Category Archives: Prevention

Physical Therapy to Prevent Falls in the Elderly

falls

Did you know that 1 in 3 adults over age 65 has a fall in a given year?’ Not only can falls cause serious injuries, but they can cause older adults to become less active due to fear of falling and this can affect their long­term health. The fear of falling can also prevent older adults from being able to respond appropriately to prevent falls when they lose their balance. Balance can be affected by multiple factors including medications and health conditions as well as the person’s posture, strength deficits, gait deficits and balance disorders.

The therapists at Accelerate Physical Therapy can help older adults who are at risk for falls. We provide a full assessment of gait, balance, posture and strength and then develop a treatment plan based on the client’s individual needs. Therapeutic exercise to address balance deficiencies can be highly beneficial to increase the client’s confidence and ability to respond to balance challenges. Gait training can prevent falls by improving foot clearance and dynamic stability. Increasing strength and postural control allows the client to improve reactions and tolerance to regular activity.

Anoslipfallther aspect of fall prevention is discussing home safety habits. Our physical therapy evaluation will also include a. discussion of client’s home environment and their ability to perform daily activities safely. We will educate clients in fall prevention at home through good safety practices and the use of appropriate assistive devices.

Physical therapy is an excellent resource to prevent falls in any clients who have experienced falls or are reporting difficulty with their balance, and for those with chronic health conditions causing weakness or unsteady gait. We look forward to teaming up with our referring physicians to prevent falls in older adults, veterans and the actively challenged.

Four Exercises for Knee Pain

The following 4 exercises will help you soothe the pain in the knees quickly:

Bent-Leg Raises
You should start in a sitting position. Extend one leg in front of you and elevate it to be parallel to the ground. Hold for a minute, and then bend the knee to lower the leg halfway to the ground. Hold for half a minute, and return to the starting position. Make 4 repetitions, and switch legs.

Half-Kneel Hip and Quad Stretch
Place a mat on the ground, kneel on the right knee, and put the left foot in front of you. Stretch the hip downward by leaning forward to the left knee. Then, lift the back ankle toward the hip to stretch the hamstrings, and switch legs. Make 15 repetitions.

Knee Flexion
Sit on a chair, with the feet in front of you. Then, take a towel and loop it under the foot while resting on the floor, and pull on the towel slowly until the foot is about 4-5 inches above the ground, and the knee is bent. Switch legs and do 5 repetitions.

Wall Calf Stretch
Lean against a wall, standing, and rest one foot on the wall, and the other on the ground. Lean forward to stretch the calf, and hold for 5-10 seconds, and then release. Change the leg and perform the same 10-15 times.

If you perform some of these exercises on a daily basis, you will effectively treat and prevent knee pain.

Source: www.healthandlovepage.com

Tensor Fascia Latae Pain

Reference from: http://www.newhealthadvisor.com/Tensor-Fasciae-Latae-Pain.html

The Tensor Fasciae Latae is a muscle, which helps in flexing and abducting the thigh. It becomes very vital for a runner due to this function. If the TFL is consciously kept flexible, it will help in keeping the body injury free as well as being fit. Activities like walking, bending and moving around can get affected if the muscles of the thighs and hip are injured. They will also affect exercise pattern. Tensor fasciae latae pain can be caused due to a tear or strain in the muscle. With proper directed exercise, the muscle can be healed and strengthened.

What Are the Symptoms?

The symptoms include:

  • Pain in the outer hip
  • Referred pain down the outer thigh
  • Pain when lying on the affected hip
  • When weight bearing on the affected side, the pain worsens

The trigger points for TFL myofascial can get misdiagnosed as trochanteric bursitis because they have very similar symptoms. In the beginning the treatment for either case should be to get the surrounding muscles in good condition and make corrections in existing imbalance in the muscles. If the case persists, it should be investigated for bursa involvement.

What Causes Tensor Fasciae Latae Pain?

