Posted on 3/16/2018 by Stephanie Wilkins, MSEd, ATC, and Leah Friedland, M.S., ATC

Concussions are a great concern throughout the world of sport and especially in the high school setting. They can impact the student-athlete not only on the field, but also in the classroom and their daily lives. As athletic trainers in the high school setting, when a concussion has occurred, we are involved in the entire process, including:

Baseline testing
Evaluation
Diagnosis
Follow-up
Return-to-play
We help with education, implementation of proper concussion protocols and serve as an advocate for the student-athlete in their sport, classroom and life.

Education – Despite the growing awareness and concern that is present in the media over concussions, we find that coaches, parents and athletes are often still uninformed about the seriousness of concussions and the proper way to handle them. A concussion is a traumatic brain injury that is caused by either a direct force/blow to the head or a force transmitted through the body to the head. As high school athletic trainers, we find ourselves explaining to coaches that “getting your bell rung” is the same as sustaining a concussion, and that it is not something that can be ignored. “This wasn’t a big deal back when I played sports, and I turned out fine,” is not an acceptable way of viewing this issue.

We are seeing now that, decades later, people are experiencing abnormal brain function and lasting damage as a result of previous head trauma that might not have been managed properly. Concussion education is not intended to scare people, but rather to inform and stress that concussions should be handled appropriately and taken seriously.

We must also work to change the team attitude around concussions and urge athletes and coaches to take responsibility for their well-being and the well-being of their teammates. The culture of not reporting concussions for fear of sitting out or being made fun of must not continue. High school athletic trainers are in the unique position of helping create this cultural change within sports programs and we strive to do this by forming relationships with our coaches, parents and student-athletes that are based on trust and compassion.

Baseline Testing – Every concussion is different; even in one person, different concussive episodes can present in different ways. Symptoms of a concussion include:

Headache
Appearing dazed or confused
Nausea and vomiting
Difficulty concentrating
Imbalance… and more
There are few objective measures available to diagnose concussions, so it’s important to have a baseline evaluation for each athlete to help determine return-to-play.

We perform this evaluation at the beginning of the season to obtain a baseline score, i.e. an athlete’s “normal” level of functionality. If the student-athlete sustains a concussion during that season, a second test will be administered. This second test occurs when they are symptom-free and have completed the return-to-play progression.

In our high school, we implement two different tools for baseline testing. With more than 800 student-athletes, we prioritize the high risk contact sport athletes (like those participating in football or soccer) and administer baseline tests to those sports. The first test is ImPACT®, a computer neurocognitive exam that tests word and image recall, reaction time, motor speed and symptom report. The alternate test we use is C3 Logix. In addition to a neurocognitive exam, C3 Logix includes a balance and vision component. It is more comprehensive and time intensive, whereas the ImPACT® Test is more easily administered to a large team all at once.

We don’t use ImPACT® or C3 Logix to diagnose concussions, but rather as a tool to monitor their healing process and identify any potential problem areas. 

Evaluation and Diagnosis – The most important aspect of concussion management in the high school setting is communication. We’ll discuss concussion management with both the student-athlete and parents/guardians to discuss next steps and answer any questions they may have

Next, we communicate with our Concussion Oversight Team (COT). The COT is a multidisciplinary group of individuals who help manage the student-athlete’s post-concussion care. It includes the athletic trainers, team physician, school nurses, athletic director and school counselors. We also email the coach and physical education teacher. This is our opportunity to provide athletic and/or academic accommodations as needed. The counselors and nurses are vital for helping communicate with the student-athlete’s teachers.

Occasionally, a student-athlete will require academic accommodations. These are specific to each individual and can include wearing sunglasses to help with sensitivity to light, postponing quizzes or tests, limiting use of computer work or leaving class early. Most students don’t require academic accommodations, but all are excused from gym class and athletics until their symptoms have resolved and they have completed the return-to-play progression.

Follow-Up – Oftentimes, parents will ask, “Does my son/daughter need to go to the doctor or the emergency room?” The emergency room is rarely indicated unless there are signs and symptoms of a brain bleed. This will be evaluated at the time of the injury and, if there is concern, a referral to the emergency room will be made.

