• Woman with white hair lifting lightweight dumbbells in her home with the guidance of a physical therapist.

    Posted 11/18/2022 | 4 min. read

    Why successful medical rehabilitation should have both

    Bad knees, bad hips, bad back.

    These are just a few common complaints that bring people to physical therapy (PT) in search of relief.

    Feeling off balance?

    Sprains and strains?

    Pain in the neck?

    More reasons why more than one million patients sought help through our outpatient physical therapy centers in 2021.

    But the past two years, coming out of the pandemic, have brought a renewed focus to in-home care delivery throughout the industry, like physical therapy treatment.

    While in-home physical therapy isn’t new – our centers have offered it since 2010 – some newer ways to receive it are growing in popularity.

    Take virtual physical therapy, or telerehab, for example.

    Its biggest benefit is convenience. Stay in your home and do sessions on your own from your computer or smartphone. If you’re technology savvy, a virtual care delivery model might be appealing.

    Recovering from an illness or injury at home? Some level of in-home care delivery can be beneficial in getting you back on your feet again.

    But so can in-person rehabilitation at a physical therapy center.

    Physical therapist guiding the arm of a woman with white hair as she lifts a small hand weight in an office therapy setting.

    In-center you’ll have the benefit of one-on-one time with clinical specialists who can assess your movement and progress. If you’re new to physical therapy, this is an important consideration. You’ll need feedback to help you become aware of proper body movement, posture and form in doing exercises.

    With decades in providing outpatient physical therapy, we look at each patient as an individual. Our treatment of them is also as an individual, which means the best treatment isn’t a this-or-that way; in-center or in-home.

    It’s both, one after the other.

    Curious about why?

    Read on to learn more.

    In-home physical therapy: where does it fit in treatment?

    Many of our patients come to us for orthopedic rehabilitation. This is the side of physical therapy that treats musculoskeletal pain – bones, muscles, joints and tendons.

    Injury and degeneration of the musculoskeletal system can lead to tremendous pain. At its worst it can mean lost function in these essential body parts.

    Pain may also result from overuse or overexertion. Ask any of your weekend warrior friends who push the limit of their athletic exercise and end up with injuries.

    Musculoskeletal joint-related pain, in particular, makes up a good portion of what we treat in our centers:

    • Neck
    • Shoulder
    • Wrist
    • Hand
    • Low back
    • Hip
    • Knee

    Aside from injury and overuse, joint pain can also be brought on by repetitive stressors, like typing, lifting, bending and other activities going long periods without interruption.

    In most cases, we treat in-center using hands-on or manual therapy techniques and exercises tailored for your condition or injury.

    But there’s an aspect of joint-related conditions where combining in-center and in-home physical therapy is a win-win: joint replacement surgery.

    Surgery can reduce the severity of joint pain or get rid of it entirely.

    But it’s not a magic bullet, as anyone who’s had a knee or hip replacement can tell you.

    Surgery is disruptive to the body.

    Post-surgery pain is real.

    Also called post-operative pain, it can include inflammation of tissue at the incision site. The surgical site and surrounding ligaments – and the new joint – will need time to adapt to movement. This can be very uncomfortable.

    Physical therapy rehabilitation post-surgery will help with reducing pain and discomfort, and regaining function.

    Recovery in these early stages after surgery is effective at home, when led by a clinical therapist, in-person.

    In the comfort of your home, therapy exercises will help you safely work through muscle and joint stiffness to get back to normal movement. At this point, we like to get patients back for in-person sessions at our centers to continue toward full recovery.

    “We see positive outcomes if patients leave their house and come to an environment that provides social, hands-on interaction,” said Kelly Scott Kover, national director of clinical innovation at Select Medical. “Those are the patients we’ll have the best impact with – in a hybrid care model.”

    About 8 in 10 patients in our physical therapy programs take part in therapy before and after joint replacement.

    Why before?

    Let’s take a look at that.

    As effective as physical therapy is for rehabilitation after surgery, it’s also effective in preparing for surgery.

    Called “prehab,” it’s becoming better known as part of joint replacement therapy.

    Post-operative studies show it leads to better outcomes, including:

    • fewer days in the hospital
    • more stamina for physical exercise after discharge
    • getting familiar with therapy equipment – before surgery – that will be used in your recovery

    Of course, there are many other considerations where in-home physical therapy can be effective in rehabilitation.

    You may be limited by travel, injury or a weakened immune system from cancer treatments. Our clinical experts will bring our services to you to help you heal in place and rebuild strength.

    Both in-home and in-center options have benefits. Both may be considered when we put together your treatment plan in an initial evaluation. Combining the two may work well for you.

    If you’re on the road to surgery, joint replacement or other, or need rehabilitative treatment for other reasons, fill out our online Request an appointment form. A member of our team will connect with you to confirm your visit.


  • Female physical therapist treating a man's ankle.

    Posted 11/3/2022 | 5 min. read
     
    If you google physical therapy definition you’ll find this short explanation. You’ll even be able to hear how to pronounce it.

    phys-i-cal ther-a-py

    /ˈfizikəl ˈTHerəpē/

    noun
    the treatment of disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise rather than by drugs or surgery.

    While that’s pretty straight-forward, unpacking this definition reveals much more about this medical practice than a simple definition.

    It may surprise you to learn that physical therapy isn’t a new thing. In fact, the roots of modern-day physical therapy go back in time…

    Way back.

