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. 

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. 

Posted on 10/12/2020

For the management of some types of pain, prescription opioids can certainly help. However, there is not enough evidence to support prolonged opioid use for chronic pain. We sat down with Katie McBee, P.T., DPT, OCS, M.S., CEAS II, PYT-C, regional director of our WorkStrategies Program, to ask her a few questions regarding opioid use, chronic pain and the benefits of physical therapy as a safe alternative to prescription medication. 

1. In your opinion, what are the main reasons for the opioid epidemic in the United States?

There is no simple explanation as to what caused the opioid epidemic in the United States. Opiates are not a new drug and have been abused at other time periods in American history, but not nearly to the extent that is happening now. For example, with health care access issues due to COVID-19, opioid prescription rates are on the rise with death rates up 30% since the pandemic’s onset.

Initial research on opiate medications said they were effective and safe and addiction was rare when used for short-term pain.¹ The development of FDA approved OxyContin in 1995 had labeling that stated iatrogenic addiction was “very rare,” and a widespread marketing campaign to physicians started to build medical providers’ confidence in prescribing these medications to decrease pain-related suffering.² Add to that Joint Commission standards from 2001, now rescinded, calling for organizations to use "pain" as a marker for treatment, asking patients about their pain levels with the idea that pain was being undertreated. Both efforts likely catalyzed the beginning of the ongoing opioid epidemic.  

With medical providers focused on pain as a vital sign, pain quickly became the enemy and had to be eradicated to show successful management for many conditions with an increased focus on post-operative pain management. As drugs became more widely available, aggressively advertised and culturally acceptable, a three-fold increase in prescription rates for these medications ensued. With the increase in opioid prescription rates, overdose death rates rose to 47,000 Americans in 2017.

2. What is the difference between chronic pain versus pain suffered as a result of an injury? 

Pain is a mechanism designed to protect us from harm. Pain is not the enemy. A common misconception about pain is that it is not a simple cause/effect relationship. The amount of injury does not equal the amount of pain we experience. Pain is a complex process based on many areas of the nervous system and the brain communicating together to let us know what we need to prioritize and protect. The more threatening the brain perceives something, the more we potentially feel pain. 

Acute pain or pain suffered immediately after an injury or surgery to the body’s tissues is a protection mechanism from the brain to remind you to protect the area so that no further harm is done. As the tissue heals and time passes, there is less threat of injury so the brain stops signaling, the pain eases and you slowly get back to normal activities. 

In chronic pain, the tissues are not signaling danger to the brain as much as they are in acute pain. When the brain perceives threat for extended periods, it starts to change the nervous system to become a pain-producing machine. It creates new nerve junctions to make things hurt that wouldn’t normally hurt, like light touch on the skin. It can decrease the amount of pressure needed to create a pain signal. It creates more chemicals along the nervous system so it can create greater pain experiences with fewer stimuli. Research is still trying to figure out why some individuals have pain that goes away as the tissues heal and others have pain that persists despite the fact that the tissue has healed.

Individuals can be at risk of developing chronic or persistent pain for a number of reasons, including unhelpful coping strategies, stress, chronic illness and poor sleep habits. It appears the more emotional or physical stress going on at the time of the injury and/or during the healing process, the more at risk you can be of developing a persistent pain issue. A holistic approach to address some of these drivers of persistent pain is showing promise in being able to reduce the pain and get people with chronic pain back into their normal lives again.

3. Why is physical therapy important and what are some of the benefits to patients? 

Physical therapy is an ideal treatment for many types of acute and chronic pain and should be a part of any single or multidisciplinary treatment plan for pain. The goal of physical therapy is to increase function and keep people in their meaningful life activities while they are healing. Physical therapists are trained to address many of the drivers of chronic pain and can perform testing and screening to see if your pain system is sensitized and adjust treatment to desensitize the pain system as well as address the functional limitations many people often experience when they are in pain.  

Physical therapists have many tools they can use to decrease pain and desensitize the pain system. These tools include education on pain to discover what could be driving pain issues. Once the pain drivers are discovered, a physical therapist will develop a holistic plan to address these drivers, including increased activity, sleep hygiene, stress management skills and pacing techniques. 