Research shows that most concussions resolve within 7-14 days. Our protocol recommends following up with a physician if the symptoms have not resolved within 7-10 days. And, referral to an appropriate health care provider is essential. When possible, we will refer to a concussion specialist who works with these cases on a normal basis. The average primary care physician will not have expertise in concussion management. We will sometimes recommend following up with an ophthalmologist if the student-athlete is having difficulty with vision or physical therapy due to vestibular problems.

As athletic trainers, we take care to be as best prepared to diagnose and treat concussions as possible. We put a strong emphasis on communication with the athlete, parents, coaches and school in order to return the student-athlete safely to school and sport. Concussion research will continue to evolve over the years to come, just as we will continue to adapt and update our management protocols to keep student-athletes safe and active.

By: Stephanie Wilkins, MSEd, ATC, and Leah Friedland, M.S., ATC. Stephanie and Leah serve certified athletic trainers for NovaCare Rehabilitation in Chicago, Illinois, and currently work at York Community High School. Stephanie also serves as the sports medicine program director and helps manage other sports medicine contracts around the Chicago-land area.

Posted on 1/2/2019 by Grant Shanks, P.T., OCS

For many patients recovering from injuries and surgeries, a period of immobilization in a cast or sling and/or restrictions on weight-bearing and activity is necessary to ensure proper recovery and tissue healing. Immobilization and lack of use comes with a significant cost, though: decreased muscle strength and size, known medically as atrophy.

Even after the restrictions are lifted, it takes months to recover to pre-injury levels of strength and ability. However, recent research has led to exciting advancements in what is possible when it comes to regaining muscle strength, size and ability following injury and/or surgery. The development of Blood Flow Restriction training has opened up new doors for patients and the therapists who treat them.

What is Blood Flow Restriction (BFR) training?

Blood Flow Restriction (BFR) training uses external pressure – via a tourniquet – to reduce (restrict) arterial blood flow to working muscles and completely occlude (block) venous blood flow return to the heart. By doing so, one can achieve substantial hypertrophy (muscle growth), strength and endurance changes while using significantly decreased loads/weight. The gains in these areas of performance are consistent with what is typically observed with heavy load lifting.

To this point, the American College of Sports Medicine has shown that optimal muscle strength and hypertrophy can be achieved by lifting at high intensities, defined by their research as: eight-to-10 upper and lower body exercises, performed two-to-three times per week for six-to-eight weeks at intensities greater than 65 percent of the individual’s one repetition maximum (RM). Certainly, this is not possible for the immobilized/injured/post-surgical patient. Utilizing BFR, these same gains in strength and hypertrophy have been observed using only 20 percent of an individual’s one RM and in just two-to-three weeks.

How does BFR work?

While the exact mechanisms are not completely understood, it appears to be a combination of factors related to muscle physiology:

Decreased oxygen to the muscle causes a build-up muscle-building metabolic products.
A preferential recruitment of larger, fast-twitch muscle fibers.
An increase in growth hormone and stem cells following exercise with BFR.
Increased muscle protein synthesis via the extreme “muscle pump” following BFR.
 BFR Leg What kind of device/equipment is used for delivering BFR?

By definition, anything that restricts blood flow is a tourniquet, which is considered a medical device and falls under FDA Class I regulations. In order to determine how much blood flow restriction to create in a limb (upper or lower extremity), an individual’s limb occlusion pressure (LOP) must be determined. In order to do this, a Doppler is used to assess for the presence or absence of a pulse.

Once enough pressure has been created by the tourniquet, the pulse will be absent. This amount of pressure is the LOP and then the working pressure is a percentage of this amount – either 80 percent for the lower extremity or 50 percent for the upper extremity. Machines that have a built-in Doppler are considered the gold standard. A hand-held Doppler could also be used.

Who would benefit from BFR?

Patients who are recovering from surgery to the upper or lower extremity and cannot bear weight, move their extremity and/or have been weakened by conditions may be good candidates to receive BFR. Some conditions include:

Total joint replacements
ACL repairs
Rotator cuff repair/injury
Upper extremity fracture
Lower extremity fracture
Knee arthroscopy (knee scope)
Achilles tendon repair/injury
Shoulder labral repair/injury
Hip labral repair/injury
How do I know if BFR is right for me?

Your physical therapist will be able to go through the indications (reasons to perform) and any possible contraindications (reasons not to perform) BFR with you.

BFR is a new and growing area of rehabilitation, strength and conditioning and not all physical therapists have been trained and educated on the matter. Contact your local Select Physical Therapy or NovaCare Rehabilitation center to see if BFR is available.