    Back to ancient Greece and Rome and the early practice of water therapy and massage to help improve movement. Water therapy and massage are still widely used as part of physical therapy treatments.

    As its name suggests, physical therapy (PT) had its beginnings in physical, hands-on treatment.

    Today’s physical therapy, also called physiotherapy, is still a hands-on practice. But it also includes technology in care delivery, like telerehab care. This lets people work with a therapist over the internet for in-home physical therapy.

    Whether hands-on/in-person or web-based, physical therapy is a way to treat movement and mobility issues, without the risk of surgery, and is drug-free.

    Physical therapy’s scope and purpose

    In practice, physical therapy covers a broad scope of treatment for:

    Physical therapy, at its core, treats impairment and functional limitation. Therapists are medical professionals and highly skilled in understanding anatomy and body function. They are also licensed to perform treatment.

    Before delivering any services, a therapist will take a thorough history of your condition to understand its severity. Depending on your symptoms, they may also gauge:

    • Standing and walking ability
    • Skin and muscle tone
    • Breathing
    • Posture
    • Reflexes
    • Comfort and fit of orthotics and prosthetics

    This consultation helps determine the kind of care and treatment techniques that may be of benefit for healing and recovery.

    If physical therapy can help, this is the best time to ask questions and learn more about what your treatment will include.

    What might physical therapy treatment look like for you?

    Everyone’s body structure is different. As we age, our bodies change.

    Pain and discomfort may become less tolerable. Healing may take longer.

    Between any two people, pain, discomfort and healing ability are different too.

    At [Brand Name], we take all of that into consideration. After an initial consult, a treatment plan will be tailored for you. The treatment plan is the guide for what, when and how treatment happens. This is a key factor in the success of your physical therapy experience.

    To begin, there’s a time element for physical therapy and getting the best results.

    Typically, therapy sessions last from 30-90 minutes.

    Sessions are scheduled two to three times per week. Your first session may start right after the initial consult or be scheduled for a different date.

    At each session your therapist will assess your progress based on your treatment plan.

    Sessions involve physical activity, so it’s important to dress comfortably.

    Tip: Wear loose clothing. If you choose to wear exercise gear, be sure that you can roll up your pant legs and sleeves (or wear shorts/t-shirt). This allows your therapist to easily work on your arms and legs.

    Your treatment may include the use of a variety of therapy exercise equipment to get the best experience in your sessions:

    • Treadmills
    • Training stairs
    • Balance stabilizers
    • Recumbent bikes
    • Free weights
    • Therapy bands
    • Parallel bars
    • Posture mirrors

    Some of these may be unfamiliar at first, but therapists are your partners in learning. They will teach you what the equipment is and what it’s for. They will also explain proper use and the results you can expect.

    Some therapy aspects are more familiar like water, ice and heat.

    Others may be specialized therapies delivered by therapists with advanced training. Some of the leading techniques:

    Your physical therapist may recommend doing some exercises at home. These will be prescribed by your therapist so that they are consistent with your treatment plan. The goal is to keep moving and improving in between one-on-one sessions.

    Physical therapy helps millions of people improve mobility and function. Also called PT, physical therapy can help reduce pain and improve healing after injury or illness. PT is an effective way to promote overall wellness, improve endurance, strength and balance to age well.

    A proactive benefit of physical therapy

    Physical therapy is most often done for corrective and rehabilitative reasons.

    But physical therapy is moving beyond being just for recovery. It’s now also a preventive practice to help avoid injury.

    Athletes and individuals who are active in hobby or league sports may benefit from therapy designed for athletic health.

    While a physical therapist may work with athletes, treatment can also be given by certified athletic trainers working with the newest techniques for treating athletes.

    A primary focus of athletic health is education on injury prevention. It’s designed to optimize athletic performance, specifically to avoid injury or re-injury.

    Preventive therapy crosses into other functional areas. This includes working with people who engage in active, physical or repetitive activities.

    Called prehab in some medical circles, here, again, the emphasis is on the proactive side of preventing injury. Prehab uses education and preventive techniques with patients to strengthen muscles and joints used on a regular basis.

    Prehab can be especially effective in on-the-job safety to manage work injury risks and with performing artists to help prevent common injuries in their art form.

    Physical therapy and its specialty areas have the goal of restoring movement and improving impairment for better quality of life.

    This is our goal. If physical therapy sounds right for you, fill out our online Request an appointment form. A member of our team will connect with you to confirm your visit.


  • close-up of a person's hand with bones drawn on it

    Posted 10/6/2022

    Busting the myth that nothing can be done to treat hand and thumb arthritis

    • 58+ million adults are affected by arthritis (1 in 4)
    • 57% of working adults (18-64 years old) are affected by arthritis
    • Arthritis is the leading cause of work disability in the U.S.
    • Osteoarthritis (OA) is the most common type of arthritis

    As someone who provides care for people with osteoarthritis, my heart sinks at those numbers from the CDC. The sheer number of people impacted by arthritis is disheartening.

    And as a hand therapist, I often have people tell me that they are having issues but “know there is nothing that can be done about it.”

    Osteoarthritis of the thumb affects the base of the thumb, where the thumb meets the bones at the wrist. Over time, and as we age, the cartilage in this joint breaks down.

    Sometimes called "wear and tear" arthritis, OA was once thought of as something that we just have to deal with.

    Well, I can say that's no longer the case.

    While we can’t change the wear and tear on our cartilage, we can reduce the resulting symptoms.

