How the ravages of history launched two profound professions

Posted 4/20/2022

When a doctor recommends occupational therapy (OT), rather than physical therapy (PT), many people don't at first realize there are two kinds of therapies.

It might also not be understood that there's a difference between them, or why a doctor prescribes one over the other.

As therapists, we get this question a lot.

For sure, there's a difference between the therapies and how they're used in healing and recovery. And the story is more interesting than you might imagine…

A short history of modern therapy

Movement and manual therapies can be traced back to ancient Asia, Greece and Rome. Those early practices included massage and hydrotherapy (water therapy).

Fast-forward to modern-day therapy which began in 18th century Sweden with the practice of orthopedics — the medical focus on bones and muscles.

A bit later, Hanrik Ling, developed the Swedish Gymnastic System (also known as the Swedish Movement Cure). His motivation? Having experienced the benefit of improved body movement through his practice of fencing.

At its core, Ling's system emphasized physical conditioning for its ability to improve health and body function. It combined lesser intensive floor-style of gymnastics with manual therapy. Ling's approach brought wide acceptance of his methods.

In 1813, the Swedish government appointed Ling to start the Royal Central Institute of Gymnastics (RCIG).

Ling's system became wider spread as graduates of the RCIG adopted its four core components:

• physical education
• fencing
• massage, physical therapy, physiotherapy
• dance performance

One more fast-forward to the 1920s. The polio epidemic was raging in the United States, especially among children.

During the epidemic, two schools of thought emerged.

One used the practice of immobilizing the limbs of patients believing limb movement and stretching would impair muscle recovery and cause more deformity.

A second practice re-introduced the Roman practice of hydrotherapy. Here therapists used exercise in heated pools to improve a patient's muscle recovery and movement.

Polio paralysis spurred working with patients to improve balance and regain muscle strength. The benefit of warm water was helpful as well as buoyancy – water supports body weight and reduces stress on the joints.

The practice – active polio therapy – helped grow a population of physical therapy (PT) specialists who became instrumental in treating polio paralysis.

These early PTs developed methods for assessing and strengthening muscles – methods still used today.

This piece of history gave the push to establishing the profession of physical therapy in the U.S.

Turning now to the topic of occupational therapy (OT), its history doesn't stretch back as far as those of physical therapy.

But its roots in America began to grown in the late 1800s. This happened primarily as a way to help individuals with mental illness by engaging them in meaningful tasks. Examples include gardening, painting and arts and crafts creation.

The U.S. military also began recognizing the importance of mental health services for wounded and traumatized soldiers to help them resume daily living.

This marked an entry for OT services in the treatment of individuals with mental and physical needs.

Three movements of thought were significant in the development of OT:

1. The consensus that mental health patients should be treated and not put in asylums or prisons.
2. The reemergence of the value of manual occupation and vocational skills over mass production.
3. The rise of thought that working with your hands to produce items of value can be beneficial to a person’s overall health.

During this time, mental health asylums changed to reflect these new ideas. They were ideas of humane rehabilitation and included craft and recreational activities to help patients return to society through their contributions.

These ideas were foundational for developing OT.

About 1915, a social worker named Eleanor Clark Slagle started the first formal OT education program at John Hopkins University in Baltimore.

Dubbed the "mother of occupational therapy" she trained more than 4,000 therapists and promoted OT within the medical community.

While PT and OT therapies were in their infancy on the two sides of the Atlantic, it was America's entry into the Great War in 1917 where they came together.

To summarize some of the above timeframes, it's worth a look at how it happened.

World War I and its transformation of therapy

World War I transformed medicine and contributed to the development of today's scope of medical care. 

The total number of military and civilian casualties in World War I was about 40 million.. and about 23 million wounded military personnel.

– Wikipedia

With the staggering number of wounded worldwide, orthopedics and therapists rapidly advanced to meet the need.

The course of thought was that society had a moral responsibility to help these soldiers return to a normal and purposeful life. Thus, medical specialties developed to fill this need.

The U.S. military hired a small group of women, calling them "reconstruction aides." In their roles they provided treatment by teaching occupation skills to the wounded. 

The initial 18 aides were trained in the latest European physiotherapy practices at the time. Aides were chosen from civilian women and women from the newly established profession of OT.

Both therapy groups expanded rapidly to help the soldiers with recovery.

Of the original 18 Aides, 16 went on to form the American Women's Physical Therapeutic Association. This later became the American Physical Therapy Association with McMillan as president.

– The U.S. World War One Centennial Commission.

