• woman wearing covid protection mask

    Posted on 5/25/2021

    Have you ever heard the term “mask jaw”? Well, guess what? It’s a thing!

    Mask jaw is the jaw pain and pressure many of us experience as we wear our masks for an extended period of time since the start of the COVID-19 pandemic. Now, while the Centers for Disease Control and Prevention recently put out new masking guidance for vaccinated people, masks will still be part of most of our lives for the foreseeable future. And, all that mask wearing can take a toll!

    If you jut your chin forward or tense your jaw muscles to hold your mask in its proper position over your nose and mouth, you are likely experiencing jaw tightness. Headaches and muscle tension can also be caused by stress, something we’ve all felt more of since March 2020!

    Let’s take a closer look at how your jaw works. Your jaw bone connects to your skull on both sides of your face, and is referred to as the temporomandibular joint, or TMJ. It is a rounded bone, with a disc that provides a cushion to support the joint, much like the discs in your spine and meniscus in your knee.

    When you first open your mouth, your jaw hinges and rotates. As you open further, it glides and translates until you open it fully. This action happens with large muscles from your temples and cheek, to smaller muscles deep within the jaw. At least that’s how it works normally. When there is an issue with the disc, the muscles or the joint itself, it is referred to as temporomandibular joint dysfunction, or TMD.

    TMD includes a wide range of symptoms, such as pain in the jaw or neck, headaches, locking of the jaw in an open or closed position, clicking noises and pain or difficulty with speaking, eating or chewing. TMD symptoms are widely reported by many people, but become troublesome when they start limiting your day-to-day activities.

    Now, let’s dive into how your mask may be the culprit to any lingering jaw pain you may be experiencing.

    1. Maybe you are breathing through your mouth while wearing your mask. Did you know that this places more stress on the jaw from it being constantly open?

      Wearing a mask can feel like you are not getting enough fresh air, but it should not alter how you breathe. Each inhale and exhale should pass in and out of your nose. Your jaw muscles are relaxed in this “resting” position. This means that the tip of your tongue is gently touching the roof of your mouth while your back teeth, the molars, are not quite touching.  

      If you breathe in and out of your mouth, your jaw remains open. To keep your jaw open means your muscles are doing extra work. When you breathe with a mask on, focus on the air passing in and out of your nose.
    2. Maybe the ear loops are too tight. This creates tension and can throw off the alignment of your jaw and, in some cases, cause headache. 

      Masks come in all shapes and sizes, and the fit is important. Whether made of fabric or disposable, it should never feel like it is pulling your ears forward or your chin backward. These compressive forces can easily trigger a headache. Consider a mask extender or “ear savers” to keep the ear loops from tugging and avoid a potential headache altogether.
    3. Are you clenching your teeth more because of stress? This is an easy trigger for TMJ pain and dysfunction. 

      Remember the resting jaw position? This is the most relaxed position for the muscles. When you clench your teeth and hold that bite position for extended periods of time, the jaw muscles can go into spasm. Avoid gum chewing or biting your nails, which can make symptoms worse. Exercise is a key component to overall health and managing stress. Take a walk or jog, meditate or find another way to get moving. Your body and your jaw will thank you.
    4. Chances are, you are moving your jaw in altered positions to adjust how your mask is resting on your face. 

      With a proper fitting mask, you will avoid overusing your jaw. Use a mask that has some moldable wire that can be shaped around your nose. Additionally, avoid masks that are too big and sag on your face, or that are too small and tug on your ears. You should be able to speak and breath through your mouth (wink, wink) comfortably. To avoid jaw pain, make sure your mask is molded to your face and does not slide or move easily.  

      If you are feeling pain or clenching in your jaw, experiencing headaches or are having difficulty with chewing or eating, physical therapy can help. To learn more about our TMD program or to schedule an appointment at one of our centers, please contact us today.

      By: Nicole Romaine, P.T., MPT. Nicole is a physical therapist for Kessler Rehabilitation Center in West Orange, NJ. 