    What are the symptoms of hand and thumb osteoarthritis and what can help?

    • Pain
    • Weakness
    • Swelling
    • Stiffness
    • Loss of motion
    • Loss of function

    With a lot of research in recent years, we now understand that OA is more than just cartilage breakdown.

    OA also involves the fluid in the joint, as well as the ligaments and the muscles that support the joint.

    Age, gender and genetics all play a part in the onset of osteoarthritis. And while there's not much we can do about those, the good news is there are things we can do. These include:

    • Reducing extra stress placed on our joints
    • Eating healthier
    • Doing gentle movement
    • Retraining muscles

    An easy way to remember what helps reduce arthritis symptoms is a phrase often used by therapists, “Motion is Lotion."

    How do I know it's time to do something about my thumb OA?

    Because thumb OA usually is a gradual process and the changes are subtle, early symptoms can go unnoticed until you begin having pain or weakness. Increased stress on your joints adds to the factors contributing to what you experience as pain and swelling.

    The base of the thumb is a unique joint. It gives us the ability to twist, pinch and grip. With OA, you may have stiffness that prevents pulling your thumb away from your palm.

    On the other hand (no pun intended!), weakness causes your thumb to collapse. This makes it hard to twist off a lid, turn on a faucet or pinch buds in the garden.

    If you're experiencing limitations in everyday movement, it's probably time to seek expert help.

    A therapy program that treats the full spectrum of your symptoms can move you from saying, “Nothing can be done,” to saying, “How come I never knew therapy could be so helpful?”

    Hand therapists are specially-trained in treating conditions of the upper limb. This includes the hand and thumb.

    This advanced training makes therapists great partners in helping reduce your pain and restore lost function.

    What can I expect in working with a hand therapist?

    Your first therapy appointment will begin with a thorough evaluation of your hand and abilities.

    With that evaluation, you therapist can help you see what's triggering your symptoms and coming up with a treatment plan. The plan will be unique to you and your specific issues.

    Thumb arthritis is different for each person, and your treatment plan will reflect that.

    Treatments and techniques can include:

    • Retraining your muscles to provide stability when you pinch
    • Hands-on techniques to improve motion and reduce pain
    • Changing how you do what you do – modifying behavior

    This last one can be one of the more challenging aspects of managing your OA. But it’s critical in reducing stress on your involved joints.

    Everything you and your therapist do has the goal of getting back as much natural range of motion as possible.

    Therapy for thumb OA is designed to help you “work smarter, not harder.”

    Therapists may introduce adaptive equipment or assistive devices into your care as well.

    While those words may sound a bit "techy," the items themselves are quite simple but can lend a helping hand (again with the puns!) with your day-to-day tasks.

    Some everyday items to make things easier include:

    • Using a wider pen for easier gripping
    • Using a jar opener instead of your hands
    • Using a coffee mug with a wide handle so all four fingers fit under the handle.

    I’ve found that changing the tools used for gardening helps protect my joints but still lets me enjoy digging in the dirt.

    close-up of a person's hand using shears to cut a plant in the garden

    Spring handled shears reduce stress on the hand.

    woman gardening

    Ergonomic gardening tools reduce stress on larger joints.

    You may benefit, too, from the short-term use of orthoses (braces or splints) in treating your thumb arthritis. This will keep the thumb in a neutral position and ease pressure on the joint while doing tasks that may trigger pain or discomfort.

    Structurally, the thumb is designed like a column and under pressure if the muscles are not strong your thumb will “collapse."

    A collapsing thumb reduces the strength to do pinching movements.

    Just as we learn to use our core muscles when lifting, we can re-learn how to use muscles that stabilize the thumb column to perform grip and pinch motions.

    close-up of a person's hand grasping an object

    Thumb collapse during pinch due to weakness and too much joint mobility.

    close-up of a person's hand with their finger being stretched by a therapist

    Motor retraining can help correct the collapse.

    close-up of a person's hand grasping a USB adaptor

    Relearning how to use your muscles results in a stable strong pinch.

    As you progress in therapy you will relearn how to use your muscles in a stable way.

    The more you know, the faster you can dismiss the myth that there's nothing to be done about treating OA.

    Admittedly, I initially thought this 15 years ago when I developed early signs of thumb arthritis.

    Thankfully, we stand on the shoulders of giants who have done research to show the effectiveness of therapy.

    I now use joint protection strategies and adaptive equipment. I use my “feel good” exercises when needed and my brace regularly. It has allowed me to continue the things in life I so love – cooking, gardening, mountain biking and working as a hand therapist.

    Arthritis is a common condition.

    While it's not preventable, you can take steps to help protect your joints to reduce the risk of further injury and discomfort.

    Closing checklist

    Take a quick assessment of the following:

    • Change in the appearance of your thumbs
    • Pain or aching at base of thumb
    • Loss of motion, stiffness or weakness while doing activities, especially when you pinch

    If you notice a change in any of these, know that there is treatment to help you.

    Talk with your doctor or click the blue button above to request a consultation with one of our therapists. Ask about our arthritis program and get started with your personalized treatment plan.

    Article courtesy of Molly Hudson, O.T., CHT, COMT-UE, Hand Therapy Program Coordinator Houston, TX.


  • boy wearing backpack

    Posted on: 9/20/2022

    How to easily fix bad habits and ace backpack injuries prevention

    If you're old enough to remember book bags, you know they've long been replaced by backpacks.

