupational therapy, led by the World War Reconstruction Aides Assocation. Learning basket weaving (Reeve 000290), National Museum of Health and Medicine.
The work of these aides brought the military to begin seeing disability in terms of capability in function, and not as limitation.
Their successes were many, helping wounded soldiers learn to walk again and freely move about in their environments.
These early therapists gave training in the use of arm prosthetics, adapted home and work spaces and taught crafts and vocational skills for mental diversion and future employment.
The convergence of today's therapies and practitioners
After WWI, occupational and physical therapy continued to advance.
And with their evolutions came recognition for the benefits they each provided.
But sometimes there was division in which to prescribe: occupational therapy vs physical therapy.
What became clear over time, with advances in the professions, is the benefit to individuals when providing therapies in tandem.
Today's occupational and physical therapists work together in the shared goal of improving an individual’s function through movement.
As individual medical treatments, the therapies, when used together, can have profound results.
Because of this they are recognized as separate but symbiotic professions.
Working in a variety of settings
- Outpatient rehabilitation centers
- Home health agencies
- Nursing homes
Training in key disciplines
Using similar therapy techniques
- Soft tissue mobilization
- Functional activities
- Pain relief
Opposites attract, even in medicine
Even with similarities between the two professions, there are also key differences.
Physical therapy focuses on improving movement, flexibility and mobility. This includes improving physical motion required for a task.
Physical therapy has a unique approach to mobility – movement and muscle balance. It uses prescribed treatment techniques to maximize function, capacity and performance.
PTs work with patients before and after surgery to build strength and kick-start healing. Therapy uses movement to reduce pain, recover from an injury and promote balance to reduce the risk of falls.
The occupational therapy profession has a different focus.
That focus is on functional ability – the ability of an individual to do activities, work and tasks that are normally performed in everyday living and occupation.
That focus gives occupational therapy its name.
Occupation is defined as an activity that is meaningful and purposeful to the individual. It can include basic activities such as dressing, bathing or fixing a meal.
It can also include specific activities which are unique to the individual.
For example, you may be a high school teacher, home gardener, pianist or an electrician. Each occupation requires a unique set of activities. If those activities are compromised by illness or injury, OTs can help.
Your therapist will assess your current function and how to improve your ability to perform a task or modify it to help you complete it.
Now that you know more about the differences between OT and PT, should you need therapy you'll be able to spot the differences in what your therapist recommends.
Of course, it all depends on your condition, your needs, and personal goals.
But thanks to a long history of the disciplines, and more than a century of experience since WWI, PTs and OTs are specialists in your care.
Our job is to help get you back to enjoying the activities that matter to you.
If you or someone in your family might benefit from our therapies, request an appointment with us. We're here to help.
Sports medicine’s health care specialists on and off the field
You’ve seen them hustling across the football field or crouching beside a player on the sideline whose face is twisted in pain.
They don’t wear the black and white stripes of the referee, but their breed is just as easy to spot. And their presence on the field can be just as critical as a game-changing field goal, free throw or hat trick.
Enter the athletic trainer, or AT.
Often sporting khaki pants, a fanny pack and a polo or sports shirt in team colors, ATs are recognizable in how they look and, more importantly, for what they do.
But if in your mind’s eye you picture an NFL or NBA game, it might surprise you to know the diverse places where ATs work.
With March being National Athletic Training Month, we want to recognize ATs as vital practitioners of health care. This year, the National Athletic Trainers’ Association (NATA) is celebrating the theme “Providing Health Care Everywhere.”
The theme broadly promotes ATs whose profession centers on injury prevention, treatment and ongoing wellness management. And while most often associated with sports, ATs work as health care professionals in many settings beyond the playing field.
Beyond just athletics
There’s high regard for the public work that athletic trainers do in helping individuals avoid injury and recover from injury.
Not surprising, then, are the national standards that trainers are held to.
ATs must graduate with a bachelors or master’s degree and pass the Board of Certification Exam (BOC) to work with professional athletes. There’s also regular renewals on that certification to demonstrate continued learning and competence.
All this is to ensure that athletes are healthy and performing at their peak potential.