The best thing about physical therapy for pain is that the outcomes for some of the techniques are better than many medications and procedures available; plus, there are no negative side effects. If you or someone you know has an issue with pain, please request an appointment today to begin physical therapy treatment. 
References

1. Porter J, Jick H.  Addiction rare in patients treated with narcotics. N Engl J Med. 1980;302:123.
2. Van Zee A. The promotion and marketing of OxyContin: commercial triumph, public health tragedy. Am J Public Health. 20:99 (2):221-227.

Posted on 10/7/2020

Up until a few months ago, my life as a physical therapist was pretty normal. I went to work, did my job, helped my patients and team to the best of my ability and went back home. At the time I was working in a critical illness recovery hospital with some of the sickest patients in my geographic area, people recovering from major trauma and significant illnesses. I was part of a great team, but it was heavy work. I felt myself becoming burnt out and struggling to do my best work. I have done hospital-based and outpatient work throughout my career, so I began to think that a transfer to Select Medical’s Outpatient Division might be my next move. 

Fast forward a few months and interviews later and I accepted a site supervisor position at an outpatient center. About a month into my new role, COVID-19 wreaks havoc on the world. It was a daily pivot in terms of center operations and managing a team during a global crisis. I was also in a really unique position because I had spent almost 10 years working in critical illness, learning about cardiopulmonary physical therapy, infectious diseases and protective equipment. I felt confident I could lead my team effectively with the best information I had. As we started to move through the pandemic, our greater area was looking for someone to help lead a developing COVID-19 recovery program and I felt uniquely qualified.  

Select Medical’s clinical team had put together a top-notch Recovery and Reconditioning Program for those compromised by a variety of acute and chronic conditions, such as after-effects of the flu and cardiovascular disease. Developed in partnership with leading physicians, including physiatrists and infectious disease specialists, the program focuses on identifying key areas of deconditioning and weakness in patients. Select Medical’s licensed physical and occupational therapist are specially trained in the program, with each clinician having access to the most up-to-date COVID-19 information, best practices and safety precautions. 

Physical, occupational and speech therapy is critical in helping COVID-19 survivors get back to their lives and jobs. This virus can be extremely debilitating on its own, and even worse when combined with the effects of limited mobility during hospitalizations, prolonged mechanical ventilation or additional medical complications. As physical rehabilitation professionals, we are uniquely qualified to work with these patients to: 

• Increase mobility, balance and stability
• Decrease pain, soreness and general fatigue
• Improve range of motion and breathing capability
• Address cognitive impairments, dizziness and weakness
• Ensure a safe recovery to activities of daily living  

Our clinical team believes firmly in safety first and have put out guidelines for monitoring patients to ensure we are exercising them hard enough to make progress, but not overstress their systems. We are also educating these survivors on how to monitor themselves during home exercises or simple household activities like cleaning and chores.  

While this global pandemic has had a lot of challenges and negative aspects, when I really step back and look at the whole picture I am impressed with how we positioned ourselves. Every day, we are committed to putting patients first, keeping patients and clinicians safe and assisting those who have survived COVID-19 back to their highest quality of life. That’s something to be proud of, and we look forward to helping more and more heal through our Recovery and Reconditioning Program.

To learn more about our program or to schedule an appointment today, please click here.

By: Erica R. Noel, P.T., MSPT. Erica is a physical therapist with Banner Physical Therapy in Phoenix, AZ. Banner and Select Physical Therapy are part of the Select Medical Outpatient Division family of brands. 

Posted on 10/2/2020

It's official, our favorite month of the year is here: National Physical Therapy Month. Please join us as we celebrate our amazing team members and the power of physical therapy throughout October. #NPTM2020 #ChoosePT #ThePowerOfPhysicalTherapy

View our National Physical Therapy Month video

Posted on 6/7/2018 by Annette Monaccio, O.T., CHT

Hand Therapy Week is held during the first full week of June and hosted by the American Society of Hand Therapists. Certified hand therapists are dedicated to helping patients with hand and arm injuries and conditions that may be affecting their daily life.

As a certified hand therapist, I’ve had the privilege to meet many people with a wide range of injuries. Watching an individual perform a task or activity that we often take for granted is a proud and exciting moment for both a patient and therapist after an injury.