    From the littles to the not-so, each category of kid wears their backpack like another piece of clothing. Color, creativity and the right amount of cool factor all go into making the choice, whether for school, sports or sleepovers.

    But that choice can also create risks to kids' health and safety, if not done with some thought.

    Things to keep in mind:

    • The width of the pack should be about the same as the wearer.
    • Length should be no longer than the torso (central part of the body) and not hang more than four inches below the waist.
    • The weight of what gets loaded into backpacks increases as books, sports equipment and the number and types of electronic devices increase.

    If you've seen your child twist and contort as they hoist or sling a backpack over their shoulder racing out the door, the following shouldn't surprise you.

    Each year, an estimated 14,000 children need treatment for backpack-related injuries... while from 2019-2020 an estimated 1,200 kids ended up in the ER for the same.

    – cpsc.gov

    Here's where that statistic gets interesting and why backpack safety is so important.

    There’s growing awareness on this topic over the last few years that’s making a positive impact. The result is that numbers for backpack ER visits have gone down.

    A lot.

    From the same source noted above, in 2013 the annual average for kids under 19 being seen in the ER was 5,000.

    Going from 5,000 to 1,200 is a big deal (cue happy dance music!).

    So, let’s keep it going.

    Here's a basic three-step guide to follow for any age backpack wearer. Watch our video for a quick summary to see it in action. Then see the steps below for more information.

    This 1-minute video may help keep your backpack-wearing kid from becoming and ER statistic.

    1. LOAD

    Since the objective is to keep the backpack light, choose one that has sturdy compartments but is lightweight.

    As you load, distribute by weight, the right way. Put heavy items on the bottom and in the rear compartment (the side that will be against the back) and lighter items in the front compartment. This helps keep weight off the shoulders.

    2. LIFT

    Like unloading luggage after a road trip, proper lifting is key to backpack safety.

    Bend at the knees before lifting -- both knees. Then grab the pack with both hands before lifting it to the shoulders.

    3. ADJUST

    Once lifted, both straps should be worn. No single-shoulder slinging!

    Using just one strap causes a lean to the side and may cause the spine to curve.

    girl facing backward wearing red backpack

    Check the bag as your child grows, especially for those in growth spurts.

    Whatever your child's age or size, teach them how to wear a backpack correctly and to know their carry limit.

    A loaded backpack should not be more than 10-15% of their body weight. For example, if a child weighs 50 pounds, the backpack should not weigh more than 7.5 pounds.

    These tips can help fix bad habits and prevent backpack injuries. But if your child has shoulder soreness, pain or tingling in arms, hands or fingers, we can help. Physical therapy can help strengthen muscles used for lifting and carrying and relieve symptoms.

    Click the blue "Request an appointment" button. Most states do not require a doctor's prescription for physical therapy.

    For a deeper dive into backpack safety, other considerations when choosing a backpack and creating a "shoulder shadow," check out these safety tips by Anne Marie Muto, OTR/L, CHT.


  • Batter swinging his bat at home plate during a game

    Originally posted on 4/19/2021; updated 9/16/2022

    Why they happen and what to do about it

    Compared to many sports, baseball is known for its slower pace and long duration.

    Despite the less than hard-hitting action of a football game, baseball can place a lot of strain on the body.

    And although typically a low-intensity sport, the repetitive movement in playing baseball can lead to annoying at best and critical at worst overuse injuries.

    These days an MLB pitcher, for example, throws about 95 pitches per game. In comparison, an official Little League pitch count for ages 9-10 is 75 pitches.

    That’s a lot of pitches in a year!

    Position players, too, get their share of high volume throwing, plus hitting and base running. Game after game, this adds up to lots of repetition.

    So, despite its slower pace, baseball takes a toll on the body – upper and lower body.

    Let's take a look at some of the most common baseball injuries due to overuse.

    Rotator cuff tears

    Rotator cuff tears are prevalent in baseball, especially with players who do a lot of high-speed throwing, like pitchers.

    The rotator cuff is made up of four muscles that work together to help rotate your shoulder and arm away from and toward the body. Think of a hinge. The cuff is the part that sits at the top of the shoulder.

    Animated rotator cuff illustration

    The act of pitching over and over, game after game, season after season can wear down the tendons that attach the muscles. This leads to a breakdown in the shoulder's movement, which can lead to muscle tearing.

    If diagnosed before a tear, this injury can be helped with physical therapy. But if the muscle is fully torn, surgery will likely be needed.

    UCL injuries

    There's a ligament on the inside of the elbow called the ulnar collateral ligament, UCL for short. This is a stabilizing ligament and the one most commonly injured of the various elbow ligaments.

    Known in sports circles as the Tommy John ligament, this little ligament can take a beating with the stress that throwing places on it. And there’s an alarming number of young athletes we’re treating for UCL injuries.

    Watch our video: What is Tommy John Surgery and who’s at risk for an elbow injury.

    Inner elbow pain is one of the tell-tale symptoms that something's not right. It may have a "pins and needles" type of feeling in the ring and pinky fingers, which can impact an athlete's grip on the ball.

    Most cases can be fixed with rest and physical therapy.

    However, full and partial tears of the UCL may require reconstructive surgery (Tommy John Surgery), as for pitching namesake Tommy John.

    Labral tears

    This is another injury that impacts the shoulder.

