I wear many hats in my daily life. I’m a mother of two, three if you count my fur baby and I do count him as one of my children. I work full time in an office. I am a wife. I am also an athlete in one of the toughest sports. I am a roller girl. I skate for the Ohio Valley Roller Girls and we train hard. During one of our training sessions I fell and broke my ankle. I have no extravagant story like I took on an entire pack and was able to finish the game and our team won. Nothing that magical or amazing I just fell and broke my ankle six days before our first game ever. I had surgery three days later to put a plate on my ankle. I woke up from that surgery and that’s when the pain set in. Continue reading Limping to Walking, Astym resolves ankle pain
Training for my 3rd marathon I injured my Achilles in the tail end of the training program and was unable to do the race. I went through traditional PT however returning to running kept on being put off and off. When just about ready to run went through extensive pre-run testing (??) jumping jacks, trampoline..and had a set back.
Researched Astym looking for a better way, was encouraged to run shortly after beginning treatment. Continue reading Return to Running; Improved Achilles with Astym
I started experiencing pain along the outside of my right knee and a tightness that prevented me from running downhill on one of my trail runs. The pain reoccurred every time I attempted to run in the following weeks. Rest, ice, and stretching were my first approach to healing from this injury that came on out of the blue. My next attempt at running led to frustration and disappointment as the pain and tightness were still there! I did some research on IT Band Syndrome and determined that was my problem. Everything I read stated that rest and stretching were the recommended treatments, but complete healing would take weeks! Not willing to wait weeks, my physician recommended physical therapy and she even informed me about Astym. Continue reading Runner’s Relief
I started experiencing pain along the outside of my right knee and a tightness that prevented me from running downhill on one of my trail runs. The pain reoccurred every time I attempted to run in the following weeks. Rest, ice, and stretching were my first approach to healing from this injury that came on out of the blue. My next attempt at running led to frustration and disappointment as the pain and tightness were still there! I did some research on IT Band Syndrome and determined that was my problem. Everything I read stated that rest and stretching were the recommended treatments, but complete healing would take weeks! Not willing to wait weeks, my physician recommended physical therapy and she even informed me about Astym. After a thorough evaluation by the therapist, I decided to give Astym a try. Continue reading Runner’s Relief from IT Band Syndrome
Carpal Tunnel Syndrome: Advice from the Experts
If you experience wrist and hand pain with numbness or tingling into your hand you may have carpal tunnel syndrome. Other common symptoms include weakness in the thumb muscles, loss of hand motion and increased pain at night. Carpal tunnel syndrome affects 2-5% of the population and most commonly affects individuals between the ages of 40-60. It frequently affects individuals whose occupations require the wrist to be flexed or extended for long periods of time, such as jobs that require computer work. Also, repetitive motion or gripping activities and exposure to repetitive vibrations such as power tools can contribute to carpal tunnel syndrome. If you suspect that you have carpal tunnel syndrome, you should see a doctor to be properly diagnosed and explore treatment options.
Common treatments for carpel tunnel syndrome include rest, anti-inflammatory medication, night splints to immobilize the wrist, physical therapy, and steroid injections. If these options fail, surgery may be recommended. Although carpal tunnel syndrome is caused by increased pressure on the median nerve which travels through the carpel tunnel at the wrist, it is important to remember that the median nerve originates in the neck and the neck must be addressed when treating carpal tunnel syndrome. While 14% of individuals with carpal tunnel syndrome have neck pain, neck pain does not need to be present in order for the neck to be a contributing factor to symptoms. The key point is to treat the upper extremity nerve and muscle system and not simply focus on the location of pain. In the case of carpel tunnel syndrome, this means treating the upper back, neck, and the course of the nerve (from the neck down to the shoulder, elbow, wrist, and hand). Even if nerve testing reveals poor conduction to the median nerve at the carpal tunnel, this can frequently be improved by treating the entire nerve and muscle system in the involved arm, which can often help avoid the need for surgery.
A thorough examination by your physical therapist will help you determine the best conservative treatment options for you. This treatment will frequently include gentle spinal manipulation of the upper back and neck, nerve sliding/gliding exercises to treat the nerve from your neck to your hand, and “hands-on” techniques to mobilize the bones of the wrist and hand. Tight bands or knots called trigger points are commonly found in the muscles of the forearm and the muscles around the upper back and neck in patients with carpal tunnel syndrome. These can be treated with trigger point dry needling or massage.
The repetitive motions or stress associated with carpal tunnel syndrome can also cause tightness and possible degeneration in the soft tissues (muscles, tendons, and ligaments) around the carpal tunnel. Astym treatment can help relieve this stiffness and regenerate the soft tissues.
