August 2021 COVID Update – COR continues to follow COVID safety protocols

Category: Health Basics

What are the Most Prevalent Running-Related Musculoskeletal Injuries?

Running is a form of exercise that carries many benefits. Unfortunately, many athletes experience running-related musculoskeletal injuries. The vast majority of such injuries are caused by overuse and have a high recurrence rate. A recent systematic review determined that the knee and ankle are the most commonly injured sites. The running-related injuries that occur most frequently include Achilles tendinopathy, medial tibial stress syndrome (shin splints), patellofemoral pain syndrome, plantar fasciitis, and ankle sprains.

Achilles Tendinopathy

Managing Achilles tendinopathy can be challenging. Most patients see improvements after 3 to 12 months. In some cases, however, long-term symptoms can persist for years. Physical therapy can be effective for Achilles tendinopathy, especially if it includes a program with a heavy emphasis on exercise. The authors of a recent meta-analysis study recommend starting with an exercise program, such as physical therapy, since it is low-cost, accessible, and non-invasive.

Medial Tibial Stress Syndrome

Medial tibial stress syndrome, or shin splints, comes from inflammation of the tissue surrounding the tibia. This overuse injury often occurs from downhill running, running on hard surfaces, or including frequent starts and stops. Other factors include flat feet and obesity. In addition, female runners are more likely to develop shin splints than males. Treatment includes rest, ice, stretching, and orthotics. 

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome, or runner’s knee, causes stiffness and pain around the kneecap. It can cause difficulty with daily activities such as kneeling, squatting, and climbing stairs. Runner’s knee is often associated with repetitive stress on the patellofemoral joint (in the front of your knee). Likewise, misalignment of the femur and patella can aggravate the joint. PTs can instruct patients on specific exercises to improve range of motion and strength and help reduce pain.

Plantar fasciitis 

The plantar fascia is a tissue in the bottom of your foot. Collagen breakdown and micro tears of the plantar fascia can cause pain in the heel and bottom of the foot. Typically, cases resolve with physical therapy including manual therapy, stretching, taping, and orthotics.

FAQ: How can physical therapy treat running-related musculoskeletal injuries?

Physical therapists start with an injury assessment and create an individualized treatment plan. Physical therapy usually includes stretches, exercises, and manual therapy. PTs can also apply ice, heat, and other modalities as needed. Of course, prevention is the best medicine. PTs can help runners build strength and improve running form to avoid re-injury.

COR Running Program

Many running-related musculoskeletal injuries come from small loads over repetitive cycles. A personalized running analysis can guide runners on proper form to recover and avoid injuries in the future. The COR Running Program provides one-on-one assessment and support for runners. Call our office to make an appointment at 201-833-1333.

The Four S’s of Sports Performance: Strength, Stability, Speed, and Skill

A complete training program includes the following elements of sports performance: strength stability speed and skill. Sports performance is based on an athlete’s technical skills and physical capabilities. Elite athletes want to push their bodies to become faster and stronger. You can hone technical abilities and optimize fitness with targeted conditioning and training.

Strength 

The adage “use it or lose it” applies to muscular strength. Muscle mass naturally decreases over time, so athletes must consistently work on all major muscle groups throughout the week. Plus, strength training does more than bulk you up. It is also important for building stronger bones, managing weight, and decreasing the risk of injury.

Stability 

Stability refers to the body’s ability to rebound from a disturbance in equilibrium. In the most basic sense, it’s about shifting your center of gravity. For example, you can reposition your center of gravity when knocked off balance. In sports training, a lot of emphasis is put on core stability. While core stability is crucial, athletes also need joint stability, balance, and posture. 

Speed 

Going fast requires many body systems working together. First, your sensory system perceives and processes the environment. Then, fast twitch muscles give a sudden burst of energy to accelerate. However, maintaining maximum speed results in the build-up of lactic acid. So, speed endurance training is important in order for an athlete to be able to maintain max speed for as long as possible while increasing their lactate threshold.

