Apex Orthopedic Rehabilitation in Paramus, NJ Advances Spine Treatment
Friday, May 18th, 2012 | Physical Therapy, Spine | No Comments
I’m energized after taking my last McKenzie Institute Course in the Mechanical Diagnosis & Therapy for Advanced Cervical & Thoracic Spine and Extremities. This course advanced my skills in the evaluation and treatment of complex cervical spine and upper extremity disorders.
In the treatment of the cervical spine I have seen rapid improvements in neck and arm pain with the refinements in the examination and treatment techniques in this course. One of the strengths of the McKenzie approach is the structure, ability to identify patients who won’t respond to treatment and safety of the evaluation and treatment techniques.
In the fall of this year Apex Orthopedic Rehabilitation in Paramus, NJ will be able to provide a credentialed paramus physical therapist in the area of Mechanical Diagnosis and Therapy from the McKenzie Institute.
If anyone is interested in a spine evaluation by one of our paramus physical therapists please feel free to contact our clinic Apex Orthopedic Rehabilitation located at One East Ridgewood Avenue, in Paramus, NJ at (201) 251-2422 or tomw@apexorthopedicnj.com.
Apex Orthopedic Rehabilitation off route 17 in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Oradell, Glen Rock, Ridgewood, Paramus Physical Therapy and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.
Oradell Physical Therapy, Glen Rock Physical Therapy, Ridgewood Physical Therapy, Paramus Physical Therapy, Wyckoff Physical Therapy
Does stretching your hamstrings prevent hamstrings tears?
Tuesday, May 15th, 2012 | Physical Therapy, Sports Injuries, Stretching | No Comments
As of right now it has Not Been Shown that hamstring flexibility decreases the chance of a hamstring tear. The chief risk factors include:
- Previous hamstring tear
- Age
- Decreased hip flexor and quadricep flexibility
- Hamstring weakness
- Muscle Imbalances at hip/trunk
- Type of sports pursued
One of the things that seems to reduce the incidence of tears is integrating hamstring eccentric strengthening program. If you suspect an injury of the hamstrings consult with a paramus physical therapist. Be aware that sometimes these injuries are confused with lumbar injuries that can often be exacerbated by aggressive hamstring injuries. Get an evaluation by physical therapist or an orthopedist prior to treating and delaying your return to sport!
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.
Relieve Knee Pain with Support
Tuesday, May 15th, 2012 | Physical Therapy | No Comments
Chances are you have seen runners and people in rehabilitation from serious knee injuries wearing straps or sleeves on their knees. While it might seem hard to believe, those devices can actually help relieve knee pain.
Knee pain and injuries happen when you damage cartilage, muscles, tendons, ligaments and bones in your knee. A blow to the knee, a sudden twist or an unusual landing while running or jumping can all cause significant stress to the knee. These injuries can occur during running, extreme sports, football, basketball, lacrosse and hiking, among other activities.
Twisting or landing hard can sometimes result in a torn anterior cruciate ligament, causing two distinct types of knee pain, chronic pain and acute pain. Acute pain can be more intense in the short term, but chronic pain can last indefinitely.
A knee strap or sleeve impacts the patellar tendon, producing several benefits. The patellar tendon can be overused in certain sports, which can lead to inflammation and a partial tear of the tendon. The knee strap or sleeve
• enhances knee reactions
• speeds healing
• reduces pain
• helps prevent further injury
After an injury, you will probably have to protect your knee for a while, but using a strap or sleeve should get you up and moving more quickly. Best of all, these devices usually fit all sizes, and anyone can learn how to properly tighten one. One of the major issues with supports is keeping it in the proper position on the knee. Often the knee “drops” as a person participates in their sport. A few studies have reported a decrease in their power while doning a knee brace but not typically with straps or sleeves. On the whole I feel knee strapping or sleeves can be important but only one part of a comprehensive program of stretching, strengthening, balance and sports specific exercises. It does guarantee a person will not get injured or reinjured.
Whether or not your physician prescribes a knee strap or sleeve after injury, we will gladly design a program of rehabilitation by your paramus physical therapist that hastens your recovery in a safe, effective manner. A combination of exercise, manual therapy and a positive attitude can assist in healing and put you on the road to recovery.
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.