I met Lexi, a shy and nervous young girl, who had been through a traumatic experience and hospitalization after a bon fire accident left her with severe burns over most of her body. She had spent several months at a local hospital in the intensive care burn unit. Upon beginning treatment, I knew that I needed to address and acknowledge her injuries, expectations of participation in therapy, boundaries for success and goals for recovery and independence.

Lexi had many burns on her face, arms, hands, torso, legs and back. There were many areas to address with her injuries, including:

Managing her wounds
Regaining mobility in her extremities
Performing basic activities of daily living, such as bathing, dressing and returning to school
Processing the psychological impact of others reactions to her appearance
I knew there were many things that we had to address quickly to avoid the loss of motion of her arms, especially her hands which were severely burned and beginning to form contractures/scarring along the fingers. We developed custom splints, “orthoses” made to fit the individual. It required many attempts for success due to Lexi’s injuries, but the key to our success was listening to determine the best splint, proper fit, adjustment and fashion for a preteen. A few color adjustments of splinting materials, a little added “bling” and voila, it was done and Lexi began wearing her orthotic!

The management of her wounds – cleaning, dressing, monitoring and education – were our first steps of trust and understanding, since this was one of the most difficult aspects of intervention. The next process of touching, moving and passively stretching her hands and fingers were the true challenge. Building trust and establishing goals were vital. We were on our way as a team to improve her ability to bend a finger, make a fist and then use her hands to accomplish daily tasks. There was blood, sweat and tears during many sessions, but, most importantly, there was a lot of laughter, too.

LexiLexi’s parents were dedicated to helping her in the center and at home for carryover of the program. As I watched her mom tie her shoes and write out some of the exercises we were reviewing one day, I asked Lexi why she wasn’t doing this on her own. She said, “I can’t do it myself.” This began the educational component with Lexi and her mom of why it was important to allow Lexi some reasonable time to attempt to gain her independence to complete daily tasks on her own. Yes, it was quicker and easier for someone to do this, but what would happen the first day back to school? Within two sessions, Lexi was independently putting on her shoes, tying them and had her first sense of independence since the accident.

Her laughter and smile were infectious with each new success. Next, Lexi was writing with adapting pens and pencils and back to writing poetry. Putting on her arm and leg compression garments and gloves was a tug of war match and she won each time. Again, another success. There were challenges of zipping a backpack, carrying books and fatigue following walks through the hallways in school, but Lexi overcame them all.

We initiated more challenges with fine motor skills with the purchase of a Barbie head and working on braiding hair. As a preteen, this was a must for Lexi. She now started braiding and had taken the focus of the hypersensitivity of her burns away to a new focus of allowing herself to touch different textures, which previously prevented her from using her hands for any activities. With each new challenge came a new set of frustrations, successes and, ultimately, independence.

Due to the extent of her burns, Lexi has been through several follow-up surgeries. She has returned each time to the center and hand therapy treatment with a new set of goals and motivation to quickly return to her routine. Step-by-step she continued to accomplish her goals, becoming independent with all activities. She now has excellent mobility of her arms, hands and legs.

Lexi has matured into a teen. She drives, attended prom, participates in track and other sports at school and has become a teen counselor at the burn camp she has attended each summer since her accident. I observed Lexi go from a quiet, scared child to an energetic and expressive young lady. She has taught me about determination, hard work and maintaining a positive attitude. She is an inspiration. I was not only the therapist, but the student learning each day from her.

By: Annette Monaccio, O.T., CHT. Annette is an occupational and certified hand therapist with Banner Physical Therapy in Arizona. She has treatment expertise in hand/upper extremity conditions and injuries, pelvic floor health and cancer rehabilitation.

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

Posted on 4/3/2017 by Cornelia von Lersner Benson, O.T., CHT

Join NovaCare Rehabilitation, Select Physical Therapy and our team of dedicated occupational therapists as we celebrate Occupational Therapy Month (OTM)! OTM is hosted by the American Occupational Therapy Association (AOTA) each April to recognize how occupational therapists and occupational therapy assistants help transform society by restoring and improving function in people's lives.