Skill 

Each sport has specific skill sets, such as breath control, flip turns in swimming, or passing and shooting in basketball. Better technique means increased physical efficiency. You can do more with less energy over extended periods as your skills improve. Significantly, proper skill technique also reduces the risk of injury.

FAQ: Which sports need strength, stability, speed, and skill?

Fast-paced athletics need a combination of technical ability and physical fitness. So, improving strength, speed, and skills helps in any sport. Activities that need optimal physical performance include: 

  • Basketball
  • Football
  • Soccer
  • Track and field 
  • Swimming
  • Skating and hockey
  • Martial arts
  • Cycling

Sports Performance: Strength, Stability, Speed, and Skill

Successful elite athletes train these components of sports performance: strength, stability, speed, and skill. The first step is identifying your current level in each area and developing a growth plan. Next, we’ll work with you through our Elite Athlete Performance Plan to identify specific goals and design an individual training program. Schedule a consultation online today.

Six Situations Treated with Women’s Health Physical Therapy

It goes without saying that female bodies are different from males. Women have unique bone structures, hormones, and bodily stressors. So, it takes a specifically trained professional in women’s health physical therapy to evaluate and understand how female physiology impacts overall wellness. For example, a physical therapist (PT) can teach you how to strengthen pelvic floor muscles and eliminate vaginal pain. Likewise, physical therapy can treat incontinence, prolapse, pelvic pain, diastasis recti, and more.

1. Urinary Incontinence 

Urinary incontinence (UI) can impact women of all ages, from teens to post-menopausal women. For example, high-impact sports, such as gymnastics and track, often lead to urinary incontinence in adolescent female athletes. UI also occurs later in life. For example, many women experience urinary leakage following childbirth and after menopause. Fortunately, you can counteract UI with pelvic floor physical therapy.

2. Organ Prolapse 

The pelvic floor muscles support pelvic organs such as the bladder and uterus. If these muscles become weak, or there is laxity in the supporting structures, the organs can drop down, bulge, or prolapse into the vagina. Fortunately, prolapse is very treatable. A PT can teach you exercises to strengthen the pelvic floor. Early treatment can prevent invasive surgery down the road. 

3. Pelvic and Vaginal Pain 

Women can have many different types of pelvic pain. Some discomfort is associated with menstruation, infections, or pregnancy. However, other causes are musculoskeletal. For example, vaginal muscle spasms can lead to painful penetration. Pelvic floor physical therapy offers individualized treatment plans designed to eliminate pelvic pain. 

4. Diastasis Recti Abdominis

Many women experience stretching of the abdominal muscles during pregnancy. This stretching may lead to what is called diastasis recti abdominis: the separation of the external abdominal (stomach) muscles. This is because the connective tissue between them stretches as the left and right sides separate. Fortunately, strengthening and stabilizing your core muscles before, during, and after pregnancy can help! 

5. Lower Back Pain

Pregnancy puts a lot of strain on the lower back. Before childbirth, the hormone relaxin softens the joints and ligaments. However, additional weight can aggravate the joints. For example, sacroiliac (SI) joint dysfunction causes pain in the lower back and buttocks. Physical therapy treatment can help strengthen the surrounding muscles and support the SI joint.

6. Postpartum Scar Restrictions  

Cesarean and vaginal deliveries can leave behind scars. Following a c-section, some people experience discomfort along the scar tissue. Likewise, many women have tenderness from scar tissue left by episiotomies or natural tears. Therapy for postpartum scars involves soft tissue massage, scar mobilization, stretching, and strengthening of the surrounding muscles. 

FAQ: What does a women’s health physical therapist do?

Women’s health PTs use evidence-based treatment for musculoskeletal disorders affecting women. They can help you eliminate pain and return to your everyday quality of life. For example, pelvic floor physical therapy improves the stability of the pelvis. Treatment usually involves muscle exercises, massage, and patient education.