Shoulder Injuries in Throwing Athletes
Wednesday, April 25th, 2012 | Non-surgical, Physical Therapy, Shoulder, Shoulder, Surgery | No Comments
by Raphael S. F. Longobardi, MD, FAAOS
University Orthopedic Center, PA – Hackensack, NJ
www.universityorthopaedic.com
Spring time typically marks the return of America’s favorite pastime- baseball. All over the country, baseball (and softball) teams have been gearing up to start play. In years past, baseball had remained a single-season sport. Now, teams and clubs remain active nearly year round. The results of those schedule demands has resulted in the rise of typical over-use injuries related to throwing. Injuries once isolated to older, seasoned players are now being seen in younger, even high school age throwers at a significantly higher frequency.
One of the unique aspects of baseball is the injuries its’ play manifests. The action of overhand throwing is biomechanically more difficult and taxing on the shoulder and upper extremity. Years of intensive research have established the “norms” for throwing, with respect to muscle contraction, arm position and stresses (both dynamic and static).
The act of throwing places extreme demands on the shoulder. Over a short period of time, the shoulder must maximally rotate, accelerate, and then decelerate the arm, all of this while maintaining precise control over the direction and speed of the ball. The muscles of the thigh, hip, abdomen, back and shoulder form a “kinetic chain” which generates the high loads which are necessary to propel the baseball. With each throw, these forces place considerable stress and strain on the soft tissue structures surrounding the shoulder. Repetitive throwing results in “micro-traumatic” tears of the stabilizing structures of the shoulder, such as the labrum, the capsule and the rotator cuff tendons. Eventually, this microscopic disruption of tissues leads to the development of pain, altered shoulder mechanics, and potentially worsening injuries.
There is a spectrum of over-use shoulder injuries that vary greatly with an athlete’s age. In children and adolescents, (the skeletally immature person), repetitive throwing can lead to both soft-tissue and bony injuries. Stress-fractures or reactions in the areas of growth (“growth-plates”) around the shoulder (and elbow) are commonly identified with concomitant soft tissue contractures or scar tissue.
In athletes of any ages, throwing produces abnormal laxity or looseness in the ligaments that support and stabilize the front of the ball and socket (called glenohumeral) joint. The same force that propels the baseball actually distracts the ball (humeral head) from the socket (glenoid) and causes tearing and loosening of these ligaments in the front of the shoulder. There is an extensive list of injuries to the shoulder related to throwing that is beyond the scope of this article. To suffice, they include injuries to the rotator cuff and biceps tendons (tears, tendinitis and impingement), the labrum (cartilage rim/ring around the glenoid [SLAP tears],) as well as, injuries to the artery and nerves to the shoulder.
Any and all of these structures can be damaged by throwing. Although it may seem obvious, the occurrence of pain with throwing indicates an abnormality in one or more structures in the shoulder and shoulder girdle. By understanding the exact mechanics of throwing, physicians can diagnosis the problem depending on when in the act of throwing a patient may experience pain.
The throwing motion is broken down into distinct phases, which coincide with specific arm, shoulder and body positions. These phases include (in order): “wind-up”, “stride”, “arm cocking”, “arm acceleration”, “arm deceleration” and “follow through”. Pain experienced when the player has his arm back, right before it begins to move forward, would be described as “a pain in the “[late] arm cocking phase”. Common causes for pain with this motion include SLAP tears (a specific type of labral tear) or internal impingement of the rotator cuff. Another example of concern with throwing is pain experienced during the “arm deceleration” phase. This phase is noted by the moment the ball is released from the hand. During this phase, the shoulder joint (glenohumeral joint) undergoes the maximal distractive force, as well as, the maximal anterior translative force. To better describe these forces, the ball moves forward and away from the socket at the greatest force during throwing in this phase. Pain during this phase of throwing may occur along with a feeling of numbness and tingling down the arm; both of these symptoms are related to instability of the ligaments controlling the motion of the humeral head within the glenoid socket.
Recognition of these specific types of problems, along with the accurate diagnosis of the condition can greatly assist in the development of a management plan for recovery and return to pain-free play. Sometimes, sophisticated diagnostic tests, such as MRI arthrograms, are necessary to aid in the diagnosis of these conditions, but more frequently, the clinician will be able to diagnosis these problems solely via a comprehensive and detailed patient history and physical examination. Tests that reproduce pain, reveal weakness, or identify restricted motions, are often the most diagnostically effective and accurate; the tests will often confirm the diagnosis found on MRI’s or other sophisticated scans.
