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.