Nevada Physical Therapy's Blog

Do you need surgery if you tore your ACL? Maybe, maybe not.

You tore your ACL, now what? There is a common misconception that if you tear your anterior cruciate ligament, you have to get it fixed right?! Maybe, maybe not. Over the last decade we have seen this idea come under more scrutiny and it is becoming harder and harder to justify surgery for everyone that suffers an ACL injury.

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Things to Consider After a Shoulder Dislocation

The term dislocation can be scary, and when it happens, it is even scarier. It is not just the pain that can make it scary; it is the feelings and thoughts about what to do next. The good news is that dislocations are more common than you may think, and we have an excellent handle on helping individuals return to their respective activities.

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What to Expect after Rotator Cuff Repair Surgery

Often times, post-surgical expectations regarding restrictions, precautions and guidelines are not given or were briefly reviewed prior to or post-surgery. The purpose of this blog post is to set appropriate expectations, which will help ease some of the fears associated with surgery and rehabilitation, as well as improve your understanding of what to expect after your rotator cuff repair surgery. If you are interested in reading our full protocol click HERE; this protocol serves as a guideline and is not intended to be utilized as a "one size fits all" template. If you haven’t had surgery and are wondering if surgery is right for you, we have written a blog on non-operative management of rotator cuff tears, click HERE.

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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.

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Plantar Fasciitis

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.

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Mythbusting: Adhesions

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?

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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….).

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Youth Specialization

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.

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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.

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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.

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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!

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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.

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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.

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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.

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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.

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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!

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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.

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Reviews

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Olivia

Patient

Nick was so attentive to my needs and he structured his schedule to fit mine. My therapy was focused on my strengths and weaknesses; therefore, my recovery time was much shorter than expected. I highly recommend Nevada Physical Therapy for any lingering pain you may be experiencing.

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Aleem

Patient

I cannot say enough positive things about this place. Came in with an ACL injury. I spent a few weeks working with jonathan. His evidence-based approach and motivational ability was really really inspiring. He helped me get back to normal and then some!

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Nadine

Patient

DAKOTA EZELL is at the top of MY list as a highly skilled, intuitive, present professional who values and treats me as a whole person, not just someone to fill a time slot

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Shahbaz

Patient

The best Physical Therapy place I have ever visited. Rare to see an emphasis on finding the best method to improve injury instead of giving everyone the same plan. But the best part about this place is it's approach to well being during and after PT.

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EP

Patient

I was referred to Brian Fearnley by someone with significant credibility. I consider working with Brian a huge stroke of luck. This specific 'PT' is increasing my recovery potential a hundred fold. Brian knows his stuff. He is well versed in PT. He has athletic history at UNR and is active in our local community. He is clearly in this profession to help people recover and get under their own power.

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Joyce

Patient

After two plus years of hip pain, three other physical therapists, quarterly injections and no relief, Crista made the pain go away! If I could give her and this practice 10 stars I'd do it!

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Perris

Patient

As a professional athlete, injuries can make or break a career. Luckily, in my case, I had Nevada Physical Therapy on my side. Not only did they physically help me recover from a meniscus surgery, but they provided the best emotional support you could ask for in such a difficult time.

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Ross

Patient

Phenomenal. I had some brutal injuries that resulted in four surgeries and seriously disrupted my life. There can be no doubt that the quality of life I enjoy today was a direct result of working with Nevada Physical Therapy.

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Brandon

Patient

I attended Nevada Physical Therapy for my post surgery physical therapy and have nothing but great things to say. For any of you reading this, this place is by far the best physical therapy place I have ever attended with exceptional staff. I had the pleasure to work with Dakota who is extremely knowledgeable, patient and would go above and beyond to make sure you're taken care of.

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