By: Grant Shanks, P.T., OCS, area sports medicine coordinator for Select Physical Therapy in Tennessee. Grant also serves as center manager of our Mt. Juliet location.

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

Posted on 3/25/2019 by Mike Montez, M.S., ATC, CSCS

With an aging workforce, increasing health care costs and a continued demand for physically demanding jobs to be completed by humans, more and more companies are looking into providing their employees with access to an onsite injury prevention specialist.

The injury prevention specialist role is often filled by a National Athletic Trainers’ Association Board of Certification certified athletic trainer whose unique training, skills and abilities make a great fit for the job. Athletic trainers perform skills including immediate injury triage and care, biomechanics assessment, health and wellness education and strengthening/conditioning of active individuals.

Onsite athletic trainers work with industrial athletes who might be delivering online purchases, assisting with luggage at the airport or even cleaning a hotel room. The main goal of the industrial athletic trainer is injury prevention. Just like in sports, industrial athletic trainers “keep the worker in the game.”

Many individuals don’t know when to use ice or heat, how to stretch a tight muscle, basic nutrition needs for a physical job or even how lack of sleep can affect the body’s ability to heal, decrease motor coordination and increase blood pressure. That is where the role of the industrial athletic trainer comes into play.

Employees suffering a wide array of pain or discomfort from work-related and non-work related activities can seek out care from the onsite injury prevention specialist. Care may include assessing the individual, developing a plan of care and attempting to conservatively manage the issue through a combination of ice, heat, soft tissue massage, prophylactic, non-rigid taping and the application of a topical analgesic.

More often than not, an employee’s symptoms resolve within a few visits. If not, the industrial athletic trainer will discuss potential next steps in the process which could include following up with a doctor for further treatment. The industrial athletic trainer also serves as a referral source for other available services which may include dentistry, registered dietitians, follow-up with the employee’s primary care physician/specialist or even psychological consults.

Think of the industrial athletic trainer as a one-stop shop for all your health and wellness needs while on the job. The service is free (paid for by the employer) and is designed to keep the workforce healthy, happy and safe!

For more information regarding services for the industrial athlete through the Select Medical Outpatient Division’s WorkStrategies Program, please call 866.554.2624 or email [email protected] today.

By: Mike Montez, M.S., ATC, CSCS, WorkStrategies coordinator for Select Physical Therapy’s Southern California community. He serves as the site supervisor with our OnSite Program at Delta LAX and offers more than 15 years of experience. He is a graduate of Cal State University Long Beach.

Posted on 9/13/2017 by Andrew Piraino, P.T., DPT, OCS, CSCS

Low back pain is common. It’s so common that about 80 percent of adults will at one point experience this condition. It ranks among one of the top reasons to see a physician and costs the United States more than $100 billion dollars every year.

When faced with an episode of low back pain, it’s easy to go into crisis mode. You may be routed through various specialists and receive various imaging tests, such as X-rays and MRI. These tests can reveal scary findings, such as “herniated discs,” but don’t panic.

First, many of these findings are normal. Researchers have found that in adults without low back pain, two of out three have an abnormality at one disc or more. This makes imaging of limited use, unless something like a fracture is present that needs surgical management. Physicians agree; the American Academy of Family Physicians recommends against any imaging for low back pain for the first six weeks unless serious signs are present, such as trauma.

Often, you may be referred for physical therapy. You may have some familiarity with various exercises and hands-on treatment provided by therapists. But why is physical therapy unique, and what exactly does it do?

Physical therapists today are doctoral-level trained specialists in human movement, completing four years of undergraduate education, three years of doctoral training and often further residency or fellowship training in addition to board certification. Poor movements and postures can cause low back pain and, therefore, physical therapists are optimally equipped to address the cause of the problem rather than treating the symptoms. Just like the song lyrics to ‘Dem Bones,’ each area of the body affects another, which is what physical therapists are trained to observe and address.

For example, take a truck driver who has worsening low back pain with sitting in his truck and bending (pictured below). While a massage at his back area makes him better temporarily, his pain always returns several days later. A physical therapist may look at this driver and find he has tight hamstrings (the muscles on the back of the thigh). Every time he straightens his right leg to reach his pedal, his tight hamstrings pull his back into a bent position (Figure B). And so, all day long, as he drives, his back is bent over and over while he operates the gas and brake pedals. Try sitting up straight and then straightening your knee. You may find it’s hard to do!