Once the injury has been diagnosed, a treatment plan will be outlined by the evaluation physician. The vast majority of painful throwing conditions can be successfully treated with rehabilitation programs that restore mobility and strength to the shoulder and shoulder girdle musculature. There is also a required period of rest in order to allow for the tissue to recover and to heal; thus the necessity of the “disable list” for professionals. Yet, more importantly, even the amateur needs a time to recover and get well. The common thought is that professionals play through pain and injuries. The truth is that when professionals have significant injuries, they are required to rest and to recover for a period of time. When these more conservative measures do not improve or alleviate the painful symptoms, then surgical interventions may be necessary.
The advent and revolutionizing of arthroscopic, minimally invasive surgery on the shoulder has allowed for the correction of these injuries, with the restoration of the normal mechanical functioning of the shoulder. Arthroscopic procedures are now used routinely to repair rotator cuff tears, torn labrums, and to correct instability. Following these procedures, the thrower embarks on an intensive course of rehabilitation to improve shoulder mobility, strength and function. Throwers will participate in a regulated throwing program which progressively increases their throwing workloads, while being supervised for painfree throwing. Once fully healed and rehabilitated, the player is ready to return to game, and ready to resume throwing.
Baseball is a terrific game for all ages to participate and compete. It is a game that has been shared between generations of fathers and sons, parents and children. It is a wonderful piece of American ingenuity and pride, which helps to define us as uniquely American. It is a sport that should be enjoyed for many years, by all ages. Unfortunately, it is a sport where shoulder pain looms as part of its very essence. Fortunately though this pain does not have to persist as long as it is properly identified and managed by the specially trained group of professionals who are dedicated to preserving its’ players long-term health, well being and performance.
Dr. Longobardi is a board-certified orthopedic surgeon specializing in sports medicine and athletic injuries. He is Chairman of the Orthopedics Department at Holy Name Medical Center and a consultant/team physician at Berkeley College and Bergen Catholic High School. He has authored various articles and presentations related to the shoulder. Dr. Longobardi endorses the American Academy of Orthopedic Surgeons, “STOP Sports Injuries” program.
If you wish to contact Dr. Longobardi, he can be reached at his private practice located at University Orthopaedic Center, PA, Continental Plaza, 433 Hackensack Avenue, 2nd Floor, Hackensack, NJ 07601 or by calling (201) 343-1717 or visiting his website at www.universityorthopaedic.com
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic, spine and sports physical therapy for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.
Does Weight Training (resistive exercise) Decrease Blood Pressure?
Thursday, April 19th, 2012 | Non-surgical, Prevention | No Comments
YES! A recent study in the Journal of Strength and Conditioning April 2012 indicates it does significantly reduce blood pressure. In this study blood pressure reduced with resistive exercises over a twelve week period. At the time the participants were not taking hypertensive medications and were middle age adults with Stage1 hypertension. The following is a short list of the findings:
- Blood pressure reduced 16mm Hg in Systolic Blood Pressure (SBP) and 12mm Hg in Diastolic Blood Pressure
- Similar results in aerobic exercise
- Resistive Exercise routines use high repetition programs with <30 seconds rest between sets
- Reductions in Blood Pressure lasted >4 weeks after training stopped.
A combination of resistive and aerobic training is a nice alternative to immediately starting medications. If you are concerned about starting a similar training program because of past orthopedic or sports injuries feel free to consult with the paramus physical therapists at Apex Orthopedic Rehabilitation who are experts on injury prevention and rehabilitation for many orthopedic, spine and sports related injuries.
Does the Right Footwear Prevent Injuries?
Wednesday, March 28th, 2012 | Physical Therapy, Sports, Wellness | No Comments
Because your feet are subjected to nearly a million pounds of pressure during an hour of strenuous exercise, proper footwear is important to cushion these loads. For this reason, shoe companies and medical professionals have recommended wearing specific types of footwear to prevent injuries.
It would be nice if the right shoe could really protect you from injury, but research performed by the U.S. Marine Corps and published in the September 2010 issue of the American Journal of Sports Medicine found no significant difference between shoe types when it came to injury prevention. So what does this mean for you?
Proper physical training—weight-bearing exercises to strengthen bones, stretching to avoid muscle tears, avoiding overtraining, etc.—is a proven, effective way to reduce injury and a safer bet than investing in an expensive pair of shoes. We can design a program targeted to your physical health, your fitness and sports goals, and your body type.
As for selecting footwear, stick to the basics:
• Ensure a good fit.
• Choose shoes specific to your type of exercise (e.g., running shoes for runners; basketball shoes for basketball players).
• Go shoe shopping with the type of socks you typically wear while exercising.
• Make sure to walk around the store for a while before deciding on a pair.