But think about the word “athlete.” You may think of athletics in a traditional sense – youth and high school programs to college and professional divisions – on the playing field, ice rink, basketball court, you name it.
But ATs do their work in many job settings and treat a range of individuals beyond those traditional venues, such as:
- Doctors’ offices
- Hospitals and emergency rooms
- Urgent Care centers
- Rehabilitation clinics
Outside of clinical settings, there are emerging job settings where ATs are finding new opportunities in public safety, military schools and the armed forces, performing arts and aeronautics. These industries employ individuals who need certain levels of athletic fitness to do their jobs.
Add to those, various commercial settings like airlines, warehouses, hotel/resort and theme parks, and an athletic trainer’s scope of practice broadens even more.
For each of these sectors ATs are required to have specific training to provide medical care based on the unique activities, physical demands and requirements of the patients they treat.
No matter the type of athlete or athletic patient or the job environment, ATs work as an extension of and overall medical team.
Let’s break it down by key areas of an athletic trainer’s role.
Injuries are a part of life.
But if you’re an athlete or a weekend warrior, or you have a very active or physical job, you likely have more instances of injury than someone who’s not as active.
If you’ve been sidelined from work, missed out hanging with friends or playing your sport because of injury – or a repeated injury – there’s good news.
Working with an AT now can help avoid injury later. Put another way, you don’t have to wait until you’re injured to address the issue.
Your AT can identify any weaknesses or conditions that may be leading to your injuries and plan preventive measures to correct them.
Called prehab, preventive tactics are designed to decrease your risk of future injury.
- Functional movement screen. Done by an athletic trainer to identify dysfunctional or painful movement patterns. Exercises are prescribed to correct movement and any imbalances you may have acquired in compensating for pain. Exercises can be done on their own or as part of your warm-up before activity. For example, a proper warm-up using dynamic stretching can help increase blood flow to loosen your muscles prior to your activity, whether it’s working out or warming up before performing a concert or dance routine.
- Recovery planning. Proper nutrition, hydration and sleep are all needed to keep the body in the right state for exercise. But it takes planning and adaptation to adopt the right approach for your body and your activity level. Your AT can advise on the right balance for your wellness. This advanced planning helps produce optimal performance through brain to body communication. So get good sleep, stay nourished and hydrated and warm-up!
Post-injury. Return to play. Return to work.
The moment has finally come.
You sustained an injury (ouch!).
You completed the recovery process (hooray!)
What comes next?
The next stage in post-injury progression is your return – return to play (RTP) or return to work.
This happens after your medical care provider is satisfied with your progress and clears you to get back to sports and physical activities. Working with an athletic trainer is essential in getting to this stage.
Your AT has done functional tests and collected performance stats to gauge your readiness for activity, at what level and at what pace.
For athletes, and depending on the injury, tests can include sprints, cutting drills and jumps for lower body injuries, or lifting movements such as throwing and push-pulling for upper body injuries.
ATs use the stats to pinpoint any deficits remaining post-injury recovery, like limping or weakness, which could hinder you from safely retuning to play.
If testing is clear of any concerns, you’ll get the green light to return to full activity.
If there are areas of concerns, your trainer may plan additional exercises, or modify your activity level to help you improve on the deficits and continue toward full clearance.
Return to play is unique to each athlete and injury. The goal of functional testing and injury recovery is to ensure your safety and the safety of others on the playing field when returning from an injury.
Onsite emergency care
Although it’s not something we like to think about, medical emergencies can happen at any moment, in any environment.
Athletic trainers are skilled medical providers who are trained in first aid, CPR and automated external defibrillator use (AED) in the case of sudden cardiac arrest.
With their advanced medical education, ATs are prepared to handle emergency situations that may arise, especially on the playing field.
Whether its keeping up-to-date with the most current first aid and CPR standards, revising emergency action plans or drilling emergency situations with members of the sports medicine team, athletic trainers are usually first responders and initiate emergency medical care when injuries happen.
There’s a tactical side to AT work, too – critical need-to-knows in the face of emergency:
- Emergency phone numbers
- Ambulance access points at venues
- The integrity and working condition of onsite emergency equipment
Partner to parents, coaches and clinical team
If you’re an athlete, a parent, relative or friend of one, you may have crossed paths with a sports medicine team member at some point.