Low Back Pain

A - Driver at rest.
B - Driver's hamstring pulls on his pelvis and bends his back whenever he tries to use the pedal.
C - Driver after physical therapy treatment to improve his hamstring flexibility... no more dysfunction!
While physical therapy may provide hands-on treatment to alleviate pain, it would also include exercise to decrease stiffness of his hamstrings, which would allow him to move without causing his back to compensate every time (Figure C). Therefore, our truck driver is able to sit and drive all day without pain. Rather than seeking symptom relief, he now knows what caused the pain, and the exercises and positioning to prevent it from returning.

This is a simple example, but it appreciates the entire body’s contribution to movement and pain, rather than focusing on the area of pain alone. Hopefully this demystifies what physical therapists do, and how they work to optimize each person’s movement and prevent their painful condition from returning!

If you are experiencing low back pain, please call one of our conveniently located centers in your area to experience the power of physical therapy today! For more information and to watch a brief informational video, please click here. 

Andrew PirainoBy: Andrew Piraino, P.T., DPT, OCS, CSCS, treats at Select Physical Therapy in Pasadena, TX and is involved with our orthopaedic physical therapy residencies at the market and national level. He completed doctorate and residency training at the University of Southern California in 2012 and 2013, respectively, and is board certified in orthopaedics. Andrew specializes in orthopaedic movement dysfunction across the lifespan, from young, recreational athletes to adults with complex multi-system involvement.

Posted on 3/5/20 Haley Taffera

Whether it’s on the athletic field, a job-site or in one of our outpatient centers, our athletic trainers are counted on to be the frontline support for injury prevention, treatment and ongoing management of care for athletes, workers and patients and customers. In honor of National Athletic Training Month, we asked our National Director of Sports Medicine John Gilmour, M.A., ATC, to share how our incredible team of athletic trainers makes an impact in the lives of thousands of people across the country on a daily basis. View the video here...

Be sure to visit our Facebook, Twitter and Instagram pages throughout the month of March as we recognize and celebrate our colleagues.

Posted on 5/10/2017 by Jamie McGaha, OTD, OTR, COMT, CEASI

Join NovaCare Rehabilitation and Select Physical Therapy as we celebrate National Arthritis Awareness Month! Recognized each May by the Arthritis Foundation, arthritis impacts more than 50 million people in the United States and is the number one cause of disability in the country. Did you know there are more than 100 types of arthritis? Currently, one in five adults is affected by at least one type of arthritis1. By 2030 an estimated 67 million adults will have doctor-diagnosed arthritis, with two-thirds being women2.

The hands are one of the most common sites for arthritis. The most functionally limiting type of hand arthritis affects the base of the thumb, also known as basal thumb arthritis or first carpometacarpal osteoarthritis (OA).

In the past, we thought the only way to alleviate pain from thumb OA was to rest the joint in a splint and not exercise. Now we see too much time in an orthosis can make the thumb weaker and it may even be harder for you to do things when you take the brace off.

New evidence in the field of hand therapy has taught us that there is so much more we can do other than rest and that it is important for the joints’ health to move! We have found that by understanding our own thumb anatomy and learning how to find the correct muscles in the thumb, we can strengthen weakened or disused muscle, helping to stabilize the arthritic joint. We can also decrease overuse and tightness in muscles that are working too hard because others are not helping. Better muscle function and greater stability can contribute to less pain and decrease time you need to rest or use an orthosis.

Not all thumb OA is alike. A visit to your hand therapist would allow you to find out which muscles are tight and which are weak. Together, you and your hand therapist would then design an individualized plan of care for your symptoms related to the activities you desire to do.

The right exercises can be so effective that the joint can become better aligned; this has been shown with healthy thumbs on X-ray3. Your hand therapist can also help you to determine when to wear your orthosis and when not to, so your thumb has the appropriate support at the correct time.

There are many new techniques being used in therapy. It’s even hard for the physicians to keep up to date on all the new techniques! Checking in regularly with a hand therapist may provide solutions to many of your aches, pains and limitations from hand and thumb arthritis.

