Nevada Physical Therapy's Blog
Return to Sport Timing after Anterior Cruciate Ligament Reconstruction
Anterior Cruciate Ligament injuries are one of the most commonly repaired ligaments in the body with an estimated 100-200,000 reconstructions performed each year in the United States. Having surgery does not guarantee a return to prior level of function and those who have suffered an ACL injury, unfortunately also become higher risk for a second injury with 30% of those individuals suffering a contralateral (opposite knee) ACL injury in the first few years post-reconstruction (Grindem et al., 2016, Paterno et al, 2014) or further, elite athletes can have as high as 50% risk of reinjury in the first postoperative year (Kaeding et al, 2017). Understanding the potential contributors to re-injury risk is vital to the rehabilitation process as our goal is to get the individual or athlete back to doing what they love AND mitigating modifiable risk factors for re-injury.
Plantar fasciitis (PF) is a prevalent musculoskeletal condition involving the plantar fascia, usually at the proximal insertion (connection to the heel bone). The nomenclature of this condition has evolved from what many know this condition as plantar fasciitis to plantar fasciopathy. Why? We are finding in the literature, thickening and age-related changes are more common than an actual inflammatory process (-itis).1 The etiology of PF is unclear and will often have an insidious onset (unknown cause).1,2 Typically, PF presents as a sharp pain when first walking in the morning or walking after a period of rest. The pain usually becomes better after walking but may worsen toward the end of the day or during impact activities. In this blog we will discuss potential risk factors and treatment options to help with plantar fascia pain.
Adhesions have commonly been used as an explanation for the source of an individual’s pain, loss of mobility, etc. going so far as this website calling it “possibly the most common musculo-skeletal pathology in existence”. Subsequently, this has spawned countless treatment systems used to address these alleged patho-anatomical anomalies.but where did this come from? Do adhesions even exist?
The Nordic Hamstring Exercise
If you’ve been on Instagram in the last few months then you’ve probably seen a variety of your favorite strength coaches and physical therapists demonstrating the Nordic Hamstring Curl (NHC) or Nordic Hamstring Exercise (NHE) and preaching its utility in a variety of injury risk reduction programs. I’m often asked “why” we prescribe NHCs or “why XYZ isn’t the same?” So, I figured this would be a good opportunity to breakdown the current literature regarding this vogue training exercise. This isn’t meant to be an exhaustive literature review but more of an introduction to the conversation, and as always, feel free to message me with any questions or to tell me I got something wrong (it has happened before….).
Are youth athletes training too much? When is sport specialization appropriate? What are the current research-based recommendations? In this blog post two articles will be reviewed on this controversial topic to help answer questions athletes, parents, coaches, and clinicians ask themselves.
Rotator Cuff Tear: Surgery? No Surgery?
Did a recent MRI confirm a Rotator Cuff Tear (RCT)? You are not alone! RCT is a common musculoskeletal injury that results from trauma or age related changes. The purpose of this blog post is to discuss non-surgical options for a rotator cuff injury and when surgery may be indicated. Petri et al. (2016) reviewed multiple clinical outcome studies and found conservative management for rotator cuff tears to have a 75% success rate.1 That is a very promising statistic, as most rotator cuff injuries can be managed well with physical therapy. With this success rate, does that mean there will still be pain? Not likely! Here are a few imaging studies that confirm we can have rotator cuff pathology with no symptoms. Frost et al. (1999) showed rotator cuff pathology was related to age but did not correlate the MRI findings with symptoms.2 Girish et al. (2011) found abnormalities in 96% of asymptomatic (no symptoms) individuals.3 Do these tears get worse if I do not have surgery? In a study by Kong et al. (2017) found partial thickness tears to progress in 16% of their participants. BUT, the more important statistic from the study was, 25% of the tears decreased in size.
What makes a good physical therapist?
I was thinking about this as we end 2018 here in Reno and begin focusing on 2019 for Nevada Physical Therapy. One of the things we are constantly trying to improve on is the Patient Experience. We want every patient to have an amazing experience here which may be an odd concept because we don’t sell churros and most of our patients are in pain when they come to see us. Yet, this is also the population that needs to have a positive experience the most. They are often depressed, anxious or scared that this injury will not get better; that they will be relegated to a life of pain which grants great responsibility on our profession and specifically, our clinicians. So it got me thinking, what makes a good physical therapist? Here’s what I came up with and true to point number 3, this is an ever-evolving list.
Why I think every woman should see a Physical Therapist after they have a baby
No, it’s not because I am a physical therapist, but yes I am a physical therapist. I am a mom. And I am proud to be part of a group of superwomen whose bodies have the capacity to grow little humans, push them out of our vaginas or get them ripped out of our bellies, and then miraculously find the energy to get up and immediately pour our heart and soul into keeping these tiny humans alive. Meanwhile we go through such a critical time of healing with literally no guidance on what the heck to do. This is unacceptable! Read More
K-Tape – Does it really do anything?
Have you ever wondered what exactly kinesiology tape (K-Tape) does? Let’s first start by describing why the tape is so unique. Read More
My Injury Story
Being an athlete (a term I use loosely) I have sustained my fair share of injuries. Like most of you, I give them some time and assume they will heal on their own. In the biz, we call this “Regression to the Mean”. Injuries are a part of being active and while we can reduce our risk for injury through a variety of ways such as managing workload, improving technical proficiency with a movement before progressing weight/distance etc., improving awareness of psychosocial contributors such as stress, nutrition, poor sleep, and a variety of other risk factors that we can modify, sometimes injuries happen. Read More
Direct Access To Physical Therapy: Skip the Doc, Save Time and Money
In the state of Nevada, you have direct access to physical therapy services!1 Many patients we have seen in the physical therapy clinic do not realize they are able to access us first on a self-referral basis, which would save you time waiting weeks or even months to see your primary care physician or physician specialist for a referral. Read More
The Reno-Tahoe Odyssey: An Evidence-Based Training Guide for All Skills
The Reno-Tahoe Odyssey is just around the corner! Have you started training yet? If you were like me, you figured a few miles, a couple times a week in February (ok, March) would be a good start. Never really had a plan, just try to not die the first few weeks and then just figured I'd add a few miles each week and hope it was enough when the RTO came. Sometimes it was. Usually it wasn't. Over the last few years, Tim Gabbett (gabbettperformance.com) has been leading the charge on sports science and injury reduction. Read More
Medical Imaging: Pathology or Interesting Anatomy?
If it's often times more normal to be abnormal then shouldn't abnormal findings be called normal and does it suggest being "normal" is now abnormal? Wait...what? If that was confusing, imagine being a patient and getting a 30-second review of your most recent MRI results! Read More
Shoulder and Neck
In 2003, it was found 6 in 10 working adults used a computer on their job.1 At Nevada Physical Therapy we commonly treat individuals who hold a desk job and have developed neck and shoulder pain over time. We hear complaints of tightness, weakness, and the most common being pain. Usually, these pains have evolved into what we consider chronic pain, meaning pain lasting >12 weeks. These pains can be constant or intermittent, but ultimately make it difficult to concentrate throughout the day. These symptoms often have developed as a result of a sustained posture/position our bodies no longer tolerate. Unfortunately, during these sedentary jobs, we forget to stand and move throughout the day, often stuck in nonoptimal positions. Read More