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 2/7/2019 by Diane Jagelavicius, C.P.
An amputation, whether planned or not, is a physical, mental and emotional loss, one that requires time to adjust. A wide range of emotions occur while undergoing the process of amputation and are completely normal as you begin to process and adjust to this life-changing event. Understanding what you are feeling and why will help you to process the situation and overcome negativity and hurdles.
No matter what circumstances have brought you here, NovaCare Prosthetics & Orthotics can help and is devoted to meeting the special needs of those with all levels of amputation. As you embark on this unique journey, keep these seven tips in mind:
You are not alone.
The Amputee Coalition estimates there are two million amputees in America and 185,000 leg amputations each year. This leads to a challenging period of physical recovery and complex psychological, emotional and social issues. While everyone’s path in life is unique, you should not feel as if you are alone.
Support groups, peer mentors and online forums are all available if you are looking to connect with others in a similar situation as you. In your physical rehabilitation program, you have the potential to form strong bonds with your peers through shared challenges and successes. Your friends, family and caregivers can also provide a tremendous amount of support.
If using a prosthesis will improve your function, then you are considered a candidate for a prosthesis.
At a minimum, you must be able to tolerate standing. It is OK if you need help to stand. A strong desire to walk with a prosthesis will help you overcome any physical challenges along the way. No matter what your physical condition, motivation is the single biggest factor to your prosthetic success.
Your previous lifestyle and abilities are the best indicators of success with a prosthesis.
For below knee amputees, it is expected you will be able to return to all the activities you were participating in prior to the amputation. If you were dealing with sores and infection prior to your amputation, your quality of life will likely improve as an amputee.
Many factors also affect success, like general health and the length of your amputated limb. If you have multiple conditions or injuries, they may limit your potential. Generally, the higher the amputation level, the more energy is required to walk. If your amputated limb is short or above the knee, you can expect to be able to participate in most of the activities you were participating in before your amputation.
Take ownership of your care.
Rehabilitation is a team effort, and your participation is essential to your success. At the core, no one is more invested in the quality of your life than you. Physicians, therapists, prosthetists, patients, family members, friends and caregivers are all part of your team. Spend time picking the right people for your team. It never hurts to do a little research, or seek a second opinion.
Be honest with your team members about your rehabilitation goals. They will work with you to set up small, achievable goals to help you gain momentum, stay motivated and get you back to your best.
Follow instructions and guidelines, and ask plenty of questions. Seek out solutions rather than making excuses. The more informed and proactive you are the better patient you will be, and the better choices you will make about your future care.
It’s OK to smile and have a little fun.
Sometimes life can get too serious, especially when it takes unexpected turns. It’s OK to have fun and let some joy into your life. Laughter is great medicine, too!
Some patients take it a bit further and get creative with the design of their prosthetics. Prints and fun fabrics can be laminated in the socket; patients have chosen designs like butterflies, camouflage, tie-die, lightning and American flag patterns.
Your prosthesis will be custom designed for you. The socket is the most important part.
Each prosthesis is unique and tailored to meet your lifestyle and abilities. Your prosthetist will spend time with you to understand your needs and goals and use that information to design your prosthesis. Many different styles and componentry options are available.
The most important part of your prosthesis is the socket, the portion that interfaces with your body. The socket is the part that translates your body movement to the componentry. To provide the most benefit, the socket must be snug and supportive. Your prosthetist will work with you to come up with the fit for you.
Receiving your prosthesis is a really big milestone, but it is not the end goal.
Learning how to walk or function with your prosthesis, returning to your lifestyle, work, family, home, sports, etc., are all the end goals.
After amputation surgery there is a lot of emphasis placed on receiving the prosthesis. So much so it is easy to mistake the prosthesis itself as the end goal. But really, much of the work begins after you receive the prosthesis.
Participation in a formal gait training program after you receive your prosthesis is an investment in the quality of your life. It takes time and practice to adapt to your new lifestyle and be confident with the prosthesis.