The work of these aides brought the military to begin seeing disability in terms of capability in function, and not as limitation.

Their successes were many, helping wounded soldiers learn to walk again and freely move about in their environments.

These early therapists gave training in the use of arm prosthetics, adapted home and work spaces and taught crafts and vocational skills for mental diversion and future employment.

The convergence of today's therapies and practitioners

After WWI, occupational and physical therapy continued to advance.

And with their evolutions came recognition for the benefits they each provided.

But sometimes there was division in which to prescribe: occupational therapy vs physical therapy.

What became clear over time, with advances in the professions, is the benefit to individuals when providing therapies in tandem.

Today's occupational and physical therapists work together in the shared goal of improving an individual’s function through movement.

As individual medical treatments, the therapies, when used together, can have profound results.

Because of this they are recognized as separate but symbiotic professions.

Similarities include:

Working in a variety of settings

• Schools
• Outpatient rehabilitation centers
• Home health agencies
• Hospitals
• Nursing homes

Training in key disciplines

• Science
• Anatomy
• Kinesiology

Using similar therapy techniques

• Soft tissue mobilization
• Functional activities
• Strengthening
• Stretching
• Pain relief

Opposites attract, even in medicine

Even with similarities between the two professions, there are also key differences.

Physical therapy focuses on improving movement, flexibility and mobility. This includes improving physical motion required for a task.

Physical therapy has a unique approach to mobility – movement and muscle balance. It uses prescribed treatment techniques to maximize function, capacity and performance.

PTs work with patients before and after surgery to build strength and kick-start healing. Therapy uses movement to reduce pain, recover from an injury and promote balance to reduce the risk of falls.

The occupational therapy profession has a different focus.

That focus is on functional ability – the ability of an individual to do activities, work and tasks that are normally performed in everyday living and occupation.

That focus gives occupational therapy its name.

Occupation is defined as an activity that is meaningful and purposeful to the individual. It can include basic activities such as dressing, bathing or fixing a meal.

It can also include specific activities which are unique to the individual.

For example, you may be a high school teacher, home gardener, pianist or an electrician. Each occupation requires a unique set of activities. If those activities are compromised by illness or injury, OTs can help.

Your therapist will assess your current function and how to improve your ability to perform a task or modify it to help you complete it.

Now that you know more about the differences between OT and PT, should you need therapy you'll be able to spot the differences in what your therapist recommends.

Of course, it all depends on your condition, your needs, and personal goals.

But thanks to a long history of the disciplines, and more than a century of experience since WWI, PTs and OTs are specialists in your care.

Our job is to help get you back to enjoying the activities that matter to you.

If you or someone in your family might benefit from our therapies, request an appointment with us. We're here to help.

Posted 2/25/2022

How to stay in play and on the court

What is pickleball? And why are people raving about it?

Pickleball is an improvisation of badminton and ping-pong. The game is played on a court using a softball-sized, hard-plastic ball with holes – like a wiffle ball – and paddles similar to table-tennis paddles.

Conceived in 1965 as a game that families could play together, pickleball grew in popularity. By 1972, a corporation was founded for the sport.

While there is debate around the origin of its name, there is none about how fun, fast, competitive and entertaining the game is.

With a smaller court size than its cousin sport of tennis, it’s an ideal way to stay active and fit for just about anyone.

And pickleball has taken the country by storm.

The first pickleball tournament was held in 1976 in Washington State. And while not what’s called an overnight sensation, the explosive growth of the game in the years since has led to pickleball courts popping up everywhere, and the formation of amateur and professional leagues.

There’s even a professional pickleball tour.

When injury puts you in a pickle

With the rise in popularity of pickleball, physical therapists throughout the country are seeing an increase in injuries that are similar to those found in other racquet sports.

New pickleball players sustain approximately 50% of injuries during their first year of play.

The most common pickleball injuries include:

• Pickleball elbow
• Ankle sprains
• Knee sprains
• Shoulder sprains
• Achilles tendonitis
• Wrist fractures
• Concussions from falls

In the case of older players, many are predisposed to injury, often due to prior injury, limited flexibility and range of motion and deterioration of balance, or have recurrent injuries.

So if you are looking to start playing the game … or stay in the game … keep these prevention tips in mind to reduce your risk and avoid injury:

Warm up   Pickleball is a fast-paced game, and the excitement starts right away. So it's important that you warm up before you get on the court. Try a light 5-minute jog, a slow walk with high knees or some side shuffles to loosen up.

Stretch   As part of your warm-up, make sure to stretch. Shoulder stretches, calf stretches, hamstring/quad stretches and wrist and neck stretches are all important to incorporate into your routine.