Occupational therapy is celebrating its anniversary! The National Society for the Promotion of Occupational Therapy (now AOTA) was established in 1917, marking 100 years of the profession and evidence-based practice. With more than 200,000 occupational therapists and occupational therapy assistants helping individuals across the lifespan live life to its fullest, this dedicated group of professionals focuses on treatment to help develop, recover and maintain the daily skills of patients.

Occupational therapists offer a unique approach to physical rehabilitation. The focus isn’t just someone’s motion or strength, but how it is used in their life, such as a healthy return to work, getting back to sports or hobbies or helping to braid a child’s hair before school. Occupational therapists also have specialty training in orthoses fabrication and emotional, thinking and reasoning factors that affect physical health and function. It is a service that, side-by-side with physical therapy, can offer a return to health and function in an all-inclusive and progressive way.

This service offering, however, all began for NovaCare Rehabilitation in 1990, prior to joining the Select Medical family, within our Southern New Jersey community when I was hired by our then company president to develop an occupational therapy program. I was hired as the first occupational therapist for the company, likely as an informal pilot study to determine a consumer’s benefit of receiving occupational therapy and its contribution as a service and unique offering for our organization. As we knew it would, occupational therapy was a hit! Occupational therapy allows patients to achieve independence and participate in tasks they want and need to accomplish through therapeutic interventions following trauma or disability. Our local success meant that the occupational therapy service offering quickly grew, adding additional staff members in New Jersey and then Philadelphia, Maryland and Minnesota.

Today, occupational therapy is a national service for NovaCare Rehabilitation, Select Physical Therapy and other brands within the Select Medical Outpatient Division family. We employ more than 480 occupational therapists across the country. We continue to treat patients on a daily basis as well as provide education and mentoring to support new occupational therapy graduates who desire to achieve his/her certification in hand therapy. We help to supervise all levels of occupational therapy students, ongoing development for staff and continued service expansion to meet the needs of our community at large.

At NovaCare Rehabilitation and Select Physical Therapy, our occupational therapists are everyday heroes and know that each patient is unique and requires an individualized approach to care. Our team finds the right solution for each patient to reach goals and return to function and the things they enjoy doing as soon as possible.

I am proud to work for a company that holds occupational therapy in such high regard and encourages and supports therapists in their growth, their unique contributions and their skills to improve the lives of our patients. This comes as a result of having a company creed that is dedicated to providing an exceptional patient experience in a compassionate environment. It all fits! Happy OTM, everyone!

Cornelia von Lersner Benson By: Cornelia von Lersner Benson, O.T., CHT. Cornelia serves as NovaCare Rehabilitation’s hand and occupational therapy director for the Southern New Jersey community. NovaCare in New Jersey proudly employs 46 occupational and hand therapists within 27 offices, including those who provide in-home care and services within physician offices.

Posted on 3/30/2020

Each March, the National Athletic Trainers’ Association (NATA) celebrates National Athletic Training Month. This year’s slogan is “ATs Impact Health Care Through Action.”

Since I became a certified athletic trainer in 1995, I am often posed the question “Why did you choose this profession?” Many times my answer is not only an expression of my own feelings, but a compilation of answers I have heard from the number of interviews I have conducted through my position as regional coordinator for sports medicine.

As many athletic trainers have, I came from an athletic background. I enjoyed success as a high school athlete, but I was not gifted enough or provided the opportunity to take my talents to the next level. However, my friend invited me to a college career fair at the local university, and a window of opportunity presented itself to me when I learned about athletic training. Following that career fair, I knew this profession would impact me for the rest of my life. I had found a profession that would allow me to maintain my appetite for sports: the competitiveness, the excitement of game day, the ability to be part of a team and, most importantly, the ability to impact every athlete through my actions as a health care provider.

Oftentimes during the interview process, I hear the response from candidates that the reason they became an athletic trainer was because of the effect their athletic trainer had on them. Whether they sustained an injury in high school or college, they were impacted by their athletic trainer and this profession. No matter the response they give, all athletic trainers possess a number of similar traits, including the innate need to help others.

Our ability to walk side-by-side with an athlete through their journey from training, prevention, performance, injury, treatment, recovery and return to play is the most unique in the health care field (though I may be biased). As an athletic trainer, our collaboration with all facets of the health care spectrum are unmatched.