Tensor fasciae latae and Iliotibial band muscle pain can be caused due to the following activities:

Running, climbing, cycling, dancing, excessive walking when not in shape and playing court sports like basketball, volleyball and tennis.

How to Relieve Tensor Fasciae Latae Pain

Therapies

  • Warm and Cold Therapy Gel: A pain relieving gel, which provides therapeutic warmth with burning, can be used. Or else a cooling gel, which reduces inflammation by cooling the area. The gel should be applied on the outside of thighs and knees. It will help in reducing the tensor fasciae latae pain as well as tightness.
  • Hot and Cold Compress/Wrap: This kind of wraps can be used on thighs, knee, hip and back. It can be cooled in the freezer or heated in the microwave. It helps in reducing the pain and swelling in the injured muscle by cold therapy and chronic pain and swelling by warm therapy.
  • Tensor Fasciae Latae Brace and Support: This brace is useful in providing compression and support to the TLF muscle. This type of support can be used in high thigh and groin injuries as well. The brace is held in place by wrapping around thigh and abdomen.
  • Compression Leggings: Compression leggings are usually used for preventing injuries, however, they are excellent when used as support for injured muscle. They help in reducing swelling as well. Good compression leggings cover the thighs and end below the knee. Tight compression at lower end of limb and decreased compression at top is essential for reducing inflammation and circulation.  
  • Massage Tools for Self Treatment: A roller is an excellent massage tool, which can be used on upper and lower leg muscles. It is easy to use and helps in relieving tension and pain. It just needs to be rolled up and down the muscle and usually does not strain the hands and wrists.

Stretching and Strengthening Exercise for Tensor Fasciae Latae Pain

Some exercises are described below which help in strengthening the muscles and dealing with the tensor fasciae latae pain.

  • Outer Hip Stretch

Start by lying down on the back, and bend your right knee. Cross the bent leg over the left knee and pull with your left hand. Hold this position for 10 to 30 seconds. This exercise stretches the gluteus medius, gluteus minimus and tensor fascia latae muscles.

  • Standing Outer Hip Stretch

Start by placing the leg to be stretched behind the other leg. Lean your body on the side, which is not going to be stretched. The hip to be stretched should be pushed out to the other side. Hold for 10 – 30 seconds. The muscles stretched in the exercise are TFL, Iliotibial band and Sartorius.

  • Hip Abduction with Band

This exercise is done to strengthen the hip abductors present on the outside of the joint. To start wrap a resistance band around the ankle and other end to a doorway or chair leg. Stretch the leg outside, as far as possible and slowly come back to position. Muscles stretched in this exercise are TFL, Gluteus medius and gluteus minimus.

  • TFL Trigger Pointing

A trained person should help you in this exercise. A massage ball is laid on the bad side, under the TFL and moved around. It helps in identifying the painful or sensitive spot. The pressure is maintained for 10 – 15 seconds till the tenderness decreases. It should be done twice in the beginning, and repeated every 2-3 hours.

  • Squatting Exercise

Squats are helpful in strengthening the TFL muscle and also in increasing the hip rotation and flexion. To start stand with the feet at shoulder distance, keep the back straight and abdominal muscles pulled in. Bend your knees while pushing the butt out, till your thighs are parallel to the floor. Push upwards from the heels and stand straight. This can be done 5 to 10 times.

Watch this video to learn how to stretch TFL (tensor fascia latae) the right way.

Drinking Water – Fun Facts

Proper hydration promotes your healing and requires your attention every day. Muscular and spinal and joint pain, leg cramps and general malaise may be an imbalance of fluids and electrolytes. Drink water as soon as the discomfort begins.