Choose proper footwear   Pickleball requires moving side to side and back and forth. Choose a good fitting athletic shoe for this type of movement.

Pivot   Similar to tennis and other racquet sports, you will be executing groundstrokes, volleys and serves. Remember to pivot your hips and shoulders as you face the approaching ball.

If you are injured, stop playing!

Don’t try to tough it out, especially if it is a head injury.

Contact a physical therapist to help you heal and recover before you return to play.

Pickleball is as fun as it sounds, and you’ll want to play for years to come.

If you’re in a pickle with pain or injury of any sort, click now to request an appointment to find one of our centers near you.

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

Select Medical is proud to be the official physical therapy partner of the PPA Tour.

Posted 2/15/2022

If you clicked to read this, it’s likely because you or someone you know has long COVID. Or maybe you’re now hearing people talk about long-lasting symptoms of COVID-19.

With research now being published, millions of people having a COVID diagnosis will experience “long” COVID – post-COVID syndrome or long-haul COVID, earning some who experience it the nickname of “long hauler.”

Putting aside that bit of levity, long COVID is no joke.

So if you are struggling to read this because you’re dealing with “COVID brain fog,” you may be thinking, How did I get so unlucky?

It’s a fair question to ask.

But in reality, long COVID is more common than most think.

According to Penn State College of Medicine researchers, more than half of the 236 million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience post-COVID symptoms.

Months after recovering from COVID-19, millions of people are still suffering one or more debilitating symptoms like:

• Brain fog
• Difficulty breathing
• Muscle weakness
• Fatigue
• Joint pain
• Dizziness and more

If you or a loved one is suffering, don’t give up. There is hope and help.

Physical therapy is medicine for long COVID

Professional physical therapists, like me, understand what you are going through. Indeed, if you have long COVID, physical therapy can help.

Yes, physical therapy.

As physical therapists, we are specialists who are trained in identifying the clinical symptoms and effects of long COVID. For example, the profound fatigue you’re feeling? Reminiscent of chronic fatigue syndrome, it’s a post-acute leftover of the viral COVID infection, and we can help.

That joint pain? We’re trained also to understand musculoskeletal conditions that can be causing your pain. We can assess the pain and determine the appropriate treatment for it.

I work in an outpatient physical therapy center and help treat patients with long COVID. Our parent company Select Medical collaborated with the Centers for Disease Control and Prevention on an important clinical study regarding the long-term impact of COVID-19.

The study validates our Recovery and Reconditioning program which focuses on specific deficits in patients recovering from COVID-19 and other debilitating illnesses and conditions.

Our Recovery and Reconditioning program helps, specifically, with:

• Fatigue
• Labored breathing
• Weakness
• Headache
• Dizziness
• Joint and muscle pain

Our program was developed in partnership with leading physicians, infectious disease specialists, physical and occupational therapists and speech-language pathologists to help those impacted to heal, gain strength and return to an active, full lifestyle.

We hear all the time that people suffering with long COVID don’t feel heard. Feel misunderstood. Feel like giving up.

If that sounds like you, then trust me, we understand.

We are proud to offer the Recovery and Reconditioning program to you, your loved ones and/or friends – anyone who may be dealing with lingering effects of having COVID-19.

Together, we will address your specific post-COVID symptoms and create an individualized treatment plan for your road to recovery. During care, you will learn ways to pace yourself throughout the day and move your body so that you don’t tire so quickly.

As part of your treatment, we will track your vital signs and symptoms to ensure your safety and progress. We will be there every step of the way back to a healthier you.

You deserve a medical professional who understands you. If you’re tired of feeling alone in your recovery from long COVID, let a physical therapist help.

Schedule a consultation with a physical therapist trained in treating long COVID. Click the blue Contact Us button below to request an appointment at a center near you today.

By: Corey Malone, P.T., DPT, OCS. Corey is physical therapist, center director and Recovery and Reconditioning program champion with KORT in Kentucky.

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

Originally posted 3/21/2018 by Dorothy Lehr, DPT, OCS, Cert. MDT updated 2/3/2022

Major snowstorms have a way of causing major headaches…and major muscle aches!

Snowstorms have already hit many parts of the country this winter, with more on the way. And while there’s beauty in a landscape covered in white, there’s potential for back aches and muscle strain in the chore of removing snow if not done safely and with preparation.

So before powering up that monster snow blower and pushing it along the sidewalks or layering up with hats, scarves and gloves, read on for tips to keep you safe and healthy while out in the bluster.

