Posted on 8/23/2017 by Colleen Boucher, P.T., DPT
Wearing proper clothing, getting the right amount of sleep and practicing proper stretching techniques are vital to an athlete’s success. But, just as is important is eating the right foods. A proper diet will allow athletes to remain active, maximize function and minimize risk for injury. Eating the right foods will also address factors that may limit performance such as fatigue, which can cause deterioration in skill or concentration during an event.
Using guidelines from the American College of Sports Medicine, we believe practicing these tips will help athletes remain active in their favorite sport. What and when you eat prior to physical activity makes a big difference in the way you perform and recover.
Eat three to four hours before your workout and make sure you’re eating food that not only contains adequate amounts of proteins and carbohydrates, but also provides sustainable energy, speeds recovery time and boosts performance. Early fatigue caused by malnutrition can result in improper mechanics, creating predisposition to injury.
Athletes should eat a diet that gets the bulk of its calories from carbohydrates, an athlete’s main fuel. Eating foods such as breads, cereals, pasta, fruit and vegetables will help to achieve maximum carbohydrate storage.
Re-fueling after exercise is just as important. Eating protein, carbohydrates and a small amount of fat after activity prevents the breakdown of muscles and can lead to better next-day performance. While protein doesn’t provide energy, it is needed to maintain muscles. Focus on incorporating foods with high-quality protein, such as fish, poultry, nuts, beans, eggs and milk.
Practicing proper hydration is equally important in reaching your optimal level of success. Athletes, especially those participating in high-intensity sports, should drink fluids early and often. An easy way to ensure you’re properly hydrated is focusing on the color of your urine. A pale yellow means you’re getting enough fluids, while a bright yellow or dark color means you need to drink more. We encourage athletes to:
Drink 17 to 20 ounces of water two to three hours prior practice.
Drink 7 to 10 ounces every 10 to 20 minutes during activity.
Drink 7 to 10 ounces of water after practice for every two pounds of body weight lost.
Drinking the right liquids is also a key factor in an athlete’s diet. Milk is preferred by many athletes as it provides a good balance of protein and carbohydrates. Sports drinks are great for replenishing electrolytes, which are lost when you sweat. If you’re losing a lot of fluid as you sweat, it’s a good idea to dilute sports drinks with equal amounts of water to ensure you’re getting the right balance of fluid and electrolytes. If possible, drink chilled fluids, which are more easily absorbed than room-temperature liquids and can help to cool your body.
Finally, avoid extreme diets as they increase the risk of micro-nutrient deficiencies. Vitamin and mineral supplements aren’t necessary if your diet includes a variety of nutrient-dense foods. Often, these supplements require supervision and monitoring for safety and effectiveness.
By: Colleen Boucher, P.T., DPT, center manager from NovaCare Rehabilitation’s Sicklerville, NJ center. Colleen has been a part of the NovaCare team since 2001 and enjoys treating all types of patients. She has a strong interest in vestibular rehabilitation and concussion management.
Posted on 7/20/2017 by NovaCare Rehabilitation and Select Physical Therapy
The dog days of summer are upon us, but you don’t have to stop exercising outside just because of the warmer temperatures. NovaCare Rehabilitation’s Paul Hansen, ATC, from our Minnesota community, and Select Physical Therapy’s Andy Prishack, P.T., ATC/L, center manager, from the Fair Oaks, VA center, explain how to keep safe while enjoying some of your favorite summer activities.
• Avoid exercising between the hours of 11 a.m. to 3 p.m. as that is considered the hottest part of the day. Limit high intensity workouts to either early morning or early evening hours when the sun’s radiation is minimal.
• Stay hydrated by drinking a glass or two of water before you head outside. If possible, carry a bottle of water or even a hydration pack and take a drink every 15 minutes even if you’re not thirsty. The easiest thing to do is pay attention to the color of your urine. Pale and clear means you’re well hydrated; if it’s dark you need to drink more fluids.
• Wear clothing that’s light in color, lightweight and has vents or mesh. Microfiber polyesters and cotton blends are good examples. The lighter colors will help reflect heat and the cotton material will help with the evaporation of sweat.
• Feeling nauseous, dizzy or exhausted, along with moist and flushed skin are symptoms of heat exhaustion. Stop what you’re doing and get out of the heat. Remove or loosen any tight clothing and apply cool, wet cloths. Slowly drink a half-glass of cool water to rehydrate yourself and continue doing so every 15 minutes until you feel better.
With the temperature rising, many are also headed to the nearest body of water with kayaks, surf and paddle boards. Water sports are an excellent way to get in exercise and challenge our upper body strength and balance. Heather Wnorowski, P.T., from NovaCare Rehabilitation’s Sewell, NJ center, has a few tips to keep in mind for the water sports novice and seasoned pro.
• Always get in an adequate warm-up. While the temperatures may be warm, it doesn’t mean our muscles are. Dynamic stretching is a great way to get your blood circulating and muscles warm before hitting the water.
• Since water sports are heavily dependent on our shoulders, it’s important to strengthen your postural and rotator cuff muscles in order to avoid repetitive stresses and impingements of the shoulder.