Dehydration is a particular problem among the elderly, in part because the thirst mechanism becomes less efficient as we age. Medications, vitamins and supplemements, forced-air heat from furnaces and automobiles, protein and salt consumption, exercise outdoors, diuretics,  alcohol or caffeine may raise your demnds for water. Yellow urine, dry feet or elbows, exercise and massage are reasons to ingest water deliberately

The body loses water in perspiration, exhaled moisture, and bowel movements. As a rule, drink eight 8-ounce glasses of water daily. Fruits and vegetables, juices, milk and soups, are generally as good as water.

Inadequate water intake caues hunger pangs, and daytime fatigue. 8-10 glasses of water a day may ease back and joint pain for up to 80% of sufferers. A mere 2% drop in body water content reduces short-term memory, math skills, and mental focus.

Drinking water at a certain time maximizes its effectiveness on the body:
5 glasses of water daily decreases the risk of cancer: colon (45%), breast (79%), and bladder (50%)
2 glasses of water after waking up – helps activate internal organs
1 glass of water 30 minutes before a meal – helps digestion
1 glass of water before taking a bath – helps lower blood pressure
1 glass of water before going to bed – avoids stroke or heart attack
Water at bed time helps prevent night time leg cramps. Your leg muscles are seeking hydration.

Are you drinking the amount of water you should every day?

Flip Flops Kill You

Flip Flops cause:

  • Flat feet or falling arches (pes planus)
  • Foot pronation
  • Ankle eversion
  • Elevated Q angles at the knee (valgus)
  • Uneven hips (pelvic obliquity)
  • Lumbar scoliosis.
Ask us about how to resolve these issues.  Try this page for your independent consideration: http://acceleratept.com/wear-arch-supports/

Infographic by Jan Diehm for The Huffington Post.

Click on the picture or these links to see an enlarged graphic:

http://www.huffingtonpost.com/2013/07/11/flip-flops-foot-problems_n_3569222.html

Youth in Sports

The participation of children in organized athletic activities raises many concerns in parents’ mind:

  • At what age is my child ready to participate in organized athletics?
  • What is the risk of significant injury?
  • What sports carry the highest likelihood of injury?
  • Are there specific injuries related to specific sports?

In 2001, American Orthopaedic Society for Sports Medicine (AOSSM) prepared this information to help provide parents with some answers.

smilingrugby

Should my child participate in organized athletics?

Yes!  Participating in sports is a fundamental part of our way of life.  When kept in the proper perspective, athletic activities can become an important part of a healthy growth and development pattern.  A child’s participation in sports should be regarded as an extension of school time, playtime or family time – coaches or parents should never view it as an end unto itself.

Participating in sports is a very healthy way, both physically and socially, for a child to channel youthful energy in a positive manner.

When is a child mature enough to begin participating in organized sports?

Understanding a child’s social development is the first step in answering this question.  Children under age six cannot compete in an adult sense.  They live in a “play world” of their own where even play with other children is often incidental.

These youngsters have minimal ability appreciate achievement in a sporting sense and are difficult, if not impossible, to organize.  The adult measurements of competition are lost on pre-schoolers.  Sports activities for children in this group are best promoted as playground opportunities.

Between ages six and ten, children come to appreciate interaction with their peer groups but, psychologically, still do not compete in the adult sense.  Play and fun are the primary goals for these youngsters, with structure, organization and scoring, at most of secondary importance.  Children in this age group generally have very short attention spans and generally cannot perform in the adult-imposed structure of most sports activities.  They are ready for group interaction but not for many restrictive rules or structure.

Between age ten and the onset of puberty, a youth develops increasing awareness of the goals, structure and discipline require for team sports.  The prime motivation of children this age is still joining in and having fun with their teammates. However, they will accept increasing amounts of structure and are becoming more goal-oriented.

During and after puberty the aspiring athlete develops an increasing sophisticated perspective of the structure and organization of team sports, the post-pubescent athlete is ready to develop sports-related discipline.

When is a child physically capable of participating in organized sports?

In terms of physical capabilities of the young athlete, participating in sports depends upon both chronological age and physiological maturation.