Keep up the hard work and, before you know it, you will reach your goals in no time!
At NovaCare Prosthetics & Orthotics, we consider it part of our job to be your advocate. If you have questions, concerns or would like more information specific to prosthetic devices and/or other organizations and resources that can help you, please contact a NovaCare Prosthetics & Orthotics center near you today. We’re here to be your partner for life.
By: Diane Jagelavicius, C.P., prosthetist for NovaCare Prosthetics & Orthotics. Diane earned a bachelor’s degree in exercise physiology from Rutgers University and post-bachelorette certificate in prosthetics at Northwestern University. She completed residency at POSI prior to becoming an ABC certified prosthetist. Diane is passionate about patient outcomes and specializes in lower limb prosthetics with an emphasis on socket fit. She has extensive experience with microprocessor knees and ankles, suction/ elevated vacuum suspension and various socket designs. NovaCare Prosthetics & Orthotics is part of the Select Medical Outpatient Division family of brands.
Posted on 1/17/2019 by Sarah Donley, MSOT, CHT
Mother Nature has yet to truly make her presence known in 2019, but that all could change this weekend. Many in the Midwest and Northeast will feel the effects of a storm that’s slated to bring dangerous amounts of snow, wind, ice and rain. With that in mind, we've provided a few snow shoveling and snow blowing tips to practice if your area turns into a winter wonderland!
Remember to wear appropriate layers of light, loose and water resistant clothing for warmth and protection when you go outside in these low temperatures. Layering allows you to accommodate your body’s constantly changing temperature. Switch to mittens if your hands are becoming cold quickly. Mittens trap body heat by keeping your fingers together and reducing evaporative heat loss.
Before you begin to clear snow from your driveway or walkway, remember that snow shoveling is a cardiovascular and weight-lifting exercise. It should be treated like a day in the gym – stretch before exercising and take it slow if you’re not in shape.
Move smaller amounts of snow and tackle the job by dividing it into thirds, with one-hour rest breaks.
Keep your back straight and your knees bent to decrease the pressure to your lower back when lifting. When moving the snow, turn your whole body by pivoting your legs, not just your upper body.
Use an ergonomically correct shovel, one where the rod of the shovel bends in an elbow shape, not the straight line shovel. These shovels help you to keep your back straighter reducing spinal stress.
Sometimes, however, there will be a storm when a snow shovel simply isn't enough. And while a snow blower can certainly help, hand injuries such as burns, lacerations, crushed bones, fractures and even amputations can also occur if proper techniques aren't practiced. Here are some tips on how you can keep your hands safe during these snowy months.
While it sounds simple, never put your hands down the chute or around the blades of a snow blower. Use a broom handle, clearing stick or another tool to clear any clogs. Wait 10 seconds after the engine has been turned before you attempt to unclog the chute; blades could still be spinning even though the machine has been turned off. Generally, keep your hands and feet away from all moving parts.
Avoid wearing scarves and loose fitting clothing which could become tangled in the moving parts and pull you into the machine.
Never direct the discharge chute toward you, other people or areas where any damage can occur. The blower can also discharge hard objects, such as salt, sticks and ice further and faster than snow.
Use proper hearing protection for your ears, and wear glasses or snow goggles for your eyes.
If the ground is icy or slick after you’ve finished shoveling or snow blowing, spread sand or salt over the area to help create foot traction. Be aware of areas that may be uneven which could cause you to slip, trip or fall.
Finally, think spring! Punxsutawney Phil saw his shadow and predicted six more weeks of winter ahead, but here’s to hoping the furry seasonal prognosticator is wrong this year.
By: Sarah Donley, MSOT, CHT. Sarah is an occupational therapist at NovaCare Rehabilitation in Swedesboro, NJ. She focuses on fractures, tendonitis and compression injuries. She is Graston- certified, providing her with an advanced method of soft tissue mobilization.
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
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.