Finally, poor posture will place increased stress on the nerves coming out from the neck and going to the hand. Maintaining good posture and taking frequent breaks when working at your computer will help alleviate this stress. Also, having the proper ergonomic set up at your computer to minimize stress on the neck, upper back, and wrists will also reduce your chances of experiencing carpal tunnel symptoms.
If you suffer from carpal tunnel syndrome, it is important to treat the body as a system and not simply focus on the carpal tunnel. Just because your pain may only be in your wrist or hand does not mean that the source of all your symptoms is in the wrist and hand. Your upper back and neck are likely contributing factors and should be treated along with the hand and wrist. A comprehensive conservative treatment program addressing all contributing factors will help you avoid more aggressive and costly procedures such as surgery.
Meet today’s guest bloggers:
Dr. Timothy W. Flynn, PT, PhD
Dr. Flynn is board certified in Orthopaedic Physical Therapy (OCS), a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT), and a frequent research presenter at state, national, and international meetings. Dr. Flynn is widely published including 5 textbooks, 6 book chapters, over 50 peer-reviewed manuscripts on orthopaedics, biomechanics, and manual therapy issues. He was the editor and author of The Thoracic Spine and Ribcage – Musculoskeletal Evaluation & Treatment and The Users’ Guides to the Musculoskeletal Examination, and the author of 3 educational CD-ROMs on Orthopaedic Manual Physical Therapy. Dr. Flynn has received numerous research grants. Awards include the James A. Gould Excellence in Teaching Orthopaedic Physical Therapy, the Steven J. Rose Excellence in Research (twice), the AAOMPT Outstanding Research Award (twice), and the Distinguished Alumnus- Marquette University Program in Physical Therapy. Dr. Flynn continues to maintain an active research agenda in the areas of spinal and extremity manipulation, low back disorders, characterization of spinal instability, and the development of clinical prediction rules. Continue reading Carpal Tunnel Syndrome: Advice from the Experts
Hamstring Strain and Injury: Advice From The Experts, Part II
In Part I of this entry, we discussed some of the most effective treatments for chronic hamstring strains and injuries. Despite being pain-free with typical daily activities, many athletes continue to have pain with their sport several months and even years after a hamstring injury. Unfortunately, there is a high recurrence rate of hamstring strains because of incomplete rehabilitation or returning to sport too soon. Residual scar tissue and persistent muscle weakness are two common reasons for the persistent pain and high recurrence rate following a hamstring strain.
Fortunately, regardless of how long the injury has persisted, Trigger Point Dry Needling and Astym treatment can help reduce or eliminate scar tissue and knots in the muscle called trigger points. These hands-on treatments combined with the appropriate exercise routine can help resolve even the most chronic hamstring strains.
Considering there is such a high recurrence rate of hamstring strains, many have asked what can be done to prevent these injuries from recurring and even better, prevent them from happening in the first place. Although hamstring stretching is commonly recommended for injury prevention, a hamstring flexibility program has not been shown to reduce the incidence of hamstring injuries and in fact it may lead to what is called stretch weakness, where the muscle is highly flexible but weak and prone to injury. In contrast, several studies have found the incorporation of specific strengthening called eccentric exercises into a training program can significantly reduce hamstring strain injuries. Eccentric exercise involves slowly straightening your knee against resistance (working your hamstring muscles) so that the muscle is engaged while it is lengthening. If you are recovering from an acute or chronic hamstring strain, your physical therapist can help you determine when it is appropriate to begin eccentric training. It is important to start slowly when beginning an eccentric strengthening program, as there tends to be greater muscle soreness associated with this type of strengthening.
In addition to eccentric training, exercises that focus on neuromuscular control of your core muscles and lower extremities have been shown to accelerate injury recovery and prevent re-injury. Think of neuromuscular control as the system that creates coordinated movement. This control system frequently “shuts down” following injury. Simply strengthening the muscles is usually not enough to restore neuromuscular control. Exercises to re-establish the motor control are critical in preventing injury recurrence. Examples of such exercises following a hamstring strain include high knee marching, skipping, and explosive running starts with a focus on leg power development. Finally, a program emphasizing varying trunk movements during running (e.g. upright posture, forward flexed and forward flexed and rotated) has been shown to reduce hamstring injury recurrence by 70%.
If you participate in sports where hamstring injuries are more common such as running, soccer, softball, and tennis, remember to include exercises similar to those listed above to reduce your risk of hamstring injury. Your physical therapist or personal trainer can help you develop the optimal training program. If you happen to be one of the unfortunate ones who is still suffering from a chronic hamstring injury, remember you do not need to put up with the pain. There are effective treatments available to help you return to the sport you love.