The positive effect of sports activity or training on the body is measurably less in the pre-pubescent (before puberty) athlete that in the post–pubescent (after puberty) athlete.  The benefits of conditioning to the cardiopulmonary system (heart and lungs) are scientifically measurable in the younger athlete, but are of a much lower magnitude than in the older child.  Training with weights also can have a positive effect in the pre-pubescent athlete, but it cannot result in the dramatic increase in muscle mass or strength that is seen in the post-pubescent athlete.

One of the major factors responsible for this lack of response to weight training is that the pre-pubescent child has not undergone the hormonal changes, which physiologically permit the muscle-bulking phenomenon to occur.

It should be noted that no matter what the form of specific training or sport activity, stretching and flexibility drills should be included in any pre-participation or warm-up program, even in the very young.

Is there anything to be gained from sports activity and training at an early age?

Given the fact that children have certain physiological and psychological limitations is there any reason for them to participate in sport before puberty?  Once again, the answer is yes!

Youngsters involved in such activities develop motor skills, proper training habits and a work ethic, which can carry over to life in general.  They will also benefit from proper training with weights, cardiovascular conditioning and from the non-parental discipline.  Involved parents, coaches and administrators should encourage such activities, while refraining from imposing adult performance standards.

How should organized youth sports programs be structured?

The phenomenon of puberty is a troublesome period in any youngsters’ life and athletic participation during this time may actually compound nature’s “built-in” problems.  A major reason is that most youth sports programs group participants according to chronological age.

Anatomic age (stage of body development), emotional age (maturity) and social age do not always coincide with calendar (chronological) age.  An ideal system would be to group athletes by more than one standard.  For example, arrange them not only by chronological age and weight, but also by emotional and physiological maturity.

The post-pubescent athlete can be thought of in near-adult terms.  This athlete will practice with competitive goals in mind and can physically benefit from strength and endurance training. A youth in this age group should also participate in an aggressive stretching and flexibility program, which is sport specific.

However, the best system is only as good as the coach or parent who understands the psychosocial and physical maturity factors involved – and who will foster athletic participation at a level appropriate for each individual child.

What type of sports should a youngster participate in?

The young athlete should participate in a variety of sports activities.  Psychologically, the sports goal for a child under ten, and perhaps even the older pre-pubescent should be fun.  Physically, the young athlete should be encouraged to acquire basic individual skills.  There is no overriding reason to recommend participation in non-contact sports over contact sports.

Sports participation by these younger athletes should be an opportunity to develop motor skills and to have fun.  These limited goals will give the child a healthy mental attitude as well as a healthy body, both of which will benefit him or her throughout life.

Above all, a pre-pubescent child-athlete must not become the focus of the personal athletic dreams of wishes of a parent or coach.  While parental and coaching guidance is of immense value, the young athlete should not be pressured to swim or play football, for example, when another sport better fits his or her emotional and/or physical make-up. The post-pubescent athlete will usually select athletic endeavors based on a personal skill or through associations with a particular role model or peer group.

What is the risk of injury in youth sports?

The question is not whether injuries accompany youth sports, but whether there is undue risk.  Many studies have documented a very low incidence of injury in the total spectrum of youth sporting endeavors.  Interestingly, the occurrence of injury in the pre-pubescent athlete has been documented as being much lower than in the post-pubescent athlete, and lower in the post-pubescent than the young adult.

This is probably due to the fact that the younger athlete has a lower ratio of kinetic energy to body mass – the more immature the physical body, the lower the speed and power.

Since the magnitude of injury is almost always directly related to energy expended in a traumatic event, the younger athlete is less likely to get injured then his older counterpart.  The athletic injuries, which do occur, are usually minor contusions and sprains.  Fractures, dislocations and major ligament injuries can happen, but are more common in older age groups.