    The labrum is a rubbery, flexible tissue that helps keep the shoulder socket tight. Picture a gasket that seals the space between two adjoining items. But because it is a soft tissue, it can tear.

    Illustration of tear at top portion of shoulder labrum tissue

    In baseball, this type of tear can be caused by the overuse with repeated motion. This injury typically presents with the shoulder joint locking up or weakness of the shoulder.

    A labral tear is typically confirmed by a doctor. Depending on severity, it can be either repaired surgically or helped with professional physical therapy and time off the field to recover.

    Knee injuries

    Although less common than with higher-intensity sports, like basketball and football, knee injuries are part of baseball.

    They happen most with base running. The sudden stopping, sliding and quick pivots in direction can cause a player's knee to give out.

    Sprains and tears of the ligaments supporting the knee are painful.

    One of the most devastating lower body injuries is an ACL tear. Injury to this ligament typically happens with sudden, excruciating pain and the sensation of popping or cracking in the knee.

    Similar to UCL injuries, an ACL injury can sometimes be healed with specialized physical therapy and rest. But in cases of a fully torn ACL, surgery will likely sideline play for a few months.

    Muscle sprains and strains

    Like the other baseball injuries we've covered here, muscle sprains and strains are a biggie.

    These types of injuries are common in the legs, arms and back.

    Symptoms will vary based on the player and the seriousness of the injury, but typical symptoms include:

    • pain
    • weakness
    • muscle spasms

    They may also include bruising and swelling.

    It's rare for these to require surgery. Professional physical therapy and the RICE method (rest, ice, compression, elevation) are effective.

    With sports injuries like we've covered here, a common theme is that working with a physical therapist can help with healing.

    Physical therapy can also help with pre- and post-surgical intervention if necessary.

    If you have an injury, you can get an injury screening at one of our centers. A personalized treatment and exercise plan with a licensed physical therapist will help get you back to your sport. Click the Contact Us button below to find a location and request an appointment.


  • 3D color illustration of human anatomy highlighting the brain and attachment to cervical spine

    Originally posted on 2/9/2017; updated 9/7/2022

    One of the myths about concussion is that it takes a big blow to the head to get one.

    A second is that getting your “bell rung” or “seeing stars” isn’t a big deal.

    They’re just that. Myths.

    The fact is any impact to the head, neck or body has the potential to cause a concussion. In turn that can temporarily shift the neurological function of the brain.

    While a hit to the head during a high-intensity football game or from a car accident can result in concussion, less intense trauma can do the same.

    In my years of practice, I’ve seen people with significant concussion symptoms from a slip and fall on ice. And from accidental encounters with a cabinet door to taking an elbow to the head.

    And from luggage falling out of the overhead bin. There’s a reason for those cautionary announcements when the plane lands.

    I see patients suffering from motor vehicle collisions who never even hit their head, and I see athletes who can’t pinpoint a specific hit. Yet they showed concussion symptoms after the accident or game.

    A third common myth: concussion requires a loss of consciousness.

    Wrong.

    A loss of consciousness is not the norm. Losing consciousness happens in less than 10% of concussion cases.

    Concussion: an invisible condition

    Young female, eyes closed, holding her hands at the temples with imaginary white rings circling her head.What makes concussion more complicated is its invisible nature.

    Unlike a cut or broken bone where you can see physical trauma, concussion can often go unseen.

    So you need to look for common symptoms:

    • Headaches
    • Dizziness
    • Foggy or difficulty thinking
    • Blurred or double vision
    • Sensitivity to light or sound
    • Changes in sleep patterns
    • Increases in anxiety and irritability

    Any of these symptoms can significantly impact your ability to function. They could also indicate a deeper type of trauma.

    It’s critical that if you experience one or more of them, tell someone and get checked out by a medical professional.

    Concussion PT: return to sport and return to life

    As physical therapy specialists, our job is to promote awareness and education across the many types of health conditions our patients come to us for.

    Patients sometimes come to us for physical therapy from a doctor’s recommendation after medical treatment. Or they may come to us of their own accord.

    In either case, we’ve seen that starting physical therapy early can be hugely beneficial in a successful recovery.

    An important first step is recognizing any of the symptoms listed above that could be connected to a physical impact, even if it seemed like “just a bump” on the head.

    Despite how or when someone sustained a concussion, the current recommendation to help is an active treatment and rehabilitation program. Our concussion rehabilitation clinicians will do an assessment to develop a care plan unique to each person and case.

    In the past, the primary treatment for concussion was total rest, sometimes called “cocooning.”

    More recent findings show that after an initial 24-48 hours of rest, a combination of carefully prescribed physical and mental activity is better than total rest. That doesn’t mean, though, that you should go full force into your previous activities.

    Rather, as long as you have lingering symptoms post-concussion, the care plan set for you can help guide your activity until fully healthy, safe and ready to safely return to your sport or normal symptom-free life.

    So, what are some common concussion rehabilitation treatments?

    Visual exercises can help when symptoms are due, in part, to the eyes not communicating well with each other and the brain. These exercises can help increase visual clarity due to the eyes working inefficiently. This may involve doing simple eye movements or complicated tasks of watching a busy scene with many moving items.

    Vestibular rehabilitation is used when the inner ears are involved. The inner ears control balance and keep us oriented to the space around us. Treatment can be varied but typically involves head or body movement activities. You may initially feel dizzier with these exercises, but they are effective in eliminating symptoms in the end.