Beware the Shovel

• While a shovel with a standard handle may be cheaper to purchase, beware! Shovels with “bent” handles – ergonomic handles – are a better choice for reducing back strain. Choose one with a cushioned grip too.
• Look for a shovel that also has a sharp bend in the shaft. This type of shovel is made to decrease back strain as you push and stoop to scoop.
• The weight of the snow makes a difference in snow tool choice. Snow tool? That’s right!
  Today’s shovels have come a long way from the standard shovel and come in a range of blade features (the scooping or chiseling part) to lessen strain and injury.
  • Light and fluffy? Aluminum is the way to go.
  • Heavy and slushy? Polycarbonate, shatter-resistant gets the job done.
  • Icy and compressed? Galvanized steel chips away with lower impact.

Tame the Technique

Proper shoveling is just as important as the correct shovel.

Keep your back straight.

Bend at your hips and knees.

Avoid twisting your body when dumping snow. Instead, pivot your legs to turn your whole body.

Wear shoes or boots with good tread to avoid slipping on slick areas or black ice. Applying pet-friendly salt, sand or kitty litter gives traction and decreases the risk of slipping.

Snow shoveling can be as physically demanding as a gym workout and should be treated like a day in the gym.

Don’t overexert yourself, especially when the snow is wet and heavy. In deep snow, take a few inches off the top and tackle the job by dividing it into thirds, with one-hour rest breaks.

Prepare and Prevent Injury

Snow shoveling is a cardiovascular and weight-lifting exercise. So just like you need to stretch before working out or exercising to get its great benefits, stretching before and after is important.

If you need to tackle a big snow that will take more than a few minutes, taking a break and stretching in between clearing snow or drifts will help prevent injury.

Lumbar Extension

This stretch helps balance in any forward-bending movement while shoveling. Choose a standing or laying position.

Extension 1: Stand and bend back as far as is comfortable and hold for three to five seconds. Do 10-15 repetitions.

Extension 2: Lie on your stomach and bend back as far as is comfortable and hold for three to five seconds. Do 10-15 repetitions.

Quadriceps Stretch

While standing, use your right arm to pull your right leg up toward your buttocks. Keep your trunk straight and use opposite arm to hold onto a sturdy object to maintain balance.

Duration: Hold each stretch for 20 seconds doing five reps on each leg. This will stretch out your quad muscles that you’ll be using to lift while shoveling.

Hip Flexor Stretch

In a half-kneeling position and while maintaining an upright trunk, lunge forward until you feel a stretch in the front of your hip.

Duration: Hold position for 20 seconds doing five reps on each leg. This stretch will help to stretch the muscles you’ll be using while moving snow and helps to keep your spine in a neutral position.

Beyond Shoveling Safety Tips

Sometimes, there will be a winter storm where a snow shovel isn’t enough.

While a snow blower can certainly help with snow removal, snow blower injuries and accidents do happen. Burn injuries, lacerations, fractures and even amputations are the biggest reasons for ER visits from snow blower injuries.

"The Consumer Products Safety Commission estimates that 3,000 persons are treated in emergency rooms in the United States for snow-blower injuries each year."

Practice these to stay safe while operating a snow blower:

• Never put your hands down the chute or around the blades of a snow blower. If you need to clear wait 10 seconds after turning off the engine for the blades to stop spinning. Use the handle or a broom, a stick or another tool to clear any clogs.
• Keep hands and feet clear of all moving parts of a snow blower.
• Avoid hanging scarves and loose-fitting clothing which could become tangled in the moving parts and pull you into the machine.
• Direct the discharge chute away from you, other people or areas where any damage can occur. The blower can throw hard objects, such as salt, sticks and ice.

Winter can be brutal, even when you do prepare and follow safe practices.

If you’re feeling nagging aches and pains or you’ve suffered an injury during your winter clean-ups, we’re here for you.

Click the Contact Us button below to request an appointment with a nearby center. Stay safe and keep thinking spring – it’s coming!

By: Dorothy Lehr, DPT, OCS, Cert. MDT. Dot is a physical therapist and center manager with NovaCare Rehabilitation in Willingboro, NJ. A treating clinician for 12 years, Dot is a board certified orthopaedic specialist and McKenzie credentialed therapist, specializing in spine treatment.