This team is a group of trained individuals who care for an athlete’s health in variety of ways.
At the center of this team is the athletic trainer.
The athletic trainer is generally the first on the scene and tends to the immediate and long-term needs of the athlete – injury evaluation through treatment and rehabilitation. But they also rely on the support of other experts.
Surrounding the athletic trainer are other talented individuals, often including:
- physical/occupational therapist
- strength and conditioning coach
- massage therapist
- sports psychologist, among others.
The athletic trainer coordinates care between each of these individuals. They also handle all communication with coaches and family members to keep everyone in the loop with the care of the athlete. This open communication is key to managing medical care and the expectations surrounding care.
Around the world, ATs are looked to as trusted professionals playing a crucial part in health management and health care.
Multi-skilled and holding advanced certification to help athletes, performers and patients across many job settings, athletic trainers truly do provide health care everywhere.
By: Joshua Cramer, DAT, LAT, ATC, CSCS, CES, area sports medicine director for southeastern PA, and Katie Olenek, M.S., LAT, ATC, PES, area director of sports medicine for central PA.
How to stay in play and on the court
What is pickleball? And why are people raving about it?
Pickleball is an improvisation of badminton and ping-pong. The game is played on a court using a softball-sized, hard-plastic ball with holes – like a wiffle ball – and paddles similar to table-tennis paddles.
Conceived in 1965 as a game that families could play together, pickleball grew in popularity. By 1972, a corporation was founded for the sport.
While there is debate around the origin of its name, there is none about how fun, fast, competitive and entertaining the game is.
With a smaller court size than its cousin sport of tennis, it’s an ideal way to stay active and fit for just about anyone.
And pickleball has taken the country by storm.
The first pickleball tournament was held in 1976 in Washington State. And while not what’s called an overnight sensation, the explosive growth of the game in the years since has led to pickleball courts popping up everywhere, and the formation of amateur and professional leagues.
There’s even a professional pickleball tour.
When injury puts you in a pickle
With the rise in popularity of pickleball, physical therapists throughout the country are seeing an increase in injuries that are similar to those found in other racquet sports.
New pickleball players sustain approximately 50% of injuries during their first year of play.
The most common pickleball injuries include:
- Pickleball elbow
- Ankle sprains
- Knee sprains
- Shoulder sprains
- Achilles tendonitis
- Wrist fractures
- Concussions from falls
In the case of older players, many are predisposed to injury, often due to prior injury, limited flexibility and range of motion and deterioration of balance, or have recurrent injuries.
So if you are looking to start playing the game … or stay in the game … keep these prevention tips in mind to reduce your risk and avoid injury:
Warm up Pickleball is a fast-paced game, and the excitement starts right away. So it's important that you warm up before you get on the court. Try a light 5-minute jog, a slow walk with high knees or some side shuffles to loosen up.
Stretch As part of your warm-up, make sure to stretch. Shoulder stretches, calf stretches, hamstring/quad stretches and wrist and neck stretches are all important to incorporate into your routine.
Choose proper footwear Pickleball requires moving side to side and back and forth. Choose a good fitting athletic shoe for this type of movement.
Pivot Similar to tennis and other racquet sports, you will be executing groundstrokes, volleys and serves. Remember to pivot your hips and shoulders as you face the approaching ball.
If you are injured, stop playing!
Don’t try to tough it out, especially if it is a head injury.
Contact a physical therapist to help you heal and recover before you return to play.
Pickleball is as fun as it sounds, and you’ll want to play for years to come.
If you’re in a pickle with pain or injury of any sort, click now to request an appointment to find one of our centers near you.
By: Deborah Santiago, P.T., DPT. Deborah is a physical therapist and center manager at NovaCare Rehabilitation in New Jersey. NovaCare is part of the Select Medical Outpatient Division family of brands.
Select Medical is proud to be the official physical therapy partner of the PPA Tour.
If you clicked to read this, it’s likely because you or someone you know has long COVID. Or maybe you’re now hearing people talk about long-lasting symptoms of COVID-19.