Meet today’s guest bloggers:
Dr. Terry Gebhardt, PT, DPT
Dr. Gebhardt completed his Master of Physical Therapy at the U.S. Army-Baylor University Graduate Program in 1998. During Dr. Gebhardt’s 7 years of physical therapy practice in the Army he specialized in treating a broad range of musculoskeletal injuries. He has worked extensively with injury prevention initiatives and has been a leader in the development of training programs designed to maximize fitness while preventing injury. Dr. Gebhardt relocated to Colorado in 2004 to complete his Doctorate of Physical Therapy degree and Fellowship in Manual Therapy at Regis University. His areas of clinical expertise and interest include spine and sports rehabilitation where he incorporates his passion for fitness with physical therapy. Continue reading Hamstring Strain and Injury: Advice From The Experts, Part II
Hamstring Strain and Injury: Advice From The Experts, Part I
Those of you who suffer from chronic hamstring strains know how frustrating this recurrent injury can be. Hamstring strains and injuries typically occur with high-speed activities such as sprinting, soccer, or tennis. As physical therapists, we treat an increased number of hamstring strains as recreational league softball gets into full swing. Many “weekend warrior” athletes are not adequately conditioned or prepared for the quick starts and change of directions required for these sports. Minor muscle strains may resolve with rest, gentle pain-free movement, and ice over a couple weeks. More serious hamstring strains may cause swelling or bruising and can take several weeks to months to resolve. Strains that occur where the hamstring muscle attaches at the “sit bone” tend to take longer to resolve than strains that occur in the muscle belly.
If a muscle strain is not treated appropriately there is greater chance for another strain to occur leading to a chronic injury. The hamstring may not be painful with typical everyday activities, but can be aggravated as the athlete returns to running or sports requiring quick movements. Residual scar tissue at the injury site and persistent muscle weakness are two common reasons for the increased re-injury rate. As the muscle remodels itself following a strain, scar tissue forms at the injury site. Early, pain free movement can help reduce the formation of scar tissue. However, excessive hamstring stretching should be avoided as it can result in dense scar tissue formation. As the muscle continues to heal and pain decreases, specific strengthening exercises called eccentric exercises should be included in the rehabilitation program. Eccentric exercise involves slowly straightening your knee against resistance (working your hamstring muscles) so that the muscle is engaged while it is lengthening. Your physical therapist can show you how to perform these exercises. Part II of this entry will provide more detail on rehabilitation exercises following a hamstring strain and tips for preventing hamstring injuries.
Even if you have suffered from a chronic hamstring strain for years, there are pulled hamstring treatments that can reduce the residual scar tissue, improve your strength, and get you back to full activity pain-free. The scar tissue that forms around the injured muscle can create a knot in the muscle known as a trigger point. While massage can effectively release these trigger points, a technique called trigger point dry needling can be more effective because the muscle can be directly treated at a deeper level by penetrating the skin with a fine needle. Trigger point dry needling uses fine filament type needles to release the trigger points in the muscle.
The scar tissue can be effectively treated with Astym treatment. With Astym your therapist will use instruments instead of her hands to engage the scar tissue and induce its resorption by the body. Also, Astym will help regenerate any degenerated soft tissues in the area and stimulate the muscle and/or tendon to remodel itself. A key part of the remodeling process is to apply controlled stress to the healing tissue with specific stretching and strengthening exercises. Astym and controlled stress will help the muscle remodel and become stronger, and help prevent scar tissue from forming. Your physical therapist can help you determine the appropriate exercise to stress the muscle enough to make it stronger while not causing damage. So remember the good news if you continue to be plagued by a chronic hamstring injury…you can get back to the activities you love pain-free!
Dr. Tim Flynn and Dr. Terry Gebhardt are physical therapists and owners of Colorado Physical Therapy Specialists in Fort Collins, Colorado, the website of their practice is www.colpts.com.