• Don’t forget the rotational mobility of your mid-back! Kayaking and other paddle sports involve a lot of thoracic spine rotation in order to propel you forward. Make sure you’re able to twist from side to side without pain before heading out for a day on the water.
• Last but not least is balance! Balance is an important part of maintaining an upright position while on the water. Practice standing on one leg at home. Once you’ve mastered that, try standing on a foam cushion and closing your eyes. Make sure you have someone or something nearby to hold onto in case you lose your balance.
Have a great summer and be sure to stay safe out in the heat!
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 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 5/26/2017 by Aileen Lysaught, M.S., CCC-SLP
Join NovaCare Rehabilitation and Select Physical Therapy as we shine a light on Better Hearing and Speech Month (BHSM)! BHSM is hosted each May by the American Speech-Language-Hearing Association which works to make effective communication accessible and achievable for all.
Being a first time mother, you don’t really know what to expect after your child is born. My son Rowan was born unexpectedly at 35 weeks. While I was in labor, the nurses warned me of all the complications that may occur with a premature baby. The neonatologist was present for the delivery, and my son was quickly whisked away before I could hold him. While he was being examined by the doctors, I couldn’t wait to hold him for the first time. I could hear him crying as well as the nurse saying, “It looks like he has a tongue tie; my grandson had one, too.”
It seemed slightly ironic, being a Speech-Language Pathologist (SLP), that my son would have a tongue tie; however, I was too overjoyed with his birth to worry about the consequences of this during our first moments together.
When I looked in Rowan’s mouth, I could see he had what’s called a Class 1 tongue tie (the small fold of membrane that normally extends from the floor of the mouth to the midline of the bottom of the tongue attaches all the way at the tip of the tongue). This would significantly impact his ability to move his tongue for feeding.
Our first attempt at breastfeeding was when things became difficult. Being a preemie, he had some difficulty feeding as the sucking pads are not developed in babies born prior to 37 weeks. The tongue tie also made it difficult for him to coordinate the movements necessary for breast or bottle feeding. So, being an experienced SLP, I knew to ask, “When can we have the ear, nose and throat (ENT) doctor come do the frenectomy?”
A frenectomy is a procedure for children struggling with speech or feeding difficulties related to tongue tie. This procedure would help my son improve his feeding skills and get the adequate nutrition needed. The next day, the ENT arrived and quickly performed the procedure. By our first pediatrician appointment the following week, he was back up to his birth weight and then some.
As time went on, I noticed some symptoms in my son that led me to believe he still had tongue restriction and a potential lip tie. He suffered from reflux, which caused him to arch his back and become fussy after feedings. He was gassy and didn’t sleep very well.
Aileen and RowanI began to research as much as I could about tongue tie in babies and children. I took courses and joined support groups for other parents with tongue tie babies and groups in which SLPs would discuss their experiences with tongue ties. I found that some of the other symptoms my son was experiencing could be related to his tongue tie. I also found that many physicians or dentists who are not specially trained in tongue tie may not perform complete revisions, which may result in the need for a second procedure. By this time my son was six months old.
After a lot of research and careful consideration, I went to see a pediatric dentist who was highly recommended and performed successful frenectomy procedures on many of my patients with great outcomes. I was worried, but I couldn’t help but think about how many times I have recommended a family to have the procedure done. The pediatric dentist we saw was extremely knowledgeable.
After he examined my son, the dentist said Rowan’s initial frenectomy was likely incomplete and he would have to use a laser to perform another revision on Rowan’s tongue as well as revise his lip tie. I trusted his recommendation and the procedure took less than five minutes.
I knew the importance of aftercare procedures, including stretching 10 times per day for 10 days and oral motor exercises to improve Rowan’s tongue’s strength and range of motion. I noticed significant improvements in his feeding abilities, ability to babble and gross motor development. Now that Rowan is a little over a year old, has well over 20 words in his vocabulary and is beginning to eat a variety of foods, I couldn’t be happier that he is able to move his tongue freely.
My situation was quite unique being a practicing pediatric SLP with experience in this area. Many mothers struggle and have to give up their attempts at breastfeeding before they discover what may be impacting their child. Many babies have difficulty with weight gain, suffer from reflux or are diagnosed as colicky when the issue lies in their tongue’s ability to function correctly. Parents may not realize their child has a tongue restriction until they have been diagnosed with a speech delay or struggle with a toddler who refuses to eat.
Tongue ties impact many areas of speech and feeding development, and it is important to find knowledgeable professionals to help with the process. It is essential to work with a SLP who can evaluate and identify if a tongue restriction exists and treat the symptoms (speech and feeding difficulties). It is also important to get referrals to an ENT or pediatric dentist to determine if a frenectomy is advised.
Having experienced these issues first hand, I feel that it not only makes me a better mother, but a better SLP. I am dedicated to helping other families overcome these difficulties so their child’s quality of daily life can improve.
Aileen LysaughtBy: Aileen Lysaught, M.S., CCC-SLP. Aileen is a pediatric SLP and the assistant center manager at NovaCare Kids Pediatric Therapy in LaGrange, IL. She has been a practicing SLP since 2010.