With research now being published, millions of people having a COVID diagnosis will experience “long” COVID – post-COVID syndrome or long-haul COVID, earning some who experience it the nickname of “long hauler.”
Putting aside that bit of levity, long COVID is no joke.
So if you are struggling to read this because you’re dealing with “COVID brain fog,” you may be thinking, How did I get so unlucky?
It’s a fair question to ask.
But in reality, long COVID is more common than most think.
According to Penn State College of Medicine researchers, more than half of the 236 million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience post-COVID symptoms.
Months after recovering from COVID-19, millions of people are still suffering one or more debilitating symptoms like:
- Brain fog
- Difficulty breathing
- Muscle weakness
- Joint pain
- Dizziness and more
If you or a loved one is suffering, don’t give up. There is hope and help.
Physical therapy is medicine for long COVID
Professional physical therapists, like me, understand what you are going through. Indeed, if you have long COVID, physical therapy can help.
Yes, physical therapy.
As physical therapists, we are specialists who are trained in identifying the clinical symptoms and effects of long COVID. For example, the profound fatigue you’re feeling? Reminiscent of chronic fatigue syndrome, it’s a post-acute leftover of the viral COVID infection, and we can help.
That joint pain? We’re trained also to understand musculoskeletal conditions that can be causing your pain. We can assess the pain and determine the appropriate treatment for it.
I work in an outpatient physical therapy center and help treat patients with long COVID. Our parent company Select Medical collaborated with the Centers for Disease Control and Prevention on an important clinical study regarding the long-term impact of COVID-19.
The study validates our Recovery and Reconditioning program which focuses on specific deficits in patients recovering from COVID-19 and other debilitating illnesses and conditions.
Our Recovery and Reconditioning program helps, specifically, with:
- Labored breathing
- Joint and muscle pain
Our program was developed in partnership with leading physicians, infectious disease specialists, physical and occupational therapists and speech-language pathologists to help those impacted to heal, gain strength and return to an active, full lifestyle.
We hear all the time that people suffering with long COVID don’t feel heard. Feel misunderstood. Feel like giving up.
If that sounds like you, then trust me, we understand.
We are proud to offer the Recovery and Reconditioning program to you, your loved ones and/or friends – anyone who may be dealing with lingering effects of having COVID-19.
Together, we will address your specific post-COVID symptoms and create an individualized treatment plan for your road to recovery. During care, you will learn ways to pace yourself throughout the day and move your body so that you don’t tire so quickly.
As part of your treatment, we will track your vital signs and symptoms to ensure your safety and progress. We will be there every step of the way back to a healthier you.
You deserve a medical professional who understands you. If you’re tired of feeling alone in your recovery from long COVID, let a physical therapist help.
Schedule a consultation with a physical therapist trained in treating long COVID. Click the blue Contact Us button below to request an appointment at a center near you today.
By: Corey Malone, P.T., DPT, OCS. Corey is physical therapist, center director and Recovery and Reconditioning program champion with KORT in Kentucky.
KORT and NovaCare Rehabilitation are part of the Select Medical Outpatient Division family of brands.
Originally posted 3/21/2018 by Dorothy Lehr, DPT, OCS, Cert. MDT updated 2/3/2022
Major snowstorms have a way of causing major headaches…and major muscle aches!
Snowstorms have already hit many parts of the country this winter, with more on the way. And while there’s beauty in a landscape covered in white, there’s potential for back aches and muscle strain in the chore of removing snow if not done safely and with preparation.
So before powering up that monster snow blower and pushing it along the sidewalks or layering up with hats, scarves and gloves, read on for tips to keep you safe and healthy while out in the bluster.
Beware the Shovel
- While a shovel with a standard handle may be cheaper to purchase, beware! Shovels with “bent” handles – ergonomic handles – are a better choice for reducing back strain. Choose one with a cushioned grip too.
- Look for a shovel that also has a sharp bend in the shaft. This type of shovel is made to decrease back strain as you push and stoop to scoop.
- The weight of the snow makes a difference in snow tool choice. Snow tool? That’s right!
Today’s shovels have come a long way from the standard shovel and come in a range of blade features (the scooping or chiseling part) to lessen strain and injury.