    Neck treatments can address any neck pain or the many symptoms that can impact the neck after concussion. Sometimes after an injury, the nerves in the neck stop communicating well with the brain. This can lead to a sense of fogginess, dizziness, unbalance or headaches. Specific exercises can retrain these nerves and, in turn, clear up remaining symptoms.

    Sub-symptom exertion training is frequently recommended post-concussion. This training is designed specifically based on a heart rate that would increase your symptoms. In basic terms, it’s a way to set a safe exercise program to help gradually return you to pre-concussion activity levels. For athletes, this can be one of the first steps of a Return to Play protocol.

    Balance and functional training may be part of your full rehabilitation program. This training is used to restore/maintain strength, balance and walking safety.

    Concussion prevention and one last myth

    Unfortunately, there’s not a lot to be done in preventing concussion.

    Protective equipment, such as helmets or mouth guards, may protect against other serious injuries but can’t prevent a concussion.

    They are important in preventing skull or jaw fractures or cerebral bleeding, but their limitation in concussion protection is an all too common misconception.

    In fact, using equipment can lend a false sense in thinking it can prevent concussion.

    The best approach is being vigilant about injuries and any post-injury symptoms.

    Early recognition of concussion can lead to faster recovery. Knowing what to look for and awareness of the myths surrounding concussion can help protect against a delayed recovery. A concussion isn’t less impactful just because it didn’t knock you out or have you seeing stars.

    Lastly, always take the important steps for recovery. Many people will recover on their own. But if you or someone you know have lingering symptoms, we can help.

    You can quickly find a center near you or request an appointment by clicking the buttons below.

    Melissa Bloom, P.T., DPT, NCS, is a board-certified specialist in neurologic physical therapy. She is Select Medical’s Outpatient Division's national coordinator of concussion and vestibular services and treats patients at NovaCare Rehabilitation in Baltimore, MD. Melissa has served as a board member on the American Physical Therapy Association's Vestibular Specialist Interest Group and as the Chair of the Georgia Neurologic Special Interest Group. She specializes in vestibular and concussion rehabilitation and has lectured nationally on both topics.

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


  • Jeena dribbling the ball and defending off a player in the USLW game.

    Posted on 8/15/2021

    How tearing my ACL made me better on and off the field

    As an avid soccer player and athlete, I’m intrigued by sports stats. Like this one:

    Each year in the U.S., between 20,000 to 80,000 female athletes sustain an ACL injury. Most of them in playing soccer and basketball.

    To me, that’s a scary statistic.

    But it was the last thing on my mind as a 15-year-old competitive soccer player in 2017.

    Back then, I only cared about getting to play college soccer at the highest level.

    Jeena wearing her Thomas Jefferson University jersey and holding a soccer ball.

    I had a plan!

    • Get recruited.
    • Play soccer at a high level
    • Figure out everything else later.

    I didn’t care where the school was or what I studied, because I had a plan – my Plan A. My plan told me I didn’t need to worry about anything else. If it was outside of playing soccer, it fell into the category of “figure out everything else later.”

    I felt good about my plan.

    Nothing could get in the way of me and Plan A.

    Right?

    CRACK!

    Jeena being led off the field after injury supported by her coach and an athletic trainer

    That was the sound that came from my knee during a high school game that year.

    I got hit while dribbling down the field.

    All of a sudden I became one of those statistics. And I was in the worst pain I’ve ever been in.
    In an instant, everything changed.

    ACL spells agony… and (eventually) accomplishment

    X-ray showing the location of the pin placed in Jeena’s left knee during surgery.

    I tore my ACL completely.

    I needed surgery, to be followed by physical therapy… for nine months.

    No soccer for nine months? In my mind, my life had just ended.

    I had surgery a few weeks later and wondered if I would be the same player as before my injury.

    There’s a reason they say ‘never Google your injury or illness.’ My brain was filled with more statistics and stories of players who never returned and players who experience an ACL re-tear soon after returning to their sport.

    Jeena’s left leg 4 days post surgery with bandages and surgical marking BIX

    After looking online, I wasn’t hopeful.

    ACL rehab took the place of soccer. I went two and three times a week.

    Without practice, I had extra time on my hands. I filled it with thoughts about how much my life sucked. I was in a dark space mentally and emotionally and didn’t know how to get out of it. A good friend noticed and invited me to go to yearbook club with her. With nothing else to do, I went.

    It opened my eyes to the possibility of enjoying something unrelated to sports.

    I saw fellow students writing stories and designing pages for the yearbook. I heard the buzz of enthusiasm as they worked as a team. Each person doing their part to create a representation of our school.

    Teamwork, huh?

    I realized for the first time since I tore my ACL that I wasn’t thinking about it. I wasn’t thinking about soccer, either. I was happy.

    I went again the next week.

    For months, as I continued to heal from my ACL injury, I was an honorary member of the yearbook team. I was also working hard at physical therapy.

    One of my teachers, and yearbook advisor, saw my work and recommended Communications as a possible college major. I put my focus into that.

    Without realizing it, I’d found my Plan B:

    • Study Communications in college.
    • Find a school I liked (location, size and culture).
    • Figure out everything else later.

    Finally, the nine months were over.

    I was released from physical therapy with no restrictions.

    But I still had a lot of emotions going on. Many less-than-confident thoughts in my head.

    It was time to play soccer again.

    I was terrified to step on the field.

    Coming back was not easy.

    It took me another six months to feel comfortable in the game. I was out of shape, and my knee hurt every day.