On any given day, we communicate with coaches, parents, school nurses, nurse practitioners, physician assistants, physical therapists, family medical physicians and orthopedic physicians to assist just one athlete. Athletic trainers also impact our workforce community by providing services to industrial athletes in manufacturing, police, fire and rescue, tactical, performing arts, transportation and aerospace, hospital and retail settings. We communicate with their employers, case managers, payers and insurers to help with return to work. In all that we do, our one common goal is to provide quality health care and safety for each athlete, patient and worker we care for.

For the past 25 years, I have been employed as an athletic trainer, 18 of them for Select Physical Therapy. As a certified and licensed health care professional, my job encompasses the prevention, examination, diagnosis, treatment and rehabilitation of emergent, acute or chronic injuries and medical conditions. I have been on the sidelines for high school, collegiate and professional sports. I have witnessed state championship games, national championship games and individual titles. I have worked in a major automobile factory providing care for employees responsible for assembling the doors on your car or truck. Most recently, I have been given the opportunity to educate, support and mentor other athletic trainers in the field.

I do what I do because, at the end of each day, I can look back on my work and feel the value and positive effect I have had on an individual’s health, well-being and ability to do what is important to them in that moment – impacting their health care through my actions. What could possibly be better than that?

By: Perry Siegel, M.S., ATC, CSCS, regional sports medicine coordinator for Select Physical Therapy in Connecticut.

Posted on 9/11/2018 by Brian Brewer, CPT

School is back in session and fall sports are underway! From the gridiron to the soccer field to the volleyball court, athletes of all levels are hitting the field. With increased play, however, there is also an increased risk for injury.

Did you know that there are movement assessments designed to assess ACL injury risk? Within Select Medical’s Outpatient Division*, we provide movement assessments using dorasaVi wireless wearable sensors to measure exactly how individuals move. This technology allows our highly trained clinical team objectively analyze body movement and muscle activation, utilizing a test called the Athletic Movement Index, or AMI. With this testing, we are able to accurately determine an athlete’s ability to safely perform higher level movements, such as cutting, pivoting and deceleration, all of which can lead to ACL injury if not performed efficiently.

The ACL is one of four ligaments in the knee that provide joint stability. Roughly 70 percent of ACL injuries during high-risk sports are non-contact injuries, meaning no collision occurred when the ACL tore. As an athlete begins to tire throughout the course of a game or event, their efficiency in movement begins to suffer, their mechanics become faulty and their risk for injury is heightened. If we can recreate these conditions during movement assessments, we are more able to determine an athletes risk for ACL injury. The AMI is a test that simulates the fatigue factor that plays a role in ACL injuries.

The AMI runs the athlete through a battery of movements, designed to assess core strength and stability, hip strength and mobility and efficiency moving through single-leg movements, such as a single-leg squat and a single-leg hop. The single-leg movements analyze the movement of the knee, whether it is collapsing inward or outward past neutral and the degree of loading, or depth, that the participant is able to go to, both of which are important indicators in assessing ACL injury risk. If the knee is not staying neutral during single-leg movements, then there is weakness in the hip, specifically the gluteus medius muscle, which is leading to inefficient movement. The higher the speed that the knee is moving out of neutral, the higher the risk of ACL injury there is. Similarly, if the athlete is not loading deep enough, and that is coupled with a high speed of displacement, then their risk is increased even more. Through strengthening the hips and core effectively and deliberately, based on the test results, clinicians can help reduce an athlete’s risk of injury dramatically.

Our exclusive ACL Play it Safe Program is an ACL prevention program, designed specifically to go hand-in-hand with the AMI and address the faulty mechanics that lead to ACL injuries. The program consists of a mobile application, with pre- and post-practice exercises and drills to be performed. Additionally, there is an ACL Play it Safe Kit that consists of equipment designed to improve strength and conditioning of the muscles responsible for controlling mechanics during dynamic movements that can cause injuries.

The pre-practice exercises are dynamic warm-ups that should be used to increase flexibility and mobility in the hips, knees and ankles:

Dynamic lunge
Sumo squat
High knee with calf raise
These pre-practice exercises should be performed for 15 yards down and back, two times each. This will help to warm-up the hips and knees, and prime them for efficient movement.