Posted on 10/25/2021

Did you know that knee osteoarthritis affects nearly 14 million adults in the United States¹ per year? Or that meniscus tears are present in 60-90%¹ of those with knee osteoarthritis? With symptoms ranging from knee pain, swelling, stiffness and limited range of motion, medication, injections, surgery and physical therapy are all commonly prescribed to manage knee pain. Medication and injections, however, may simply serve to mask your pain. Surgery can be costly and taxing on your body. Physical therapy, on the other hand, emphasizes a more holistic approach to the body with emphasis on education, pain management and strength and conditioning.

At first glance, it can be frustrating when you are referred to physical therapy for management of knee pain related to structural issues like osteoarthritis or a knee joint tear. Is the physical therapist going to magically reverse your arthritis or heal your meniscus? Shouldn’t you address the structural problem head-on instead of just “strengthening around it?”

Not necessarily.

Surgery or osteoarthritis physical therapy?

If we dig deeper, a better question to consider might be, “Do I need to change the structure of my knee in order to resume the activities I enjoy?” There are several studies to suggest that abnormal findings on X-rays and MRIs can be common, even in persons without knee pain. In fact, a 2020 study² of a population with a median age of 44 and no knee pain found that an astounding 97% of knees had abnormalities on MRI. In addition, when comparing physical therapy management to surgical intervention, there are many cases with similar outcomes.

Now, this is not to say that everyone with knee pain should get physical therapy instead of surgery. Sometimes, surgery is exactly what’s needed to improve your overall quality of life. However, including a physical therapist on your health care team – before and after surgery – is beneficial, even without changing the structural abnormalities that are often presumed to be the problem.

If physical therapy isn’t changing the “structural problem,” what exactly is the benefit?

People are more than pictures, and pain is far more complicated than what that picture shows. X-ray and MRI findings can absolutely be helpful in developing a plan of care; however, they are only one piece of the puzzle. While physical therapy is unlikely to result in a change in the X-ray or MRI findings, it can identify and help modify factors contributing to your knee pain and functional limitations.

Focusing on your unique condition, a physical therapist can work with you to determine the following:

• Health and lifestyle factors contributing to your knee pain
• Activity modification so you can safely perform activities of daily living
• Stretches and strategies to improve motion and strength
• Swelling and pain control
• How and when to appropriately get back to activities that cause you pain/discomfort

This combination can help patients to better understand their condition and develop a plan that assists in recovery. Doing all of this may greatly enhance your quality of life and ease the pain and symptoms you are currently experiencing.

Now, if you and your doctor determine that knee surgery is necessary, remember, physical therapy is a vital part of preparing for your procedure and recovering after it. Before surgery, we will work together to get you as healthy and strong as possible, which will enable your post-surgical recovery to be that much more successful and faster. Following surgery, we will focus on helping you to restore your strength, balance and flexibility.

No matter what, physical therapists are committed to helping you be as mobile, independent and pain-free as possible. Our goal is to build a relationship in which you feel comfortable asking us questions, are an active partner in your care and we’re able to work together to ensure the best outcomes possible.

If you have knee pain, contact us today and experience the power of physical therapy.

References:

1. Bhushan R. Deshpande, BS, Jeffrey N. Katz, MD, MSc, Daniel H. Solomon, MD, MPH, Edward H. Yelin, PhD, David J. Hunter, MBBS, PhD, Stephen P. Messier, PhD, Lisa G. Suter, MD, and Elena Losina, PhD. The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity (2017)
2. Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol (2020)

By: Patrick Smith, P.T., DPT. Patrick is board-certified clinical specialist in sports physical and orthopedic physical therapy, a fellow of the American Academy of Orthopedic Manual Physical Therapists and a treating physical therapist with NovaCare Rehabilitation in Philadelphia, PA.

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

 

Posted on 10/1/2021

At Select Physical Therapy, we believe movement is medicine. So, what moves you? Physical activity is key to good health, vitality, energy, strength and might even make you laugh more.

If pain or a medical condition is holding you back, we’re here to help. Physical therapy is a moving experience.

Physical therapy gets you back to life and the things that are most important to you. Whether it’s running a marathon, playing with the grandkids or simply cooking dinner pain-free, the benefits of physical therapy can change lives for the better.

That’s why we’re excited it is October, one of our favorite months of the year. Why, you may ask? October is National Physical Therapy Month. For 31 days, we get to celebrate all things physical therapy and the many ways our dedicated physical therapists and physical therapist assistants help improve the quality of life.

There is so much to share about the benefits of physical therapy, including the highly-trained clinicians who provide it. Did you know that physical therapy helps people manage pain and chronic conditions? How about the power of physical therapy to help heal from recent injury and reduce the risk of future injury? Or prepare the body for surgery and successful recovery or avoid the need for surgery altogether? Well, physical therapy does all this and more.