    I stuck it through and with hard work – just like I did in PT – (and muscle memory), things did start to come back.

    While my teammates were getting recruited, I was still trying to fall back in love with soccer. Things had changed a bit. I was comfortable with my Plan B.

    I found a school that checked all my Plan B boxes. I set my sights on going there, with or without soccer. Because, in Plan B, soccer now fell into the category of “figure out everything else later.”

    Turns out the school also had a pretty good women’s soccer team, and they were doing an identification camp (an opportunity to get recruited).

    Jeena dribbling the ball and defending off a player in the USLW game.
    Jeena working the ball in the United Soccer League game.

    I went to camp, but with a different mindset than previous camps.

    The old soccer me had gone into camps feeling nauseous and panicked by stress. This time I was pretty chill.

    It was one of my best performances at a camp.

    Fast forward, now five years later, and I am a rising junior, studying Communications at Thomas Jefferson University. I’ve won two conference championships and made a National Collegiate Athletic Association tournament appearance.

    I’m one of three captains, and looking to win my third championship and the team’s fourth consecutive title.

    I also completed my first season in the United Soccer League (USLW), a pre-professional women’s soccer league.

    I’m currently living out what I now call my Plan A/B:

    • Playing soccer at a high level.
    • Studying Communications at a school I love.
    • Figuring out everything else… later.

    Before surgery, I wondered if I’d be the same player after. I don’t have to wonder anymore. I am not the same player I was before I tore my ACL.

    I am a better one.

    Faster, smarter and better on the ball.

    The ACL recovery process is a long and painful one. It can be overwhelming.

    But if injury recovery is ever in your path, you have more control than you might think.

    I learned things about myself I never would have known if I didn’t take time away from soccer.

    My ACL tear gave me more than it took from me because I refused to let that happen.

    Our individual experiences will be different, for sure. What I can tell you from my experience, though, is that no one else can do it for you. Your physical therapy will be a critical part of recovery. You’ll be part of a team – working with professional therapists who will be rooting for you.

    You don’t have to give up on your Plan A… you might just need to adjust it.

    Jeena and her teammates flanking their 2022 CACC Champions banner on the soccer field.
    Jeena Pressley completed her 2022 summer intern program with Select Medical in the Communications and Branding Department. She is a student-athlete at Thomas Jefferson University studying Communications. Her return to campus as a junior captain for her soccer team will see her on the field looking to defend her team’s CACC Champion title.


  • photo of a man laying on his side stretching his torso

    Originally posted on 7/22/2021; updated 8/1/2022

    You've heard the phrase, “You are what you eat.” That to be healthy, you need to feed your body well.

    A similar idea for golfers might be, “You are how you train.”

    In golf, the way you move is important. Not just for being able to hit the ball, but in how your body functions when you do.

    In particular, golfers undergo some of the quickest changes in body movement of any sport.

    Precision is key.

    Golfers are in the category of “rotational athletes” – those who need to twist the torso in playing their sport.

    Rotational athletes move their bodies through high velocity motions. These motions put increased stress on the body’s major joints, in particular the spine, and through the hips.

    This stress puts increased strain on the entire body.

    Being aware in how to rotate correctly can help decrease your chances of injury during play.

    Hooray! More tee times!

    But it can also benefit you off the course so you can move in a pain-free manner in your daily activities.

    Anatomy of golf

    Our bodies are comprised of a system of joints. There are two types – stable and mobile. Each plays a role in body movement; each has levels of stability and mobility. In the golf swing, certain joints should have a core function, either stability or mobility, but not both.

    In a high-velocity movement, like a golf swing, you need both types of joints to be tip-top in performance. If either is subpar, the other must compensate. And that’s when injuries can happen.

    For golfers, lower back injuries are a biggie.

    In this case, the stable joint is the lower back (lumbar spine). Without the right preparation to open the core to support the lumbar spine and increase spine/hip movement before cranking that backswing, you risk playing badly at best and hurting yourself at worst.

    The good news is that you can prevent both by taking the time to stretch.

    Stretching is a key component in any sport, but it is often overlooked or disregarded. Stretching key muscle groups can improve movement and your game.

    We’ve put together a list of stretches that work from the top of your head to the tips of your toes.

    Read on. Then take the time for a good overall stretch before your next round of golf to lessen neck strains, shoulder injuries and back spasms.

    Neck flexes and rotations

    To loosen up, increase range of motion and help keep your eye on the ball during your swing.

    1. Curl your chin to your chest until you feel a slight stretch in the back of your neck.
    2. Slowly rotate your head side-to-side in small motions.

    Shoulder swing

    To loosen up and get more fluid in your backswing and follow through.

    1. Put your club behind your shoulders, resting your hands at both ends.
    2. Crouch in a golf stance.
    3. Slowly turn your shoulders back and forth 8 – 10 times

    Two-part lumbar spine stretch

    To help your body more fully rotate and increase mobility of the upper and middle part of the back to improve your swing and prevent injury.

    This is a super effective stretch! But we get it if you choose to do it at home before loading the clubs in the car.

    1. Start by laying on your side and stack your hips with knees bent.
    2. Extend one hand toward the ceiling. Use your other hand to hold your knees if you feel like they're coming off the ground.

      photo of a man laying on his side stretching his torso
    3. Slowly lower your arm and turn your neck to look toward it.
    4. Try to bring your shoulder to the floor.
    5. Breathe through the stretch – feel it in the middle of your back. Repeat on the opposite side.

      photo of a man laying on his side stretching his torso

    Hip stretch

    To help your hips move freely and efficiently in the backswing and follow-through. To increase hip movement so you don’t put too much weight on the back leg at impact and pull off early, hooking the ball.