Getting Treatment

Women’s health physical therapy is a first-line treatment for these conditions and is far less invasive than surgery. Our women’s health expert, Dr. Rachel Feldman, has extensive experience treating female-specific dysfunctions. Don’t live with pain and discomfort. Schedule an appointment online today.

How to Start Running: A PT’s Guide for Beginners

Running is an excellent exercise for maintaining health and wellbeing. Whether you have marathon ambitions or want to improve your health, knowing how to start running gets you on the right foot. Keep in mind that every runner is unique. We all have our own goals, skills, and fitness levels. So, be kind to yourself when just starting — don’t hold yourself to someone else’s standards. 

FAQ: How do I start running if I’m a new runner?

Consistency and planning are critical for new runners. When you decide to start, create a training plan you can stick with. Bear in mind that your body needs time to adjust to any new activity. So, build planned rest days into your schedule. Many people benefit from using a walk/run program that eases them into running. There are many pre-designed programs and apps that can help you start running. If you have any cardiac history, check with your primary care doctor and/or cardiologist to make sure that running is a safe exercise for you.

Training Frequency and Intensity 

When creating a personalized running regimen, consider the frequency and intensity that feels right for your fitness level. Frequency is how often you exercise, and intensity is how hard you run. For example, beginners may benefit from a walk/run program that can also incorporate jogging into their training program. In addition, it’s vital to build cross-training into your schedule. For example, you can always work on strength training and conditioning on days you’re not running. 

Injury Prevention

New runners unfortunately tend to get injured more easily, and we see a lot of preventable running injuries in the clinic. So, injury prevention is crucial to a successful running career. One straightforward injury prevention technique is to start slow. Increase your weekly distance slowly because pushing yourself too hard could quickly end your running journey. Likewise, listen to your body. If aches and pains hinder progress, it’s okay to return to your previous mileage. In addition, repetition can lead to injury, so strive for variety in your training. For example, change up your daily distance or run on various surfaces. Make sure that you include another form of exercise in your weekly exercise regimens, such as yoga, biking, swimming, or strength training. Running is a great exercise, but only using running as exercise can increase your risk of injury.

Importance of Individualization 

No two runners are the same. What works for one person may not work for you. If you decide to use a pre-designed running program, you can modify the plan to fit your needs. If you’re wondering how to start running, we suggest creating an individualized program tailored to your specific goals and needs. 

The COR Running Program offers a personalized consultation with a physical therapist to put you on the path to success. Our unique biomechanical analysis process gives invaluable insight into your gait and cadence. Running is a fun way to exercise and stay healthy. So, we’d love to help you get started on your running journey. Schedule a consultation online today

Physical Therapy Treatments for Pelvic Floor Dysfunction Following Childbirth

Women have a high risk of developing pelvic floor dysfunction following childbirth. These are complex disorders of the ligaments and muscles that support the pelvic organs. Often, postpartum patients experience weak pelvic muscle tone, leading to further complications. Fortunately, physical therapy can help patients recover faster and improve health outcomes. 

Pelvic Floor Dysfunction Following Childbirth 

Disabling pelvic floor dysfunction negatively impacts the social, emotional, and physical aspects of patients’ lives. Family duties associated with raising a newborn compound these adverse effects, causing extra stress and ailments for many new mothers. Often, these patients experience pain, numbness, or pressure in the pelvis. For some, the pain causes difficulty in walking and performing activities of daily living. In addition, if left untreated, pelvic floor dysfunction can progress to organ prolapse, unitary incontinence, and sexual dysfunction. So, patients need pelvic floor physical therapy which supports recovery through manual manipulation and exercises for stretching, conditioning, and relaxing pelvic floor muscles. 

Physical Therapy Following Caesarean Sections

Many women in the US give birth via C-section. According to the CDC, over 31% of deliveries in 2020 were Cesarean. Despite their common use, these are complex surgeries with complications such as diastasis recti, postoperative pain, and pelvic floor dysfunction. In addition, Cesarean deliveries cause prolonged pressure in the abdomen and excessive stretching of the pelvic organs, ligaments, and muscles. Fortunately, physical therapy treatment can help the pelvic floor recover after abdominal delivery. According to a report published in the Journal of Physical Education and Sport, c-section patients who received physical therapy showed statistically significant improvements compared to those who recovered independently. 