Physical therapy is also a safe alternative to taking prescription medication. It treats common aches and strains, sprains and fractures, and helps with many other issues and conditions, including:

• Back sprain/strain
• COVID-19 fatigue and other debilitating illnesses
• Headaches and concussions
• Vertigo, dizziness and balance
• Disc injury and pinched nerves
• Rotator cuff tear, bursitis and frozen shoulder…and more

So, what moves you? That marathon? Those grandkids? That culinary masterpiece? Whatever it is, physical therapy, and our compassionate team of licensed therapists, can help get you moving.

Request an appointment today and see how physical therapy can physically, emotionally and mentally enrich your life.

#ThePowerOfPhysicalTherapy #WhatMovesYou #ChoosePT

 

Posted on 9/22/2021

Sports and exercise are part of the lives of many young individuals. Typically, people who participate in sports are known to be healthier and less likely to partake in outside negative distractions compared to people who do not play sports. However, for some adolescent girls, when they only focus on the sport and not their bodies, consequences can arise. 
Many girls who participate in sports are at risk for an issue called the female athlete triad. This triad consists of three conditions, and the athlete can have one, two or all three. The three conditions include disordered eating, amenorrhea and osteoporosis.

Disordered eating

Disordered eating is a term that refers to an individual having unhealthy eating behaviors and worrying about body image. Some of the most common forms of disordered eating include extreme dieting and restrictive eating. On the top end of the spectrum are eating disorders, which involve things such as self-induced vomiting, binge eating and laxative abuse. An individual can have disordered eating and not be diagnosed with an eating disorder. Most girls with disordered eating are trying to lose weight to help them improve their athletic performance. For these specific athletes, this eating pattern can range from not eating enough calories to sustain the amount of activity that they are participating in, to trying to avoid “bad” foods, all the way to eating disorders such as anorexia nervosa and bulimia nervosa.

Amenorrhea

Amenorrhea is the lack of menstruation, or one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as well as girls who have not started their periods by the age of 15. Intense exercise accompanied with not eating enough calories can lead to a decrease in the hormones needed for menstruation. As a result, a girl’s period may never come, become irregular or stop altogether. Some girls who have been participating in sports since a young age may never get their first period, because they have been training so hard. On the other hand, some girls may have gotten their period, but it disappears as their training intensifies or their eating habits change. On one hand, dysfunction of the menstrual cycle can lead to infertility. And on the other hand, it can lead to unplanned pregnancies in young women recovering from the triad. While the cycle is being restored, an egg may be dropped early and, without contraception, pregnancy can occur.

Osteoporosis

Osteoporosis is translated as porous bone. It is a disease in which the density and quality of the bone are reduced. For people with osteoporosis, boss loss overtakes the growth of new bone. Consequently, over time the bone becomes more porous and fragile, and the risk of fracture greatly increases. This typically happens silently, and there are usually no symptoms until the first fracture occurs. In girls with the triad, estrogen is typically lower. Low estrogen accompanied with a poor diet, especially low calcium, can lead to osteoporosis. During the teen years, a lot of bone growth is supposed to happen and the peak bone mass should be reached. An athlete with the female athlete triad will have a hard time getting to her peak bone mass, and it can affect her greatly later in life.

Takeaway: Diagnosing and treatment

Girls who have female athlete triad are typically invested in their sports and would do almost anything to be the best athlete possible. Girls in particular sports have more of a risk than others. Sports with a weight class like wrestling, martial arts and rowing, and sports where being thin is more optimal for performing like gymnastics, diving, figure skating, cross country and ballet, have a higher risk. However, the truth is, being very thin, and losing those last few pounds, doesn’t typically improve performance at all.

If a female athlete is suspected to have the triad, a wide-ranging physical examination is needed for diagnosis. A doctor will likely ask questions about her period, diet, exercise habits and overall feelings about her body. From there, blood test will be ordered to check for vitamin deficiencies and to rule out any other reasons for a lack of period and weight loss. A doctor may also order a bone scan to check for osteoporosis, since the athlete will be at a higher risk for bone breaks.

Doctors will not work alone to help treat a girl with female athlete triad. Coaches, athletic trainers, parents, physical therapists, nutritionists and dietitians and mental health specialists all work together and play a role in the recovery of this athlete. They focus on both the physical and emotional issues that the girl is likely facing to help prevent long term issues.

References:

• https://kidshealth.org/en/teens/triad.html
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435916/
• https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/06/female-athlete-triad
• https://www.iofbonehealth.org/what-is-osteoporosis

By: Wyneisha Mason, MAT, ATC. ‘Neisha is an athletic trainer with RUSH Physical Therapy in Chicago, Illinois.

