• Baseball Pitcher

    Posted on 6/12/2017 by Heather N. Wnorowski, P.T., DPT, OCS

     

    Across the country, baseball and softball season is in full swing. Whether it’s at a backyard barbecue or an official game, athletes of all skill levels are taking part in America’s favorite pastime.

    Over the past few years, a large emphasis has been on the youth athlete and overuse injuries in pitchers. We have learned to monitor pitch counts, plan structured rest and encourage multi-sport participation with athletes.

    But what about outfielders, catchers and the weekend warriors who enjoy playing in their neighborhood league?

    Common injuries aside from the shoulder and elbow exist in youth and adult baseball/softball athletes, such as back pain, knee pain and Achilles injury. Many overhead athletes have concurrent complaints of back pain or contralateral knee pain (knee pain opposite of their throwing arm). Why?

    When you think about baseball and softball, a player is doing rotational movements that require the entire body. Unless they switch hit, these rotational patterns are always to the same side. What then happens is they may overdevelop certain muscular groups on one side in comparison to the other. In doing so, this can cause overuse injuries of these groups or we may injure or strain ourselves doing normal daily activities due to this imbalance.

    The easiest way to avoid injury at practice or during a game is to develop a proper warm-up routine. An adequate warm-up usually involves a little bit of sweat, which can be hard to get in the dugout. Try performing some of these full body movements to warm-up quickly and efficiently:

    Overhead squat
     Heather Squat

    Overhead walking lunge
     Heather Overhead Lunge

    Split squat with one foot on the dugout bench
     Heather Split Squat

    Lunge with trunk and arm rotation
     Heather Lunge Rotation

    Shoulder rotation with banded pull aparts
     Heather Band Rotation

    PNF diagonal pattern with banded pull aparts
     Heather PNF Bands

    Incorporating a low back and abdominal strengthening routine into your normal strengthening routine is also recommended. To be most efficient, you need a good transfer of force between the upper half and lower half during throwing or batting. Without a solid core, athletes with lose force and become less effective. Abdominal exercises that require rotation in both directions, isometric holds (planks, side planks), and lumbar extension strengthening should all be incorporated into your programming.

    Heather Stretch 1 Heather Stretch 2

    Having a good balance of strength (right and left sides comparable) and a solid warm up routine will help to prevent injury and enhance performance. Hopefully these tips prepare you for your season and keep you healthy on the field. Best of luck in your upcoming season!

    By: Heather N. Wnorowski, P.T., DPT, OCS. Heather is a staff physical therapist at our NovaCare Rehabilitation center in Sewell, NJ. She earned a doctorate of physical therapy from Widener University and is dedicated to developing efficient avenues of treatment to influence superior patient outcomes.


  • Posted on 11/10/2020

    Did you know that exercise is one of the most under-utilized tools for managing many aspects of your health? It is well known that exercise can help with weight loss by boosting your metabolism and burning calories, but there are so many more benefits, especially as we age.

    Individuals naturally lose bone density and muscle mass as they age. Studies show that after the age of 50, bone breakdown occurs more than bone strength. Women particularly see an acceleration in bone loss around menopause, which puts them at a higher risk for osteoporosis. While there are supplements to help with this, regular weight-bearing exercise reduces the risk for osteoporosis.

    At age 30, we naturally begin to lose muscle mass; physically inactive individuals can lose between three-to-five percent muscle mass each decade after 30. These factors lead to an increase in frailty, which in turn increases the likelihood of falls and fractures. The good news is that you can offset these problematic changes by sticking to a regular exercise program.
    Here are some other great and important benefits of regular exercise:

    • Exercise helps to reduce the risk of chronic disease. According to The National Institute of Health, lack of regular exercise is the primary cause of chronic disease in the United States. Getting into a fitness routine can increase insulin sensitivity, which in decreases blood sugar, blood pressure, fat levels in blood and cholesterol. It also improves cardiovascular health.
    • Do you have a high stress job? Do you easily allow anxiety to interfere with life? Regular exercise can help with that. Exercise triggers your brain to release endorphins in your body which are mood enhancers and natural pain killers. They create a feeling of well-being. Along with being a mood enhancer, exercise also helps to increase energy levels. Exercise has been shown to begin to help elevate moods in as little as 10 minutes into the activity.
    • Improving brain health and memory. Exercise increases your heart rate, blood flow and oxygen to your brain. According to a study by the Proceedings of the National Academy of Sciences of the United States of America, regular aerobic exercise increases the size of the hippocampus, the part of your brain that is involved in verbal memory and learning. Exercise also stimulates the release of growth factors chemicals in the brain that affect brain cell health, the growth of new blood vessels in the brain and even the survival of brain cells. Reduce your risk factors by beginning an exercise program today.

    You don’t need to exercise for hours at a time to see results in your general well-being. By setting aside 30 to 45 minutes most days of the week for moderate physical activity (brisk walking, swimming, strength training), you can reap the rewards of enhanced health and wellness.

    Now that you are aware of all of the great benefits from regular exercise, why not jump in? You don’t have to be a seasoned athlete to exercise. If you are nervous about beginning a program, a physical therapist is a great resource to help design a safe and effective program for you. Physical therapists are movement specialists who are more than qualified to set up an appropriate program to fit your needs.

    In most states, you can choose to see a physical therapist without a referral from a physician. If you do need a referral, most primary care doctors will gladly provide you with a prescription for physical therapy so that you can begin your journey to a better, healthier you.

    Make time for your wellness before you are forced to make time for your illness. Your physical therapist can help.

    By: Colony A. Hopkins, P.T., DPT, COMT, AIB - VR/CON. Colony is a physical therapist with NovaCare Rehabilitation in Uniontown, Pennsylvania.

    Select Physical Therapy and NovaCare are part of the Select Medical Outpatient Division family of brands. 


  • therapist and patient doing lunges

    Posted on 1/12/2018 by Laila Hasham, P.T., DPT

     

    Parkinson’s disease is a chronic, progressive movement disorder that affects one in 100 people over the age of 60. While the average age at onset is 60, people have been diagnosed as young as 18. It is the second most common degenerative brain disorder affecting adults (Alzheimer’s disease is the most common). Recent research indicates that at least one million people in the United States and more than five million worldwide have Parkinson’s, and there are around 50,000 new cases diagnosed each year.

    Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons. Some of these dying neurons produce dopamine, a chemical that sends signals to the brain to control movement and coordination. As Parkinson’s progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally. People with Parkinson’s disease are at risk of falling and sustaining injuries due to their movement and balance impairment.

    Treatment includes a combination of medication and physical therapy, and in some cases surgery. A physical therapist who has experience treating Parkinson’s can help a person improve mobility, strength and balance.

    The universal benefits of exercise in helping everyone feel better and improving overall health are well documented. There is evidence that exercise has specific benefits for people with Parkinson's in staying active and improving balance and coordination. Exercise approaches have long played a role in the management of Parkinson’s disease, to maximize function and minimize secondary complications and inactivity.

    For decades, the Lee Silverman Voice Technique (LSVT) has been an effective way to treat the symptoms of impaired voice and swallowing from Parkinson’s called LSVT LOUD®. In 2005, a new approach to therapy called LSVT BIG® was developed. LSVT BIG is a research-based exercise program specifically designed for people with Parkinson’s. It has been shown to improve function with significant improvements noted in trunk rotation, balance and faster walking with larger steps1. LSVT BIG is provided by physical and occupational therapists who have received specific training in this technique.