• The best shoe for you will be the shoe that feels the best.
To ensure that your body is in the best condition possible while avoiding mishaps on the field, on the court or on the street, our team of experts at Apex Orthopedic Rehabilitation in Paramus, NJ will handle all of your orthopedic and sports physical therapy needs. Our Paramus physical therapists can help you with training form and instruct you in appropriate and proper stretching and recovery techniques.
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.
Treating a Sports Hernia
Wednesday, March 28th, 2012 | Non-surgical, Physical Therapy, Sports Injuries | No Comments
Athletic pubalgia is the technical term for the severe groin pain often called a sports hernia—although unlike a true hernia, no abdominal-cavity organs protrude where they should not. Because the cause of the pain is often missed or misidentified, an accurate diagnosis of athletic pubalgia is the first step in treating the condition and often comes only after other conditions have been ruled out and nonsurgical treatment has been ineffective for a long period of time.
Pubalgia most often affects high-level male athletes. The pain results from a stretching and weakening of the internal inguinal ring, a triangular anatomical structure in the groin area through which the ilioinguinal nerve and spermatic cord pass. Tears or strains in the lower abdominal muscles, in tendons or ligaments in the groin area, or in the pelvic lining may also contribute to the pain.
The surgery to repair the inguinal canal wall is performed either through a small traditional incision or through several very tiny incisions. Because lower abdominal muscles are shifted during traditional surgery and need to heal first, some time must pass before you can engage in physical therapy.
However, if your physician wants to manage your sports hernia conservatively to avoid surgery, we can design a program that fosters core stability and carefully balances the interactions between the muscles of the hips, thighs and pelvis. Strengthening the inner thigh and abdominal muscles, and balancing the way they are used in sports can minimize the chance of future injury. In addition, we will teach you the best way to heat and/or ice the affected area and offer deep-tissue massage if appropriate. Similarly, a postsurgical physical therapy program that focuses on increasing your endurance and strength will enhance your recovery.
Whether or not you undergo surgery for athletic pubalgia, we can design a program of physical therapy to alleviate pain and strengthen the muscles, making you more comfortable and preventing re-injury. By following our program, you once again should be able to participate in the sports you love—pain-free.
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor, physical therapist, or other healthcare practitioner before engaging in a physical therapy or rehabilitative program.
What else can my Physical Therapist do for my “Frozen Shoulder”?
Friday, March 16th, 2012 | Non-surgical, Physical Therapy | 3 Comments
A recent article in the Journal of Manual & Manipulative Therapy in February 2012 highlighted a case study that used thoracic spinal manipulation in the treatment of primary and secondary adhesive capsulitis or “frozen shoulder“. Typically a patient who suffers from adhesive capsulitis goes through a series of stages. At the start a patient demonstrates a progressive loss of shoulder range of motion and onset of shoulder pain. Researchers have not been able to be able to establish a
clear reason for “Why” this condition occurs. However, certain high risk groups have been identified:
(1) Diabetes
(2) Females
(3) Thyroid Problems
(4) Greater than 40 years old
(5) Following shoulder surgery or period of shoulder immobilization
(6) Parkinson’s Disease
(7) Tuberculosis
(8) Cardiovascular Disease
In this article a significant increase in shoulder range of motion > 25 degrees was noted and decreased pain levels occurred after a spinal manipulation. This occurred in less than four treatments. For patients with this condition I recommend asking your physical therapist to assess the thoracic spine for joint restrictions especially if you have reached a plateau.
If you ever have any questions regarding our thoughts on this research feel free to contact the staff at Apex Orthopedic Rehabilitation. We offer complimentary evaluations by our staff of physical therapists specializing in orthopedic and sports physical therapy. We serve patients residing in the Paramus, Oradell, Ho-ho-kus, West wood, Wyckoff, Ridgewood and surounding Bergen County region.
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for informational purposes only and should not be used for diagnostic or prescriptive purposes. The views expressed here are the author’s views and should be taken as suggestions. Always consult your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative program.
That Groin Pain May Be Your Hip
Friday, March 2nd, 2012 | Physical Therapy, Sports Injuries, Surgery | No Comments
Both male and female competitive athletes often develop an unexplained pain in the groin. This pain occurs most often when the athlete pivots or twists and can be intense enough to end a career. Recent research suggests that this groin pain may actually arise from damage to the hip joint.
The hip is a ball and socket joint. The ball, or head of the femur, fits into a socket called the acetabulum. Both ball and socket are lined with cartilage so that the joint can move smoothly. Any abnormality in the shape of the femur or the acetabulum can wear away the cartilage, creating a painful condition in the hip called femoroacetabular impingement (FAI).