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

 

Posted on 8/11/2021

Recently, I had a runner try to increase their pace by 30 seconds from one weekend to the next. The result? Severe pain along the inside of their shin and the start of spending two days a week in physical therapy.

Many running injuries are due to overuse and/or improper training. Up to 70% of recreational and competitive distance runners sustain an overuse running injury during any one-year period.¹ One of my favorite questions to ask runners is, “Other than running, what exercises are you doing?” Usually the response is, “You mean running isn’t enough exercise?”

Running injuries can be prevented. One of the keys to proper training is cross training. The most important group of muscles to strengthen for runners are those along the side of your hip, mainly your glute medius and glute minimus.

When people hear glutes, they immediately think of their buttocks. But, two of the smaller glute muscles – the glute medius and minimus – are often overlooked. The glute medius and minimus are vital hip muscles and their main function is to stabilize your pelvis.

When you’re walking, think about the moment you put your right foot down and swing your left leg through. Does your left hip drop down? If so, then you may have some weakness in these stabilizers along your right side. Now, imagine running more than five miles and this is repetitively happening without you knowing. Imagine the wear and tear this is taking on your body. Weak hips place unnecessary stress along your back, knees and feet. The good news is that this can be prevented.

How do you strengthen your glutes? Here are some simple exercises that do not require much equipment.

• Sidestepping: Place a resistance band just above your knees (easier) or above your ankles (harder). Keeping your toes pointing forward, side-step in a mini squat about 20 feet. Then, return to the start without turning around.
• Jane Fondas: Lay on your left side completely against the wall, head, back and heels. Place a towel behind your right heel and keeping your toes pointing straight forward. Slowly lift your leg up/down. Repeat on other side.
• Side planks: These can be done from your knees or feet.
• Knee side plank: Slowly bring your buttocks back then forward to target multiple fibers of the muscle.
• Hydrants: On all fours, lift your knee out to the side without letting your hips tilt.

For more information or to request a complimentary injury screen with one of our licensed physical therapists, please contact the center nearest you today. In the meantime, train smart, run fast and run happy!

By: Sarah Zayyad, DPT, CMPT, CDNT, Cert-ART, physical therapist with RUSH Physical Therapy 

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

1:  Ferber, R., Hreljac, A., & Kendall, K. D. (2009). Suspected Mechanisms in the Cause of Overuse Running Injuries: A Clinical Review. Sports Health: A Multidisciplinary Approach, 1(3), 242–246. https://doi.org/10.1177/1941738109334272 

Posted on 7/8/2021

Select Medical, Select Physical Therapy's parent company, was proud to collaborate with the CDC on an important clinical study regarding the long-term impact of COVID-19. The study validates our Recovery and Reconditioning Program to focus on specific deficits in patients recovering from COVID-19 and other debilitating illnesses and conditions.

Findings of the study indicate that patients recovering from COVID-19 could benefit from additional personalized rehabilitation services aimed at both physical and mental health. As the nation’s largest provider of outcomes-based, innovative physical therapy, Select Medical, along with Select Physical Therapy, is expertly positioned to guide the recovery of this 33.5 million patient population.

The Recovery and Reconditioning program launched in June 2020 amid the pandemic and was developed in partnership with leading physicians, including physiatrists, pulmonologists, infectious disease specialists as well as physical and occupational therapists and speech-language pathologists. Following evidence-informed program guidelines, our licensed physical and occupational therapists tailor a plan of care to address patients’ specific needs and goals to resume pre-COVID activities and routine.

Select Physical Therapy centers are “direct access” and do not require a physician referral to receive care. If you or a loved one are recovering from COVID-19, please click here to find a center near you and schedule an appointment today.

 

Posted on 6/28/2021

Whether you’re new to the sport of triathlon or jumping back in after a longer break in racing, many are excited to drop any weight gained during the past year. It’s the perfect time of year to get outside and back to racing.

While triathlons are a great way to push our bodies and are relatively safe for individuals at any age, athletic background or ability level, participants also need to be aware of the:

• Pitfalls of overtraining
• Importance of rest
• Appropriate time to take some time off

What defines rest and why is it important?

Rest comes in many forms. It can be as simple as the time between repetitions, intervals or sets or a scheduled day off in your training plan. And, it can be skipping a workout when you are tired and feeling worn down, physically or mentally.