The post-practice exercises utilize the TheraBand CLX, TheraBand Ankle Cuff and TheraBand Stability Trainer. These should be done after practice when the athlete is tired. If an athlete can strengthen and train with proper mechanics while they are tired, then it will be that much easier for them to perform efficiently on the field when they reach the same level of fatigue. There is a multitude of post-practice exercises, with some listed below:

CLX spiral technique
TB cuff side stepping with kicks
Single leg toss on stability trainer
CLX plank with kicks
All of the post-practice exercises are designed to help strengthen the core and gluteus medius muscle and prevent a displacement of the knee during dynamic movements. Of course, as with any exercise routine, static stretching and/or foam rolling should also be performed following the completion of the program.

Through objective analysis of muscle activation and subjective observations of movement, clinicians are able to determine ACL injury risk with high accuracy. If we can address poor mechanics of movement through assessment prior to when an athlete takes the field and introduce them to ACL Programs designed to addressed these poor mechanics, we can start to minimize lost time on the field, see an increase in performance and help athletes be more confident in their sport.

*NovaCare Rehabilitation and Select Physical Therapy are part of the Select Medial Outpatient Division family of brands.

By: Brian Brewer, CPT, is a strength and conditioning specialist for NovaCare Rehabilitation in Annapolis, Maryland.

Posted on 9/26/2018 by Anne Marie Muto, OTR/L, CHT

Now that students have a few weeks of school under their belts, their backpacks – which were relatively light from a few school supplies – are now filling up. Not only are children feeling the weight of nightly homework, but also the weight of their book, binder and electronic-filled backpacks.

Aside from considering the right cartoon character/super-hero, color and cool factor, the backpack should also be the right fit. In honor of National School Backpack Awareness Day, here are few things to keep in mind when picking out a backpack:

The width should be about the same size as the student; the length should be no longer than the torso (trunk or central part of the body) and not hang more than four inches below the waist. Remember to check the bag each year, especially for younger children who are experiencing growth spurts.
Select a backpack that has a padded back, two padded shoulder straps and a waist strap to help evenly distribute the weight from the shoulders to the body’s core and hips. The extra padding will help protect students’ neck and shoulders which are rich in blood vessels and nerves and when constricted can cause pain and tingling in the neck, arms, and hands.
Finally, choose a backpack that is light-weight and has multiple compartments which can help distribute the weight more evenly. It’s also a good idea to think about picking a backpack with reflective material or adding reflective tape for younger students.
After picking out the perfect backpack, students should also be reminded on how to properly wear and pack their “shoulder shadow.”

Always wear both shoulder straps to distribute the weight evenly. Using one only shoulder strap can cause too much leaning and threaten to curve the spine.
Adjust the shoulder straps so the pack fits snugly across their back. When possible, pack lightly and carry only items that are required for the day.
Never allow a student to carry more than 15 percent of their body weight. For example, if a child weighs 100 pounds, the backpack should not weight more than 15 pounds.
When organizing the content of the backpack, distribute the weight evenly by packing the heaviest items toward to the center and lower portion of the bag to keep the weight off their shoulders.
Finally, here are a few tips to keep in mind to help lighten the load:

Ask if textbooks are available digitally, or if extra books are available to leave at home.
Consider having a “homework box” at home that contains schools supplies (pens, pencils, ruler, markers, highlighters, etc.) to reduce the amount of unwanted weight in a backpack.
Encourage kids to use their locker or desk frequently throughout the day instead of carrying an entire day’s worth of books. Only bring home the books which are truly required for homework or studying each night.
Pick up the backpack using proper lifting techniques, encouraging students to bend at their knees and use both of their hands when lifting the bag to their shoulders. It may not be a bad idea for students to participate in back-strengthening exercises to assist in building up muscles required to carry a backpack.
We hope you have a fun and healthy year at school! Happy learning!

By: Anne Marie Muto, OTR/L, CHT, from NovaCare Rehabilitation’s Broomall and Boothwyn, PA centers. Anne treats patients dealing with upper extremity injuries and is a preferred provider for the Graston Technique.

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