- Light and fluffy? Aluminum is the way to go.
- Heavy and slushy? Polycarbonate, shatter-resistant gets the job done.
- Icy and compressed? Galvanized steel chips away with lower impact.
Tame the Technique
Proper shoveling is just as important as the correct shovel.
Keep your back straight.
Bend at your hips and knees.
Avoid twisting your body when dumping snow. Instead, pivot your legs to turn your whole body.
Wear shoes or boots with good tread to avoid slipping on slick areas or black ice. Applying pet-friendly salt, sand or kitty litter gives traction and decreases the risk of slipping.
Snow shoveling can be as physically demanding as a gym workout and should be treated like a day in the gym.
Don’t overexert yourself, especially when the snow is wet and heavy. In deep snow, take a few inches off the top and tackle the job by dividing it into thirds, with one-hour rest breaks.
Prepare and Prevent Injury
Snow shoveling is a cardiovascular and weight-lifting exercise. So just like you need to stretch before working out or exercising to get its great benefits, stretching before and after is important.
If you need to tackle a big snow that will take more than a few minutes, taking a break and stretching in between clearing snow or drifts will help prevent injury.
This stretch helps balance in any forward-bending movement while shoveling. Choose a standing or laying position.
Extension 1: Stand and bend back as far as is comfortable and hold for three to five seconds. Do 10-15 repetitions.
Extension 2: Lie on your stomach and bend back as far as is comfortable and hold for three to five seconds. Do 10-15 repetitions.
While standing, use your right arm to pull your right leg up toward your buttocks. Keep your trunk straight and use opposite arm to hold onto a sturdy object to maintain balance.
Duration: Hold each stretch for 20 seconds doing five reps on each leg. This will stretch out your quad muscles that you’ll be using to lift while shoveling.
Hip Flexor Stretch
In a half-kneeling position and while maintaining an upright trunk, lunge forward until you feel a stretch in the front of your hip.
Duration: Hold position for 20 seconds doing five reps on each leg. This stretch will help to stretch the muscles you’ll be using while moving snow and helps to keep your spine in a neutral position.
Beyond Shoveling Safety Tips
Sometimes, there will be a winter storm where a snow shovel isn’t enough.
While a snow blower can certainly help with snow removal, snow blower injuries and accidents do happen. Burn injuries, lacerations, fractures and even amputations are the biggest reasons for ER visits from snow blower injuries.
"The Consumer Products Safety Commission estimates that 3,000 persons are treated in emergency rooms in the United States for snow-blower injuries each year."
Practice these to stay safe while operating a snow blower:
- Never put your hands down the chute or around the blades of a snow blower. If you need to clear wait 10 seconds after turning off the engine for the blades to stop spinning. Use the handle or a broom, a stick or another tool to clear any clogs.
- Keep hands and feet clear of all moving parts of a snow blower.
- Avoid hanging scarves and loose-fitting clothing which could become tangled in the moving parts and pull you into the machine.
- Direct the discharge chute away from you, other people or areas where any damage can occur. The blower can throw hard objects, such as salt, sticks and ice.
Winter can be brutal, even when you do prepare and follow safe practices.
If you’re feeling nagging aches and pains or you’ve suffered an injury during your winter clean-ups, we’re here for you.
Click the Contact Us button below to request an appointment with a nearby center. Stay safe and keep thinking spring – it’s coming!
By: Dorothy Lehr, DPT, OCS, Cert. MDT. Dot is a physical therapist and center manager with NovaCare Rehabilitation in Willingboro, NJ. A treating clinician for 12 years, Dot is a board certified orthopaedic specialist and McKenzie credentialed therapist, specializing in spine treatment.
Posted on 10/25/2021
Did you know that knee osteoarthritis affects nearly 14 million adults in the United States1 per year? Or that meniscus tears are present in 60-90%1 of those with knee osteoarthritis? With symptoms ranging from knee pain, swelling, stiffness and limited range of motion, medication, injections, surgery and physical therapy are all commonly prescribed to manage knee pain. Medication and injections, however, may simply serve to mask your pain. Surgery can be costly and taxing on your body. Physical therapy, on the other hand, emphasizes a more holistic approach to the body with emphasis on education, pain management and strength and conditioning.
