• 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.

  • therapist testing patient

    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.


    Categories: Physical Therapy  

  • girls wearing backpacks

    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.

  • Baseball Pitcher

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

     

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

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

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

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

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

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

    Overhead squat
     Heather Squat

    Overhead walking lunge
     Heather Overhead Lunge

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

    Lunge with trunk and arm rotation
     Heather Lunge Rotation

    Shoulder rotation with banded pull aparts
     Heather Band Rotation

    PNF diagonal pattern with banded pull aparts
     Heather PNF Bands

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

    Heather Stretch 1 Heather Stretch 2

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

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