Barbour KE, et al. Vital Signs: Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitations- United States 2013-2015. MMWR 2017; 66(9); 246-253.
Hootman JM, Helmick CG. Projections of U.S. prevalence of arthritis and associated activity limitations. Arthritis Rheum 2006;58(1):26–35.
McGee C, Adams J, Van Nortwick SS, O’Brien VH, Van Heest AE. Activation of the first dorsal ineterossesous muscle results in radiographic reduction of the thumb CMC joint: Implications for arthritis prevent [abstract] Paper presented at The British Society for Surgery of the Hand; January 2015.
Jamie McGahaBy: Jamie McGaha, OTD, OTR, COMT, CEASI. Jamie is a licensed occupational therapist focusing on hand therapy and upper extremity rehabilitation with Select Physical Therapy in Austin, TX. She completes ergonomic assessments and has experience with ergonomic interventions. Jamie is also an assistant faculty member for anatomy at the University of St. Augustine’s occupational therapy program. She is a certified orthopaedic manual therapist for the upper extremity, has current and ongoing research on the subject of thumb arthritis and is a member of the American Society for Hand Therapists and the Central Texas Hand Society.

Posted on 3/1/2019 by NovaCare Rehabilitation and Select Physical Therapy

National Athletic Training Month is held every March in order to spread awareness and celebrate all that athletic trainers do: provide vital health care services for life and sport. The National Athletic Trainers’ Association’s theme for 2019 is “ATs Are Health Care.”  

This year’s theme is a great way to educate folks that athletic trainers spend their days helping people in diverse settings with injury prevention, treatment and ongoing care management. They play a vital role in enhancing an athlete's performance and work closely with team physicians, athletic directors, coaches and employers to ensure that athletes are healthy and performing at their peak potential.

Take a moment to think about the term/word “athlete.” You may think of the traditional athlete, from high school to professional – on the playing field, ice, court, you name it. But, there’s also dancers, gymnasts, first responders and military personnel, all of which require specific training and care due to their dynamic and unique movements.

And, let’s not forget athletes working in an industrial setting, such as airline personnel, warehouse and retail workers, hotel/resort and theme park staff. We are proud to treat such individuals as part of our WorkStrategies® Program.

“Within Select Medical’s Outpatient Division, we employ more than 900 athletic trainers who work in diverse settings across the country. We are proud to employ hardworking, dedicated and talented athletic trainers who spend their days treating and helping to assess and provide care to athletes. Truly, athletic trainers are a vital part of the health care process.” - Michael E. Collins, P.T., ATC, MBA, vice president of sports medicine

In celebration of National Athletic Training Month, NovaCare Rehabilitation and Select Physical Therapy are spotlighting our all-star team of athletic trainers throughout the month on our Facebook, Twitter and Instagram pages. Don’t forget to “Like” us and “Follow” us, too! And, check out this great video on our YouTube page.

Visit the National Athletic Trainers’ Association website at www.nata.org or contact a NovaCare Rehabilitation or Select Physical Therapy center near you today to learn more!

Posted on 3/13/2017 by Select Medical Outpatient Division WorkStrategies Program

National Athletic Training Month is held every March in order to celebrate and spread awareness about all that athletic trainers do: provide vital health care services for life and sport. Athletic trainers play an integral role in the physical rehabilitative process on the playing field and keeping industrial athletes healthy and safe within the workforce. We count on our athletic trainers to be on the frontlines in prevention, treatment and ongoing management of care for our customers.

Our athletic trainers partner with high schools, colleges/universities and professional sports teams and work closely with team physicians and coaches to ensure athletes compete at their highest potential and avoid injury. Through our WorkStrategies® Program, athletic trainers partner with employers to help keep workers on the job. They provide preventative programs and services to ensure that a company’s workforce remains healthy and productive.

The National Athletic Trainers’ Association’s theme for 2017 is “Your protection is our priority.” Protecting our customers out in the workforce is most certainly a priority for us, and we’d like to shine a spotlight on some of our trusted WorkStrategies athletic trainers!

Heather Procopio, ATC, M.S., CEAS, WorkStrategies Coordinator

While working as an athletic trainer at various highs schools and universities, Heather Procopio scheduled her life around the practices and games of her athletes. While there were many memorable moments as she cheered, cried and helped athletes return to their passion, the common thread among all of her athletes was they eventually would hang up their cleats. That realization led Heather to transition from the athletic field to an industrial setting where she could help keep employees healthy by using some of the same skills she used with her athletes.