At first glance, it can be frustrating when you are referred to physical therapy for management of knee pain related to structural issues like osteoarthritis or a knee joint tear. Is the physical therapist going to magically reverse your arthritis or heal your meniscus? Shouldn’t you address the structural problem head-on instead of just “strengthening around it?”
Surgery or osteoarthritis physical therapy?
If we dig deeper, a better question to consider might be, “Do I need to change the structure of my knee in order to resume the activities I enjoy?” There are several studies to suggest that abnormal findings on X-rays and MRIs can be common, even in persons without knee pain. In fact, a 2020 study2 of a population with a median age of 44 and no knee pain found that an astounding 97% of knees had abnormalities on MRI. In addition, when comparing physical therapy management to surgical intervention, there are many cases with similar outcomes.
Now, this is not to say that everyone with knee pain should get physical therapy instead of surgery. Sometimes, surgery is exactly what’s needed to improve your overall quality of life. However, including a physical therapist on your health care team – before and after surgery – is beneficial, even without changing the structural abnormalities that are often presumed to be the problem.
If physical therapy isn’t changing the “structural problem,” what exactly is the benefit?
People are more than pictures, and pain is far more complicated than what that picture shows. X-ray and MRI findings can absolutely be helpful in developing a plan of care; however, they are only one piece of the puzzle. While physical therapy is unlikely to result in a change in the X-ray or MRI findings, it can identify and help modify factors contributing to your knee pain and functional limitations.
Focusing on your unique condition, a physical therapist can work with you to determine the following:
- Health and lifestyle factors contributing to your knee pain
- Activity modification so you can safely perform activities of daily living
- Stretches and strategies to improve motion and strength
- Swelling and pain control
- How and when to appropriately get back to activities that cause you pain/discomfort
This combination can help patients to better understand their condition and develop a plan that assists in recovery. Doing all of this may greatly enhance your quality of life and ease the pain and symptoms you are currently experiencing.
Now, if you and your doctor determine that knee surgery is necessary, remember, physical therapy is a vital part of preparing for your procedure and recovering after it. Before surgery, we will work together to get you as healthy and strong as possible, which will enable your post-surgical recovery to be that much more successful and faster. Following surgery, we will focus on helping you to restore your strength, balance and flexibility.
No matter what, physical therapists are committed to helping you be as mobile, independent and pain-free as possible. Our goal is to build a relationship in which you feel comfortable asking us questions, are an active partner in your care and we’re able to work together to ensure the best outcomes possible.
If you have knee pain, contact us today and experience the power of physical therapy.
- Bhushan R. Deshpande, BS, Jeffrey N. Katz, MD, MSc, Daniel H. Solomon, MD, MPH, Edward H. Yelin, PhD, David J. Hunter, MBBS, PhD, Stephen P. Messier, PhD, Lisa G. Suter, MD, and Elena Losina, PhD. The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity (2017)
- Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol (2020)
By: Patrick Smith, P.T., DPT. Patrick is board-certified clinical specialist in sports physical and orthopedic physical therapy, a fellow of the American Academy of Orthopedic Manual Physical Therapists and a treating physical therapist with NovaCare Rehabilitation in Philadelphia, PA.
NovaCare is part of the Select Medical Outpatient Division family of brands.
Posted on 10/18/2021
Technology has brought many wonderful things to our fingertips. However, an undue side effect of all this technology and connectivity is a condition known as tech neck.
If you have a stiff neck, experience headaches or feel frequent muscle tension around your neck and shoulders, your technology-using habits are likely a contributing factor. Physical therapy exercises can help to alleviate your pain.
Many suffer unnecessary pain due to poor posture when using a computer, tablet or smartphone. Poor posture greatly increases the amount of pressure placed on your muscles. Sitting straight up, the weight of your head is 10-12 pounds. Slouching forward with head dropped down, the weight of your head is more like 50-60 pounds to your neck. It’s easy to understand why your muscles are hurting when you imagine them supporting five times more weight for several hours each day.