Parents have expressed concern about the potential for injuries to the growth areas of developing bones and muscle in the pre-pubescent athlete.  This concern has proven to be more perceived than real, as several scientific studies have failed to document a significant increase in physeal injuries (damage to the growth areas of bones) in young athletes. Only in extreme cases, such as young gymnasts in intense training for long periods of time, are at some risk to growth plate injuries.

An argument against organized youth sporting activities, which is based on the potential for injury, is not realistic.  Although documentation is not available, it is probable that injuries resulting from participation in organized sports are fewer than those suffered on the playgrounds, or by falling off bicycles or skateboards.

Young people have definite physical and emotional energies.  It is probably less hazardous to release these energies in directed endeavors than through alternative means.  Any traditional organized sport is certainly safer than riding a motorcycle, for instance.

Are there specific injuries associated with specific sports?

While each of the individual and team sports has a family of injuries most common to it, listing of individual sports and injuries will be ignored her in favor of a generalized discussion based on contact versus non-contact sports.

The most notable examples of contact sports practiced in the United States are football, ice hockey, wrestling and basketball.  In each of these sports the athlete’s body is used to physically control the opponent and, thus, to influence the play of the game. Using the body in this manner creates the opportunity for injury.

Fortunately, the majority of injuries in these contact sports are bruises and scrapes.  The more significant injuries such as fractures, dislocations or major ligament damage occur in the post-pubescent athlete.  Parents should be responsive to complaints of pain and discomfort from athletes in all age groups and be aware that any athlete who is not playing up to skill level may be suffering from a significant injury.

In non-contact sports, major fractures, dislocations or ligamentous injuries are usually associated with accidental rather than intended collisions.  Minor sprains, muscle pulls, blisters and overuse syndromes are commonly seen injuries in non-contact sports.

The overuse syndrome is usually related to sports requiring repetitive, high-stress motion such as tennis, swimming, track, golf and baseball.  Injury occurs as a result of constant repetition of a particular movement.  Stress fractures, shin splints and tendonitis are examples of overuse injuries.

The treatment in each case is early recognition of the problem, followed by abstinence from competition and at least a decrease or change in training until the affected area is totally symptom free.  Training intensity and duration can then increase again. Return to the previous level of training should be gradual and well planned.  If the symptoms of overuse persist beyond a few day of rest or it they recur, a physician should evaluate the athlete.

youthrugby

Are youth athletics worthwhile?

Yes! While very few athletes participate on organized teams beyond high school, and even fewer beyond college, sports activity creates a physical fitness discipline and a positive learning experience which carries through to an active, healthy adult life.

Participation carries a risk of injury but, once again, the question is not whether the risk is present but whether the risk is undue.  A question of similar importance is how best to direct the naturally occurring physical energies of youth.

The American Orthopaedic Society for Sports Medicine is convinced that appropriate sports and physical training are safe and healthy applications of these energies. Physical fitness is advisable throughout an entire lifetime and is achievable only through physical activity.  The discipline, motivation and training required to remain fit should begin as a youngster.

This is general information.  It does not purport to encompass all risks associated with youth sports activities, nor is it a substitute for your own good judgment.

Expert Consultant:  Louis C. Almekinders, MD

Revised 2001.

Wear Arch Supports!

Because most individuals’ arches collapse in our shoes, we commonly advise our clients wear supplemental supports in their footwear.  Orthotics, or at least foam arch supports have been repeatedly effective in curing pain and mechanical dysfunction.Adding height to the navicular bone at the medial arch of our feet changes it’s functional position, as well as the knee and hip.  These supports dramatically prevents many common problems. Gradually, as the body adjusts to corrective changes, stresses change and the resultant pain subsides.  The problem will continue or return if left uncorrected.

Wear arch supports if you are standing, exercising, shopping, working and always at home.  A number of products are available in stores near you.  Relatively inexpensive arch supports ($20-50) are available at a variety of stores near you.