      Kessler and Novacare are part of the Select Medical Outpatient Division family of brands.
     

     

  • Posted on 5/12/2021

    “Am I Injured?”

    This is a question I get asked by many runners.

    “How do I know if I’m injured and not just sore from running/training?”

    Short of a physical examination, this is what I tell them...

    There is good pain and bad pain. Good pain stops when you stop. It is generally mild, diffuses and doesn’t affect quality of movement. Bad pain does not stop when you stop. It can get worse during or after activity. It can be sharp in nature, and significant enough to force you to change your gait whether you realize it or not.

    If you have rested or taken time off from running, and the pain has decreased or gone away only to return when you start running again, there is most likely some underlying issue that needs to be addressed. There could be an issue with muscle imbalances, running form, footwear, training schedule, joint mechanics or any combination of these.

    If you are taking non-steroidal anti-inflammatory drugs (NSAIDs) daily or after every run for pain, you may have an overuse injury. Overuse injuries account for the majority of running injuries. They occur when a tissue is loaded beyond its threshold. In bone, this can result in a stress fracture. In tendon, this usually manifests as tendonitis or tendinosis. Excessive stress to a ligament can result in a sprain.

    Overuse is relative and not always obvious. It can be a result of “too much, too soon” with regard to training or mileage. It can also be due to cumulative stress from non-running activities and/or compensation. When a structure takes on additional stress to unload another, it can break down.

    How can physical therapy help? A thorough evaluation by a physical therapist can help identify the underlying problem so that you’re not just treating symptoms.

    A progressive loading program can assist the injured tissue regain the strength needed to resume running and training. Hands-on therapy can also help restore normal joint mechanics so that muscles are functioning more efficiently and inert structures are not unnecessarily stressed.

    Physical therapy can you build strength, endurance and minimize running injuries, so you can achieve your personal best.

    By: Martine Marino, MPT, COMT. Martine is a physical therapist and the center manager for NovaCare Rehabilitation in Bethel Park, PA.

    NovaCare is part of the Select Medical Outpatient Division family of brands. 

     

     

  • baseball injuries

    Posted on 4/19/2021

    While it is America’s favorite pastime, baseball is known for being a slower paced and long duration sport that can place strain on the body. Although this sport is typically low in intensity, it can lead to overuse injuries due to the repetitive motion of it. A pitcher can typically throw more than 100 pitches a game.1 Now imagine doing that 65+ games a season; that’s a total of more than 6,500 pitches in a year. This volume can lead to multiple injuries in pitchers. Additionally, position players combine the volume and intensity of throws with hitting and base running. So, although baseball may seem like a simple game, the different components can take a toll on the body.

    Some of the most common injuries in baseball include both upper and lower body injuries.2, 3 They include:

    Rotator cuff tears
    Rotator cuff tears are common in baseball players, especially players who perform repetitive, high intensity throwing motions, such as pitchers. The rotator cuff is made up of four muscles that work together to help to rotate your shoulder and arm away from and toward the body. The act of pitching over and over can wear down the structures attached to these four muscles, leading to a break down in the long run. This then leads to the muscle tearing. If found fast enough before the tear, this injury can be helped with a licensed physical therapist. However, if the muscle is fully torn surgery will likely be needed.

    UCL injuries
    The UCL is the ulnar collateral ligament in the elbow; more commonly known as the Tommy John ligament. The volume of throwing in baseball players can cause added stress on the bones and tissues of the elbow and this repeated motion can lead to injures and even full and partial tears of this structure. In some cases, this injury can cause a pins and needles feeling in the ring and pinky finger, causing an athlete to not be able to grip a ball. Most cases can be fixed with rest and physical therapy; however, some cases may require surgery.

    Labral tears
    The labrum is a structure in the shoulder that helps keep the shoulder socket tight. A tear is caused by the overuse nature of baseball. This injury typically appears as the shoulder joint locking up or with weakness of the shoulder. A labral tear is typically spotted by a doctor and can be either repaired surgically or with physical therapy and rest.