If you’re suffering from tech neck, the good news is that it’s often reversible and treatable. Here are five strengthening and stretching exercises to combat it:
You may often find yourself sitting slouched forward with your head well in front of your shoulders. This is the starting position for retracting your head.
Pull your chin backward while looking directly forward. You should feel a “double-chin” forming under your jaw. Repeat this forward/backward exercise 10 times once every hour or two while working.
Perform this daily while sitting at your work space.
What about neck exercises for computer or laptop users? Tension in the upper trapezius muscles, which span the back of the neck and shoulders and are responsible for moving the head and shoulder blade, is common. The trap stretch can be performed any time, and you only need 20-30 seconds to help release tension on one side of your neck.
To stretch the right side, place your right hand on your waist or lower back, tilt your head to the left while looking back to the right. Place your left hand on top of your head and gently pull toward the left until you feel a comfortable stretch. Hold this stretch for as long as 60 seconds and repeat on the other side.
Perform this daily while sitting at your work space.
Lean forward in your chair as if you’re smashing a pillow between your belly and thighs. Place your hands with fingers crossed behind your head.
Reach your elbows toward the ceiling while keeping your belly close to your thighs, causing only your upper back to straighten. The thoracic extension reverses the forward bend and slouchy posture so many assume throughout the workday.
Perform this daily while sitting at your work space.
Lie face down on the floor with your arms at your side, hands near the hips.
Keep your neck straight (do not look upward) and simultaneously lift your chin, arms and knees off the ground. Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.
Perform this exercise 2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.
Lie face down on the floor with your arms reaching upward and slightly outward from your head.
Keep your neck straight and simultaneously lift your chin, arms and knees off the ground. Hold the position for 2-3 seconds and release to the floor. Repeat 10 times for three sets.
This exercise emphasizes the lower trapezius muscle between your shoulder blades due to the overhead arm position. The prone scaption should be performed 2-3 days each week to promote strengthening of the muscles across the back of your neck, shoulders and torso.
Finally, sit up straight. It’s not a complicated tip, but it is easy to forget that we need to maintain good posture when working with technology. Elevate your computer screen so that it is at eye level. If you’re working on a laptop, generally you’ll have to direct your gaze downward while keeping your posture upright, but do your best to comfortably elevate the computer. If you’re on a phone/tablet, simply make an effort to hold the device higher in front of your face.
If you have pain that persists and is impacting your daily activities, contact us today to request an appointment with a licensed physical therapist. A physical therapy plan of care can efficiently and effectively strengthen your body, reduce pain and prevent injury.
By: Joe Zucco, P.T., DPT, FAAOMPT, center manager for Select Physical Therapy in Sarasota, FL.
Select Physical Therapy and NovaCare are part of the Select Medical Outpatient Division family of brands.
Posted on 10/1/2021
At NovaCare, we believe movement is medicine. So, what moves you? Physical activity is key to good health, vitality, energy, strength and might even make you laugh more.
If pain or a medical condition is holding you back, we’re here to help. Physical therapy is a moving experience.
Physical therapy gets you back to life and the things that are most important to you. Whether it’s running a marathon, playing with the grandkids or simply cooking dinner pain-free, the benefits of physical therapy can change lives for the better.
That’s why we’re excited it is October, one of our favorite months of the year. Why, you may ask? October is National Physical Therapy Month. For 31 days, we get to celebrate all things physical therapy and the many ways our dedicated physical therapists and physical therapist assistants help improve the quality of life.
There is so much to share about the benefits of physical therapy, including the highly-trained clinicians who provide it. Did you know that physical therapy helps people manage pain and chronic conditions? How about the power of physical therapy to help heal from recent injury and reduce the risk of future injury? Or prepare the body for surgery and successful recovery or avoid the need for surgery altogether? Well, physical therapy does all this and more.
Physical therapy is also a safe alternative to taking prescription medication. It treats common aches and strains, sprains and fractures, and helps with many other issues and conditions, including:
- Back sprain/strain
- COVID-19 fatigue and other debilitating illnesses
- Headaches and concussions
- Vertigo, dizziness and balance
- Disc injury and pinched nerves
- Rotator cuff tear, bursitis and frozen shoulder…and more
So, what moves you? That marathon? Those grandkids? That culinary masterpiece? Whatever it is, physical therapy, and our compassionate team of licensed therapists, can help get you moving.