Meet today’s guest bloggers:
Dr. Timothy W. Flynn, PT, PhD
Dr. Flynn is board certified in Orthopaedic Physical Therapy (OCS), a Fellow of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT), and a frequent research presenter at state, national, and international meetings. Dr. Flynn is widely published including 5 textbooks, 6 book chapters, over 50 peer-reviewed manuscripts on orthopaedics, biomechanics, and manual therapy issues. He was the editor and author of The Thoracic Spine and Ribcage – Musculoskeletal Evaluation & Treatment and The Users’ Guides to the Musculoskeletal Examination, and the author of 3 educational CD-ROMs on Orthopaedic Manual Physical Therapy. Dr. Flynn has received numerous research grants. Awards include the James A. Gould Excellence in Teaching Orthopaedic Physical Therapy, the Steven J. Rose Excellence in Research (twice), the AAOMPT Outstanding Research Award (twice), and the Distinguished Alumnus- Marquette University Program in Physical Therapy. Dr. Flynn continues to maintain an active research agenda in the areas of spinal and extremity manipulation, low back disorders, characterization of spinal instability, and the development of clinical prediction rules. Continue reading Hamstring Strain and Injury: Advice From The Experts, Part I
Astym treatment is a physical therapy treatment that regenerates healthy soft tissues (muscles, tendons, etc.), and eliminates or reduces unwanted scar tissue that may be causing pain or movement restrictions.
Astym treatment is highly effective for restoring movement and reducing pain from soft tissue injury/dysfunction, and Astym even works when other approaches routinely fail. One of the main reasons for this is that Astym was designed to target the underlying cause of many soft tissue problems, rather than just trying to relieve symptoms. Here are some of the diagnoses where patients have demonstrated excellent clinical results when treated with Astym:
• Lateral epicondylosis, chronic lateral epicondylitis
• Carpal tunnel syndrome
• DeQuervain’s tenosynovitis
• Wrist sprain
• Plantar fasciopathy/heel pain/chronic plantar fasciitis
• Achilles tendinosis and chronic achilles tendinitis
• Shin splints
• Patellar tendinosis, chronic patellar tendinitis/tendonitis (jumper’s knee)
• IT band syndrome
• Chronic hamstring strain
• Joint contractures
• Overuse injuries
• Pain or loss of motion & function following surgery, trauma or overuse injury
Here is a full listing of diagnoses that have been monitored and the outcomes (treatment results) tracked.
Astym treatment is non-invasive, which means there are no injections or incisions. Instruments are applied topically (on top of the skin) to locate dysfunctional (unhealthy) tissue, and to transfer mild to moderate pressure to the underlying soft tissue structures. Astym treatment stimulates tissue turnover, scar tissue resorption, and the regeneration of tendons, muscles and other soft tissue structures.
Astym treatment is typically provided twice weekly for four to five weeks (about 9 total treatment sessions) and is done in conjunction with eccentric loading, stretching, and functional exercises. Unlike other treatments, Astym encourages patients to active, workers to stay on the job, and athletes to stay in their sport during treatment. The Astym process actually makes the tissues of the body stronger, and allows a patient’s body to become adapted to greater stress without injury. Patients are very satisfied and enthused with the results they see from Astym
Astym is used in settings ranging from therapy clinics to hospitals to industrial rehabilitation to elite/professional athletics. This highly-effective, proven treatment helps countless patients every day. Astym is scientifically based and supported by clinical research and extensive outcomes.
A controlled clinical trial showing the effectiveness of Astym treatment for tennis elbow was presented at the American Society for Surgery of the Hand’s annual meeting. The study showed that Astym treatment was an effective tennis elbow therapy by resolving 78.3% of chronic lateral epicondylitis (tennis elbow) cases. This figure is consistent with the 80.9% resolution rate for chronic lateral epicondylitis (tennis elbow) that was contemporaneously reported in the national outcomes database for Astym treatment. Continue reading Effective Treatment for Tennis Elbow presented at Hand Surgeons’ meeting
Meet today’s guest bloggers:
Kris Korsan, PTA (left) has been a physical therapy assistant for 20 years, and co-owns City Center Rehabilitation, a private orthopedic and sports medicine clinic in Peru, Illinois.
Tracy Daugherty, M.S., ATC, PTA (right) has been a certified athletic trainer for 14 years and a physical therapy assistant for four years. Ms. Daugherty works with Ms. Korsan at City Center Rehabilitation in Peru, Illinois.
Chronic Tennis Elbow That Would Not Improve With Other Treatments Finally Gets Better With Astym
Several years ago, I had a client who was a mechanic with bilateral elbow lateral epicondylitis (tennis elbow on both arms). He received traditional treatments of anti-inflammatories, iontophoresis/phonophoresis, modalities of e-stim and ice, stretching, and gentle strengthening exercises. He was unable to rest his elbows due to his job demands. After his bilateral tennis elbow had no success with multiple other therapies, he finally received an order for Astym treatments at a clinic that was more than an hour’s drive from his home. Continue reading Chronic Tennis Elbow That Would Not Improve With Other Treatments Finally Gets Better With ASTYM