    Knee injuries
    Knee injuries, although less common than other higher intensity sports, are still possible in baseball. Injury normally occurs during base running. The sudden stopping, sliding and quick changes in direction can cause an athlete’s knee to give out, leading to a sprain or tear of the MCL or ACL. Injury to these ligaments typically appear with sudden pain and the sensation of popping or snapping inside the knee. Similar to UCL injuries, an ACL or MCL injury can often be fixed with physical therapy and rest. However, if the ligament is fully torn surgery is usually required.

    Muscle sprain and strains
    Like many other baseball injuries, muscle sprains and strains are usually due to overuse. In baseball, these types of injuries are common in the legs, arms and back. Symptoms for sprains and strains will vary based on the person and the seriousness of the injury. Typical symptoms include pain, weakness and muscle spasms, but they may also include bruising and swelling. These injuries rarely require surgery and can typically be solved with physical therapy and RICE (rest, ice, compression and elevation).

    With all injuries, a common theme is that working with a physical therapist can help for healing and strengthening both pre- and post-surgical intervention if necessary. If you have been injury, please request an injury screen at one of our convenient locations. With a guided treatment and exercise plan by a licensed physical therapist, you can be back to your sport in no time.

    References:

    1. https://www.baseball-reference.com/blog/archives/7533.html
    2. https://rothmanortho.com/stories/blog/common-baseball-injuries
    3. https://www.michaelgleibermd.com/news/common-baseball-injuries/

     

  • Posted on 3/19/2021

    What is an athletic trainer? Often confused with personal trainers, athletic trainers are allied health care professionals recognized by the American Medical Association trained to handle the prevention, examination, diagnosis, treatment and rehabilitation of emergent, acute or chronic injuries and medical conditions. That’s important work! Athletic trainers work primarily in the field of sports medicine and are trained to handle injuries and conditions affecting the neuromuscular (nerve and muscle relationship) and musculoskeletal (bone and muscle relationship) systems.

    Now that we have a better understanding of what an athletic trainer is, you might be wondering what an athletic trainer does day-to-day. At NovaCare, we employ many athletic trainers to provide services to local middle schools, high schools, colleges and professional teams as well as club and league tournaments. Within these settings, our athletic trainers provide services ranging from:

    • Taping
    • Education on injury reduction and management
    • Emergency care and triage
    • Stretching, and other hands-on therapeutic techniques
    • Develop exercise/rehabilitation programs
    • Mental health and nutrition needs and refer appropriately when necessary
    • Create and implement emergency action plans and return to play protocols

    The goal of an athletic trainer is to prevent the athlete from getting injured in the first place. In the event that an injury occurs, they examine and treat the athlete/individual and if the injured party requires further diagnostic testing or follow-up of any sort, they refer to the proper specialist and work in tandem with them to ensure proper care.

    When the time comes to rehabilitate an athlete’s injury, our athletic trainers create a treatment plan and collaborate with one of the many wonderful physical therapists that work for our organization. They are also integral in being one of the first on scene when an athlete suffers a concussion. Athletic trainers provide both sideline and full concussion evaluations. They are able to conduct baseline tests which primarily measure the neurocognitive and/or vestibular-ocular (eyes and balance) motor system and help direct care to the proper specialist, communicate with parents, the school nurse and advisors/teachers when needed. As the athlete continues post-concussion treatment, athletic trainers help them progress through the return-to-play protocol to ensure a safe return to sport.

    Developing and implementing emergency action plans and other important procedures regarding return to play is an important part of an athletic trainer’s role. These procedures and policies include acclimatization, inclement weather including heat management, COVID-19 and others to help keep athletes safe. In addition, they maintain inventory and assist with budgets and provide ongoing communication to coaches, school administration and parents.

    It’s also important to note that while the focus here is the athletic trainer’s role with athletes, they also provide the same clinical expertise to many companies working with the “industrial athlete.”

    By: Josh Cramer, LAT, Germantown Academy, Philadelphia, PA