Physical Therapy Following Vaginal Birth

During vaginal delivery, the pelvic floor lowers and expands. Stretching of the perineum can lead to tears, a substantial risk factor for pelvic floor dysfunction. A recent systematic review suggests that pre- and postpartum pelvic floor muscle training improves patients’ quality of life. In addition, it helps reduce the risk of more severe complications. For example, Kegel training strengthens muscle tone and reduces pelvic floor disorder symptoms.

FAQ: How long is pelvic floor recovery after childbirth? 

With proper treatment, most women recover within six months. However, actual rehabilitation times depend on several factors, such as severity and treatment. Early intervention leads to faster recovery and a rapid return to a full and healthy life. 

Postpartum Pelvic Floor Care

Postpartum care is about ensuring the well-being of the mother and newborn. And the pelvic floor needs special care because it changes significantly during pregnancy, labor, and delivery. Likewise, a patient’s musculoskeletal system is vulnerable after giving birth. Regardless of the delivery method, physical therapy is essential to a postpartum treatment plan. Therefore, OBGYNs are wise to prescribe pelvic floor physical therapy starting on the first day of recovery. 

Churchill Orthopedic Rehabilitation offers a robust women’s health program for treating pelvic floor dysfunction following childbirth. To refer a patient, call our office at 201-833-1333.

Enjoy the Run, Stop the Leakage: Physical Therapy for Runners’ Incontinence

Physical Therapy for Runners' Incontinence

Does going for a jog always make you need to pee? You’re not alone—over 40 percent of female athletes experience urinary incontinence. Fear not! The problem is usually treatable with specifically designed physical therapy for runners’ incontinence. 

Why do I need to pee every time I run?

Physical activity, such as running, puts pressure on the bladder, which may lead to leakage. This can occur when muscles of the pelvic floor, which work to support the bladder and reduce leakage, are weak or inefficient. Runners’ incontinence can happen to anyone at any age. However, it is most common in women, especially after vaginal delivery.

Let’s Talk about Urinary Incontinence

Most women don’t want to talk about leakage. Even though runners’ incontinence is uncomfortable and frustrating, 95% of athletes don’t speak to their doctor. Instead, they use the restroom before running to avoid leakage. Even with preventative urination, the problem can affect overall athletic performance. The good news is: you don’t have to live with leakage—effective treatments are available. 

Physical Therapy for Runners’ Incontinence 

With the help of physical therapy, you can learn to gain control over your symptoms and reduce the need for pads and medical interventions. A physical therapist can create an individualized treatment program based on your needs. The PT may help with pelvic floor muscle coordination and bladder habits. The PT may also work to strengthen the pelvic floor muscles through specifically designed exercises. In addition, your PT will talk you through how to sense the movement of your pelvic floor and improve bladder control. Some methods include:

  • Bladder training/ behavioral modification – The therapist may use a “bladder diary” to learn about bladder habits. You may then learn various methods to improve bladder retention and urine emptying to improve function.
  • Kegels — These exercises involve tightening and releasing your pelvic muscles as if you are trying to stop urine flow. 
  • Strengthening Exercises — Specific exercises build muscle strength for surrounding muscles that support bladder function. It is difficult for many people to perform kegels correctly; a pelvic floor physical therapist can help. 
  • Biofeedback — Depending on your level of comfort, your PT may gently employ electrodes to measure muscle activity and give insight into how to best use your pelvic floor muscles. 

At Churchill Orthopedic Rehabilitation, we have expert PTs who know best practices when it comes to physical therapy for runners’ incontinence. Let’s talk about peeing. Schedule an appointment today.