Request an appointment today and see how physical therapy can physically, emotionally and mentally enrich your life.
#ThePowerOfPhysicalTherapy #WhatMovesYou #ChoosePT
Posted on 9/22/2021
Sports and exercise are part of the lives of many young individuals. Typically, people who participate in sports are known to be healthier and less likely to partake in outside negative distractions compared to people who do not play sports. However, for some adolescent girls, when they only focus on the sport and not their bodies, consequences can arise.
Many girls who participate in sports are at risk for an issue called the female athlete triad. This triad consists of three conditions, and the athlete can have one, two or all three. The three conditions include disordered eating, amenorrhea and osteoporosis.
Disordered eating is a term that refers to an individual having unhealthy eating behaviors and worrying about body image. Some of the most common forms of disordered eating include extreme dieting and restrictive eating. On the top end of the spectrum are eating disorders, which involve things such as self-induced vomiting, binge eating and laxative abuse. An individual can have disordered eating and not be diagnosed with an eating disorder. Most girls with disordered eating are trying to lose weight to help them improve their athletic performance. For these specific athletes, this eating pattern can range from not eating enough calories to sustain the amount of activity that they are participating in, to trying to avoid “bad” foods, all the way to eating disorders such as anorexia nervosa and bulimia nervosa.
Amenorrhea is the lack of menstruation, or one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as well as girls who have not started their periods by the age of 15. Intense exercise accompanied with not eating enough calories can lead to a decrease in the hormones needed for menstruation. As a result, a girl’s period may never come, become irregular or stop altogether. Some girls who have been participating in sports since a young age may never get their first period, because they have been training so hard. On the other hand, some girls may have gotten their period, but it disappears as their training intensifies or their eating habits change. On one hand, dysfunction of the menstrual cycle can lead to infertility. And on the other hand, it can lead to unplanned pregnancies in young women recovering from the triad. While the cycle is being restored, an egg may be dropped early and, without contraception, pregnancy can occur.
Osteoporosis is translated as porous bone. It is a disease in which the density and quality of the bone are reduced. For people with osteoporosis, boss loss overtakes the growth of new bone. Consequently, over time the bone becomes more porous and fragile, and the risk of fracture greatly increases. This typically happens silently, and there are usually no symptoms until the first fracture occurs. In girls with the triad, estrogen is typically lower. Low estrogen accompanied with a poor diet, especially low calcium, can lead to osteoporosis. During the teen years, a lot of bone growth is supposed to happen and the peak bone mass should be reached. An athlete with the female athlete triad will have a hard time getting to her peak bone mass, and it can affect her greatly later in life.
Takeaway: Diagnosing and treatment
Girls who have female athlete triad are typically invested in their sports and would do almost anything to be the best athlete possible. Girls in particular sports have more of a risk than others. Sports with a weight class like wrestling, martial arts and rowing, and sports where being thin is more optimal for performing like gymnastics, diving, figure skating, cross country and ballet, have a higher risk. However, the truth is, being very thin, and losing those last few pounds, doesn’t typically improve performance at all.
If a female athlete is suspected to have the triad, a wide-ranging physical examination is needed for diagnosis. A doctor will likely ask questions about her period, diet, exercise habits and overall feelings about her body. From there, blood test will be ordered to check for vitamin deficiencies and to rule out any other reasons for a lack of period and weight loss. A doctor may also order a bone scan to check for osteoporosis, since the athlete will be at a higher risk for bone breaks.
Doctors will not work alone to help treat a girl with female athlete triad. Coaches, athletic trainers, parents, physical therapists, nutritionists and dietitians and mental health specialists all work together and play a role in the recovery of this athlete. They focus on both the physical and emotional issues that the girl is likely facing to help prevent long term issues.
By: Wyneisha Mason, MAT, ATC. ‘Neisha is an athletic trainer with RUSH Physical Therapy in Chicago, Illinois.
RUSH and NovaCare are part of the Select Medical Outpatient Division family of brands.