There are two types of FAI.
- Cam impingement occurs if the head of the femur is not completely round. As the joint moves, irregularities in the femur head bite into the labrum or lining of the acetabulum, wearing it away.
- Pincer impingement occurs if the front edge of the acetabulum extends too far. When the hip moves, the labrum is crushed against the neck of the femur.
FAI can be difficult to diagnose because other muscles and joints attempt to compensate for damage to the hip joint. As a result, pain may appear to come from the lower back, groin or gluteal muscles.
People are born with the bone abnormalities that cause FAI. Nonathletes usually will not develop impingement symptoms until middle age or older. But athletes who perform repeated movements and put high loads on the hip can develop pain from FAI in their teens and 20s.Surgery is the most frequent treatment for FAI, and it is usually successful. Some studies have shown that more than 75% of competitive athletes who have arthroscopic surgery for FAI are able to return to their sport.
Following surgery, physical therapy is essential to prevent scar tissue formation, restore range of motion and develop strength in the hip. When you plan surgery for FAI, our experienced physical therapists can work with your surgeon to develop a rehabilitation program aimed at getting you back to athletic competition.
Apex Orthopedic Rehabilitation (AOR) in Paramus, NJ provides orthopedic and sports physical therapy
services for the greater Ridgewood, Ho-ho-kus, Paramus, and Bergen County region. This blog is intended for
informational purposes only and should not be used for diagnostic or prescriptive purposes. The
views expressed here are the author’s views and should be taken as suggestions. Always consult
your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitation
program.
Add Strength Training to Your Stretching
Friday, March 2nd, 2012 | Non-surgical, Osteoporosis, Physical Therapy, Prevention, Wellness | No Comments
Let’s face it: Stretching feels good. It is relaxing, and getting all the kinks out of scrunched-up muscles can be liberating. Unfortunately, improving your flexibility through a stretching class is simply not enough, either as a therapeutic approach, or to protect your body from future damage. Strength training is a necessary companion to your stretching class.
As we age, the natural loss of muscle makes it harder for our bodies to handle daily activities, such as bending, walking and picking up heavy objects. This loss of muscle tone contributes to back problems, knee injuries and a myriad of other body ailments. No matter how limber you may be, the cardinal rule for muscle is “use it or lose it.” Strength training not only helps maintain muscle but it can also
- reduce the risk of osteoporosis by increasing bone density
- help you maintain a healthy weight—lean muscle mass burns more calories than fat
- protect your joints and ligaments, helping you to avoid future injuries
- improve balance and overall well-being
It is important to engage in the right kind of stretching, as well. Some studies have suggested that the traditional static stretching (stretching a muscle or muscle group to its farthest point and then holding that position)—often a part of stretch and tone classes—is not ideal when used alone before exercise. Instead, the dynamic stretching (slow, controlled leg and arm swings or torso twists) often used by athletic teams to warm-up or a combination of the two (gentle general exercise to warm up and gentle dynamic stretching after exercise) may be more helpful. A 2008 study by the U.S. Centers for Disease Control and Prevention found that engaging in both static and dynamic workouts reduced the risk of knee injury in female soccer players by half.
To truly improve your physical health, heal from injury and prevent future chronic ailments, a good overall fitness plan is needed. We can design an individualized plan that incorporates the right kind of stretching, strength training and aerobic exercise to turn your body into a well-oiled machine.
Apex Orthopedic Rehabilitation in Paramus, NJ provides orthopedic and sports physical therapy
services for the greater Ridgewood, Paramus, and Bergen County region. This blog is intended for
informational purposes only and should not be used for diagnostic or prescriptive purposes. The
views expressed here are the author’s views and should be taken as suggestions. Always consult
your doctor or healthcare practitioner before engaging in a physical therapy or rehabilitative
program.
Welcome
I'm happy to share my thoughts on physical therapy, rehabilitation and conditioning with you and look forward to hearing from you as well! - Tom Willemann, PT, MS, OCS
Search
Categories
Archive
- May 2012
- April 2012
- March 2012
- February 2012
- January 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- January 2011
- November 2010
- October 2010
- September 2010
- August 2010
- July 2010
- June 2010
- May 2010
- April 2010
- February 2010
- January 2010
- December 2009
- October 2009
- September 2009
- August 2009
- July 2009
- June 2009
- May 2009
- April 2009
- February 2009