Bladder After Baby: Physical Therapy for Postpartum Urinary Incontinence

Physical Therapy for Postpartum Urinary Incontinence

Millions of women struggle with incontinence following childbirth. Physical therapy for postpartum urinary incontinence can improve the quality of life for these mothers. For some, pelvic floor dysfunction limits their daily activities, including caring for baby. Many women don’t feel comfortable talking about bladder problems. They try to juggle taking care of a newborn while wearing heavy pads, rushing to the bathroom, and bracing for coughs.

Will my bladder go back to normal after pregnancy?

Postpartum incontinence does not always clear up on its own. If left untreated, it can get worse over time. If symptoms persist following delivery, mothers should seek further treatment in order to regain bladder control.

Types of Incontinence after Childbirth

Not all cases of postpartum incontinence are the same. For example, women who delivered vaginally have different needs than those who had a c-section. The two most common types of bladder issues are stress incontinence and urge incontinence. 

  • Stress Incontinence —Bladder leaks caused by pressure on the abdomen from sneezing, laughing, exercising, etc. This is common following vaginal childbirth. 
  • Urge Incontinence — The sudden, strong desire to urinate associated with leakage. Scar tissue from c-sections can pull on the bladder and make women need to go more frequently.

Physical Therapy for Postpartum Urinary Incontinence 

A physical therapist can help you control your symptoms and reduce the need for pads, medication, or surgery. Kegel exercises are often prescribed for postpartum incontinence, however, this is just one piece of the puzzle. Because conditions vary from person to person, the PT will create an individualized treatment plan. Interventions include:

  • Education — learning to sense the pelvic floor muscles and how to do home exercises.
  • Kegel exercises — strengthening pelvic muscles by squeezing then releasing.
  • Biofeedback — gentle electrodes that monitor muscle activity check if exercises are correct.
  • Core exercises — strengthening your abdomen is vital to supporting the pelvic area. 
  • Lifestyle changes — Maintaining a healthy bathroom schedule and avoiding food, drinks, and activities that may exacerbate symptoms.

At Churchill Orthopedic Rehabilitation, we have experts on staff who specialize in pelvic floor and women’s health issues. If you need physical therapy for postpartum urinary incontinence, give us a call at 201-833-1333.

Top 4 Benefits of Post-Operative Physical Therapy

After any surgery, bones, muscles, and soft tissue undergo a healing process. Full recovery following an operation is going to require some physical therapy. There are many benefits of post-operative physical therapy. PT speeds recovery and helps you return to normal functioning. Proper stretching and exercises to strengthen and improve balance, control, and mobility will help. Without proper treatment, the body may not heal correctly.

Reduced Pain

Post-operative PT will start with controlling pain and swelling from surgery. Rather than masking the pain with medication, a physical therapist curbs pain at its source. Some methods your therapist might use include stretches, heat and ice packs, massage, cold laser, ultrasound and electrotherapy. Reducing discomfort makes it easier to do the mobility and strengthening exercises you need to make a full recovery.

Improved Mobility

When surgery restricts your range of movement, physical therapy can speed recovery. An individualized set of stretches and exercises will meet your specific situation. Your therapist can then adapt the plan as healing progresses. Plus, PTs have expertise in assistive devices like crutches and braces that keep you safe while your body heals.  Keep reading about more benefits of post-operative physical therapy.

Strengthened Muscles

Muscles are vital components of balance and mobility. Building strength in the core and back is foundational to getting back to top shape. Targeted exercises boost the performance of muscles surrounding the surgery site. The goal of strengthening exercises is to improve functionality and increase endurance. 

Enhanced Stability

Balance is an essential part of staying safe after surgery. Balance exercises from seated and standing positions boost flexibility. Strengthening the core, back, and pelvis improves balance as well. Often post-operative physical therapy includes programs like pilates, which increases the body’s core stability. 

Get The Most Benefits of Post- Operative Physical Therapy

Post-operative physical therapy guides your return to normal functioning. Pain reduction techniques elevate the need for opioids, and exercises improve balance, muscles, and movement. 

We want to help you get your body back in shape after surgery. Call us at 201-833-1333 to schedule an appointment.