    1. Stand and, with a straight leg, make several small circles in a clockwise motion.
    2. Do the same with a counter-clockwise motion.
    3. Repeat with other leg.

    Golf is an amazing sport, but to play or compete pain-free you need to learn (or relearn!) how to move correctly.

    Good movement helps decrease stress on your body, avoid injuries and enjoy the game more.

    Just remember to stretch first, then swing.

    Who knows? Adding regular stretching before you hit the driving range or the greens may even add a few more yards to your drive, and without that wicked slice.

    If you’re having pain when you play or recovering from a golf injury, come talk with one of our physical therapists.

    We offer a complimentary consultation to assess your condition and can do an assessment of your readiness to return to play. Click below to find a nearby location or request an appointment.


  • Select Sports Center of Excellence logo

    Posted 7/19/2022

    Extra! Extra! Exciting news alert!

    We recently rolled out centers that offer dedicated, sports-specific care to athletes – centers of excellence.

    Select Sports, our nationally recognized sports medicine program, is a comprehensive, industry-leading program that was developed to meet the physical demands of competitive and recreational athletes.

    The Select Sports Center of Excellence (COE) designation conveys the highest quality in sports physical therapy.

    These locations are provided with the opportunity to deliver superior sports medicine rehabilitation and performance enhancement to athletes of all ages and abilities.

    As a Select Sports Center of Excellence, our centers went through a comprehensive application process to meet specific criteria and determine this exclusive designation. This includes:

    • Having a sports medicine physical therapist on staff who has more than five years of experience and participates in ongoing monthly training.
    • Offering the latest vetted technology for rehabilitation and athletic performance as well as safe, reliable equipment known to get the best outcomes.
    • Partnering with key local sports medicine physicians.
    • Showcasing a positive and motivated space to help athletes heal with like-minded individuals.

    We understand an athlete’s mindset and physical demands and are committed to helping them heal, return to activity and meet – or exceed – goals.

    If you, a loved one or a friend are competing at an elite level or simply want to retain an active lifestyle, trust our expert Select Sports Center of Excellence clinical team to treat the athlete you are today and help you become the athlete you want to be tomorrow.

    Find a Select Sports COE near you and request an appointment today to begin progressing toward athletic excellence!


  • illustration showing how to do a hamstring stretch

    Posted 7/13/2022

    How to drive away aches and pains on your summer road trip or any long drive

    Ah! Summer vacation.

    Ugh! Summer vacation driving.

    Destination driving vacations are a staple of American culture. But long hours spent crammed into a car can wreak havoc on your body before vacation even begins.

    As the miles go by, an aching back, a crick in your neck or tense shoulders can put the brakes on feeling good by the time you arrive.

    If you're shaking your head in agreement (or dread!), relax.

    We’ve mapped out some quick tips to make your road trip more comfortable.

    Plan stop-and-stretch breaks

    You planned out your vacation, right? So it makes sense to plan breaks from the slog of driving or sitting for hours on end.

    Stop hourly or every hour and a half – even if it’s just for five minutes. Park away from entrances to rest stops and eating places to get in some light walking. Before climbing back into the car, stretch your hamstrings.

    illustration showing how to do a hamstring stretch

    Focus on your posture

    Don't slouch. Use a rolled-up towel or foam roller and place it at your lumbar area (low back) between you and the seat for more comfort.

    If you can spare a pool noodle, get creative and cut it in half. One for you and one for your passenger – two birds, one stone.

    Set your car seat properly

    This might sound trivial, but adjusting your seat reduces excess strain on the shoulders and neck. Here's how:

    • Sit all the way back in your seat.
    • Extend your forearm over the steering wheel.
    • The wheel should be at about your wrist when positioned correctly.

    Pay attention when unloading the car

    When you finally arrive and begin unpacking, practice safe lifting, especially with items that have been unloaded on the ground.

    • Don’t bend forward. Bend your hips and knees, like you’re doing a squat to pick up bulky items.
    • Keep luggage and bulky items close to your body/mid-section, then straighten to lift.
    • Distribute the weight evenly between both hands/arms to decrease stress on your neck, shoulders and back.
    • Don't overdo it! An extra trip back to the car can prevent injury.

    illustration showing how to lift safely

    Bonus safety tips for driving!

    While driving, don’t use mobile devices. The distraction of calls and texts isn't worth an accident.

    If it is music you're craving, let one of your passengers play DJ to keep the tunes rolling while you roll along.

    Stay alert. Roll down the windows now and then, even with the AC on, to get some fresh air and a breeze.

    Safe driving, and enjoy your road trip or well-deserved vacation!

    We’ll leave you with this parting line from Clark Griswold in the American classic National Lampoon’s Vacation. “Why aren't we flying? Because getting there is half the fun. You know that!”

    By: Brett Sanders, M.S., OTR/L, CEAS, regional manager for Select Medical’s WorkStrategies Program. Brett is the ergonomics product manager and account manager for American Airlines. He has been an occupational therapist for more than 25 years specializing in reducing employers’ workers’ compensation injuries. WorkStrategies is a product of Select Medical’s Outpatient Division family of brands.