If you sustain an injury or have an illness, rest may mean prolonged time away. However, rest doesn’t mean you have to completely stop all activity. You can take time off from typical training to work on mobility, participate in a yoga class, go for a walk, spend extra time on nutrition or enjoy a hot bath and relax.

Whether planned or forced, rest allows the body to adapt to the stressors and changes in demand being placed on it. It allows muscles to recover and gain strength, our nervous system to adapt to changes and regenerate and our body to replenish our energy stores. Rest ultimately decreases the risk of overtraining, overtraining syndrome and overuse injuries.

Triathlon training naturally allows our muscle groups to get some rest. When training in one discipline, the muscles involved in the other disciplines naturally get some time off. Spending the day in the pool gives your body a break from the repetitive pounding on the pavement from running, and with cycling or spinning, your shoulders get some needed time off from the resistance of the water.

When is it time to take off, skip a workout and push training to another day?

What are the signs of needing a break?

As you dive into your training plan and are weeks out from the year’s first event, here are some important signs and symptoms that your body is telling you to take a break:

• You are suffering through workouts that were previously done with ease
• Notice your form is deteriorating or you are slower in any of your disciplines
• It is harder to wake up
• Increased irritability
• Decreased motivation to train or in your daily life
• Decreased concentration during work-outs
• Increased sleeping
• More frequent soreness or injuries (and it’s not due to an increase in intensity level of working out)
• Increased illness

If we don’t listen to these signs, our bodies may just force us to rest. If this happens, we can end up overtraining or sidelined with an injury.

What is overtraining?

Overtraining, simply put, is doing more than your body can handle at any given time. There is an imbalance between training, nutrition and rest leading to a decrease in performance, increase in fatigue and a decline in mood. For a well-trained athlete, overtraining may occur when putting in extra training sessions on an already full schedule. If you’re a rookie, it might mean jumping in too quickly with one or two extra days of training.

Overtraining can be influenced by outside workload when we are stretching our personal schedules and sleep routines too thin. You may see you are underperforming with little to no change in your training program. Or, you may find you have more difficulty sleeping - falling asleep or staying asleep despite fatigue from working out.

Once this stage or overtraining is reached, athletes will often find an elevated heart rate, especially first thing in the morning as well as deficiencies in vitamins B12 or D, lower iron levels and increase in creatine kinase levels in the blood. All of these can be serious signs of overtraining syndrome and can force an athlete into three-to-eight weeks off from training and treatment by a medical professional.

What are overuse injuries?

The most common overuse injuries in triathletes and athletes in general are from overtraining or overuse. Overuse injuries represent the largest percentage of sports-related injuries that require medical attention and are most common in runners and endurance athletes (triathletes).

Approximately 50-70% of triathlete injuries occur when running, and the majority of those are overuse. These injuries most often occur in the knee, Achilles, foot or back or the shoulder from swimming. They can occur due to a breakdown in tissue that doesn’t have adequate time to repair itself before more use.

If you are seeing aches and pains that don’t subside in approximately three days in the well-trained athlete or seven days in a new participant (due to new muscles being trained,) it is time to take some time off and seek out your local physical therapist for guidance. A physical therapy plan of care can help you heal, regain/increase strength and flexibility and reduce pain. It can also help you prevent future injury and optimize your sports performance.

Author: Melissa Bryant, P.T. Melissa serves as the center manager for Select Physical Therapy’s Colorado Springs facility, located in the USA Triathlon headquarters building.

Select Physical Therapy is part of the Select Medical Outpatient Division family of brands.

Resources

• Vleck, V., & Alves, F. B. (2011). TRiathlon injury review. British journal of sports medicine, 45(4), 382-383.
• Koutedakis, Y., Budgett, R., & Faulmann, L. (1990). Rest in underperforming elite competitors. British Journal of Sports Medicine, 24(4), 248-252.
• Gosling, C. M., Forbes, A. B., McGivern, J., & Gabbe, B. J. (2010). A profile of injuries in athletes seeking treatment during a triathlon race series. The American journal of sports medicine, 38(5), 1007-1014.
• Budgett, R. (1990). Overtraining syndrome. British journal of sports medicine, 24(4), 231-236.
• O'Toole, M. L., Hiller, W. D. B., Smith, R. A., & Sisk, T. D. (1989). Overuse injuries in ultraendurance triathietes. The American journal of sports medicine, 17(4), 514-518.
• Collins, K., Wagner, M., Peterson, K., & Storey, M. (1989). Overuse injuries in triathletes: a study of the 1986 Seafair Triathlon. The American journal of sports medicine, 17(5), 675-680.