While pre-season conditioning is integral to athletes having a successful season on the athletic field, post-offer employment tests are key in determining whether an employee can meet the requirements needed for a job. Instead of offering advice on areas that her student-athletes needed to improve on, Heather provides vital information to an employer about perspective job candidates. These tests consist of a series of physical exercises that best represent whether an employee can complete required tasks, such as lifting, pushing and pulling substantial weight amounts, crawl under equipment and work at a certain pace without the risk for musculoskeletal injuries or cardiovascular accidents.

Victoria Vintevoghel, MHSA, A.T., WorkStrategies Site Supervisor

Victoria Vintevoghel’s dream job was to work with a Division 1 soccer program, but her goals started to change after completing her graduate assistant program. Her focus shifted to individuals who didn’t always have an athletic trainer readily accessible to them. Victoria realized the focus in the industrial setting was on injury prevention and encouraging early reporting of aches and pains. Much of her time is spent creating injury prevention programs, including mobility screens, improving strength deficits and analyzing proper biomechanics.

Working onsite in the airline industry allows Victoria the privilege of assisting baggage handlers who undoubtedly have one of the most physically demanding jobs. These men and women lift, carry and stack luggage that could weigh anywhere between 20 to 70 pounds. During some flights, these employees could be loading thousands of pounds of freight and mail in a span of 30 to 60 minutes. Since these individuals haven’t always had an athletic trainer as their advocate, Victoria has not only been able to educate them about the benefits of an industrial athletic trainer, but also make a significant change in how employees and employers view injuries that may occur on the job site.

Caroline Crowley, M.S., ATC, WorkStrategies Coordinator

Caroline Crowley’s career began on the sidelines, but she traded in her fanny pack for a pair of steel-toed boots and safety glasses. Working in a number of factories in Louisville, KY, Caroline’s day is never the same and each day brings new challenges. Louisville offers its residents a number of career options, from online distribution centers to companies that manufacture automobile parts. And as home of the bourbon industry, distilling and botting some of America’s favorite beverages generate many opportunities for injuries.

No matter what the job is, it’s Caroline’s responsibility to quantify their job demands, such as how much an employee can lift, push or pull and then develop injury-prevention strategies, like post-offer employment testing, stretch programs or educational seminars.

While they may not receive as much notoriety as traditional athletic trainers, our industrial athletes still improve the lives of their athletes on a daily basis. They help to keep employees safe at work so at the end of the day those employees can go home and do the things they enjoy with the people they love. That’s a reward that beats any trophy won on the athletic field!

Heather Procopio, ATC, M.S., CEAS, is a WorkStrategies Coordinator with Select Physical Therapy in Connecticut. Heather provides a variety of injury prevention services to numerous companies, including a medical parts manufacturer, an electric company and an airplane parts manufacturer.

Victoria Vintevoghel, MHSA, A.T., is a WorkStrategies Site Supervisor with Physio in Michigan. She is responsible for developing injury prevention and health and wellness programs onsite for a major airline.

Caroline Crowley, M.S., ATC, is a WorkStrategies Specialist and athletic trainer with KORT Physical Therapy in Louisville, KY. She provides a variety of injury prevention services to numerous.

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

Heather ProcopioVictoria VintevoghelCaroline Crowley

Posted on 4/23/2019 by NovaCare Rehabilitation and Select Physical Therapy

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. And, unused or expired prescription medications are a public safety issue that can lead to accidental poisoning, overdose and abuse. If thrown in the trash, unused prescriptions can be retrieved and abused or illegally sold. The misuse and abuse of over-the-counter medications, illicit drugs, alcohol and tobacco affect the health and well-being of millions of Americans.

With that in mind, mark your calendar for Saturday, April 27, 2019, from 10 a.m. to 2 p.m. Eastern Time, as the Drug Enforcement Administration (DEA), in partnership with federal, state, local and tribal law enforcement, businesses, medical offices, agencies and first responders, hosts events to collect and safely dispose of unwanted medications.

Removing unwanted or expired medications from the medicine cabinet is an easy way to make a difference in the opioid crisis. Make plans to dispose of unused and unwanted medications during DEA National Rx Take Back Day at a location near you. 