    LSVT programs include the combination of:

    An exclusive target on increasing amplitude, or loudness in the speech motor system, and bigger movements in the limb motor system.
    A focus on sensory recalibration to help patients recognize that movements with increased amplitude are within normal limits, even if they feel ‘too loud’ or ‘too big.’
    Training self-cueing and attention to action to facilitate long-term maintenance of treatment outcomes. In addition, the intensive mode of delivery is consistent with principles that drive activity-dependent neuroplasticity and motor learning2.
    The LSVT BIG program includes 16 sessions of therapy over four weeks, at a frequency of four days each week. These sessions are provided in a one-to-one manner and include high intensity, whole body movements. Depending on the nature and severity of the condition, treatment sessions may focus on activities that are important to the patient and education to help transfers, bed mobility and hand movement. While other exercise interventions may focus on external cues and breaking down task components, LSVT BIG focuses on movement amplitude to achieve bigger and faster movements in the attempt to restore normal movement patterns and improve gait speed.

    The program is both intensive and fun, and the hard work and dedication of the patient is integral to the success of the program. Find a local Select Physical Therapy center to see if the LSVT BIG program is offered near you.

    For more information on Parkinson’s disease and the LSVT BIG program, please visit the LSVT Global website at www.LSVTGlobal.com.

    References:

    Farley et al (2008) Intensity amplitude-specific therapy for Parkinson’s disease. Topics in Geriatric Rehabilitation 24(2) 99-114.
    Cynthia Fox, Georg Ebersbach, Lorraine Ramig, Shimn Sapir. LSVT LOUD and LSVT BIG: Behavioral Treatment Programs for Speech and Body Movement in Parkinson Disease. Parkinson’s disease. 2012;2012.
    By: Laila Hasham, P.T., DPT. Laila is a physical therapist with Select Physical Therapy in Austin, TX. Her primary expertise is in orthopaedics, but she is passionate about treating people with Parkinson’s and similar movement disorders in order to improve quality of life and overall function. Laila is pictured above treating a patient. 

  • Posted on 10/21/2020

    As recently as five years ago, if you had Googled ‘esports athletes,’ you may very well have come across many sarcastic comments about how they aren’t real athletes. In 2020, you will find items about their tremendous hand-eye coordination, work ethic and the degree to which they work to hone their craft.

    You’ll also find the following: esports are growing at a tremendous rate, for both participants and in terms of viewership. Nearly 100 million people watched the League of Legends World Championships in 2018. There are more than 1.2 billion players of esports worldwide. It is expected that there will be $1.1 billion dollars of revenue generated by worldwide esports in 2020.

    Much like their colleagues in traditional sports, esports athletes place a demand on their bodies that can sometimes be detrimental to their physical health. Unlike traditional athletes, these negative effects rarely start with one-time injuries and are not often obvious. I have had the privilege to work as a physical therapist with the Harrisburg University Storm esports program and have seen problems ranging from carpal tunnel syndrome, to tennis elbow (lateral epicondylitis), to nerve entrapments and neck and upper back pain.

    For the gamers at Harrisburg U, we take a comprehensive approach. They often train many hours a day, so things like load management, which is often discussed in regard to the National Basketball Association and National Football League, is a very real thing that our physical therapists advise for gamers. The gamers at Harrisburg U workout with a personal trainer multiple times every week. We help coordinate with their personal trainer what they should be doing with upper extremities during these sessions so they aren’t overloading muscles in the arms and hands.

    As with many problems that physical therapists address, a problem in one area can be rooted elsewhere, such that an unnoticed postural problem an lead to pain in the wrist or hand. Positioning is very important for gamers and maintaining proper posture is key, so targeted exercises for their postural muscles are a must. Sometimes correcting this can be the difference to the pain in their hands. Basic sports medicine principles like stretching, warming up and using ice after practice and competition are also vital.

    Esports is a burgeoning field both as a profession and as an avocation. Much like their counterparts in traditional sports, they place high demand on key muscle groups and face the risk of injury or pain. This is true for professional and collegiate players and weekend warriors. Just as we do with any athletes, physical therapists play an important role in prevention, management and recovery from injury for the esports athlete.

    By: Bryan Hoyt, MSPT, CEAS. Bryan is a physical therapist and regional director of operations for Select Physical Therapy in central Pennsylvania.