Everyone should wear supplemental arch supports in their shoes, slippers, athletic footwear, training shoes and cleats.  Orthotics, or at least foam arch supports have been repeatedly effective in curing pain and dysfunction of foot, ankle, knee, hip and back.

Arch supports reduce the degree of:

  • Flat feet or falling arches (pes planus)
  • Foot pronation
  • Ankle eversion
  • Q angles at the knee (valgus)
  • Uneven hips (pelvic obliquity)
  • Lumbar scoliosis.

Supporting the medial arch changes the functional position of the foot, knee and hip.  Residual pain can take a few weeks to go away, but the problem will not get better if left uncorrected.  Leg and back pain sufferers benefit from supplemental arch supports and orthotics. Even if you only stand all day, arch supports will control pain and manage many progressive problems that we commonly treat.

skeletons

Got a short leg?

skeletons

Uneven pelvic alignment, crooked knees, flat feet and an assortment of aches and pains are easily corrected.  With inexpensive adjustments to shoes and exercises, the pain subsides in just days. Pelvic Obliquity is an unfortunate result of a very common foot and ankle problem.  In most cases of knee  and back pain,  I see an “apparent” leg length discrepancy.

Want good and cheap solutions for knee and back pain?

Dr. School’s PRO ARCH supports – $10.76 (Walmart) to $16.99 (King Soopers). Walk=Fit orthotics are an inexpensive, but progressive option for comparison ($19.99 on-line and at Target)

Call us at (303) 421-PROArchW PROArch2210 for more information, and to be evaluated and begin the healing, NOW!

 

Walk-Fit-Platinum-2

Exercise is a Cure!

Accelerate PTExercise is prescribed to assist healing from surgeries, injuries and chronic pain. At every stage, exercise activities aid in your recovery.

Here are some exercise benefits:

· Improve strength and restore range of motion.
· Stimulate soft tissue healing.
· Reduce inflammatory conditions.
· Improve body awareness.
· Reduce pain in joints because muscle balance improves the ability to move correctly. Reduce joint friction, stress and instability in dynamic activities.
· Stimulate bone strength in less active individuals.
· Bowel and bladder functions are enhanced by exercise.
· Improve circulation, reduce swelling in extremities.
· Prevent and reverse atrophy of the muscles.
· Decrease muscle spasms and back pain.
· Improve posture and associated soft tissue pain.
· Heal tendonitis and epicondylitis.
· Adapt support for longer, unloaded training.
· Aquatic exercise allows higher repetitions for accelerated return to athletics.
· Achieve wellness milestones with exercise.

Conditioning programs help physical therapists accomplish faster and more complete recovery with our clients. Evaluation and treatment by a licensed physical therapist can identify muscle imbalance and tightness that, with treatment can resolve problems and prevent a re-injury. A therapist will create a personalized treatment plan for the restoration of your active lifestyle.

How Can I Prevent My Shoulder From Dislocating Again?

Dislocating a shoulder is a traumatic experience. After having it put back in place (or like Mel Gibson, you smack your shoulder into a wall), there is a good chance you will have some questions about what happens next.

After a short period of time in a sling, you will progress to exercises like pulleys, wall climbing for range of motion; and closed grip pull downs, rowing on a machine and shrugs, for shoulder blade strength.

Patients can compensate for loose ligaments by increasing the strength and control of the rotator cuff and shoulder blade muscles. These muscle groups help pull the ball (humeral head) into the shoulder socket (glenoid) and will pull more tightly if they are strong.

Strengthening programs for the rotator cuff include rotation exercises as shown:

Shoulder RTC Ex

Low, or even no resistance, high repetition exercises can teach and rehabilitate the shoulder all it needs to know for a while. It may take 4 months to feel completely normal again.

Exercises that increase coordination of the shoulder are also important. Contact your physical therapist to learn exercises specific to YOUR needs.

Call Paul O’Brian, PT, CSCS at Accelerate Physical Therapy, P.C. in Arvada, Colorado. (303) 421-2210