And, remember: To achieve pain-free movement for enhanced quality of life and independence, rely on NovaCare Rehabilitation and Select Physical Therapy’s team of extensively trained and licensed therapists. Our clinicians are movement experts who can identify, diagnose and treat your pain or injury and get you back to work, athletics and daily life.

Working with a physical, occupational and/or certified hand therapist through a plan of care that is designed specifically for your needs is a safer and more effective long-term option than opioid use. Let us help you to experience the power of physical therapy today!

Side effects include:

Reduced pain
Restored function
Increased strength and flexibility
Prevention of future injury
Improved quality of life
…And much more!
Medicine dispensed includes:

Manual therapy
Aquatic therapy
Hand/Occupational therapy
Sports performance
Work health
…And much more!
For more information or to request a complimentary consultation, please contact a center near you today.

Posted on 5/16/2018 by Erin Longhurst, P.T., DPT

National Women’s Health Week is hosted each year by the U.S. Department of Health and Human Services’ Office on Women’s Health. The week serves a reminder for all women to be vigilant of their health and wellness and to make healthy habits a priority for life.

During National Women’s Health Week, we are proud to recognize some of the more under-served issues that women deal with regarding their health. At NovaCare Rehabilitation and Select Physical Therapy, some of our physical therapists who treat women’s health issues have received specialty training specific to the pelvis and pregnancy and provide specialized treatment, education and training to help overcome challenges.

If you or a loved one are experiencing any of the below conditions, physical therapy may be able to help you maximize function, minimize pain and improve overall quality of life. Patients are evaluated by a licensed physical therapist and a personalized plan of care is designed to meet individual needs. Together, we will establish clear goals and begin treatment to help the healing begin in a positive and encouraging environment.

Incontinence refers to the accidental loss of urine, gas or stool. This most commonly happens during a cough, sneeze, laugh or force from exercise (stress incontinence) or with a strong urge to urinate or defecate (urge incontinence). Incontinence is generally caused by weakness of the pelvic floor muscles, whose primary functions include supporting the pelvic organs. Our conservative physical therapy approach includes bowel or bladder retraining, an exercise plan to strength the muscles that support the pelvic floor and non-invasive biofeedback or electrical stimulation, as needed.

Pelvic organ prolapse occurs when one or more pelvic organs (bladder, uterus or rectum) moves out of its normal position, usually in a downward direction, because of weakness of the pelvic floor muscles or pressure exerted downward on the pelvis, e.g. long pushing phase of labor. Usually, this causes a sensation of heaviness or pressure in the lower abdomen or vagina. Guided strengthening of the pelvic floor muscles by a pelvic-trained physical therapist can help reverse early stage prolapse and prevent worsening of symptoms.

Pelvic pain is experienced by many women, but it is not considered normal if the pain persists longer than three months or occurs during sexual intercourse. Women experiencing pelvic pain may also complain of pain (or referred pain) in their hips, back or abdomen. Treatment of pelvic pain by a specialized physical therapist may include exercise to stretch or strengthen muscles in the hips, core and pelvis; relaxation and breathing techniques; hands-on soft tissue work; and, biofeedback for muscle retraining.

Studies estimate that 40 to 50 percent of expectant mothers will experience some form of aches and pain during pregnancy. These pains are often caused by the dramatic changes in posture and increased demand that weight gain and weight distribution can place on the woman’s body. Following birth of the baby, mothers then spend a lot of time bent over, which can cause pain in the back, neck and arms. Physical therapy treatment during or after pregnancy includes education in proper posture and body mechanics, soft tissue manual therapy and muscle strengthening to help manage and treat pain.

Normal urinary frequency is between two and four hours, but some women experience urinary urgency that leads them to urinate more than every two hours or that wakes them up at night. Women’s health physical therapy can assist with bladder retraining and help you take back control of your bladder.

Diastasis rectus abdominis is separation of the abdominal muscles and happens frequently during the later stages of pregnancy. This often resolves on its own in the 13 weeks following birth; however, sometimes the abdominal muscles stay separated and can contribute to poor core strength and back pain. A women’s health physical therapist can help to create a targeted exercise program that resolves the diastasis recti and allows for a return to full activity.

Contact a center near you today for more information!

By: Erin Longhurst, P.T., DPT. Erin is an orthopaedic physical therapist with NovaCare Rehabilitation in Washington, D.C. She specializes in treating women's health conditions, with primary focus on pregnant and postpartum women and women struggling with pelvic pain or incontinence.