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Medial Tibial Stress Syndromes -Shin Splints

Medial Tibial Stress Syndromes – Shin Splints “Shin splints” is a general term that is used to describe pain often accompanied by tenderness along the front of the lower leg. The tibia is the larger of the lower leg bones and runs from the knee to the ankle. It can be felt running along the front of your shin. Many muscles attach to the tibia and the bone is covered by periosteum which has a good blood and nerve supply. Medial tibial stress syndromes are commonly caused by prolonged running or walking or repetitive jumping. Shin pain is most commonly diagnosed as a stress fracture of the tibia or an overuse syndrome of the muscles and their attachment to the periosteum. The difficulty in diagnosing between these two conditions is that stress fractures are often missed on X-ray because the hairline fracture is typically not seen until after about 3 weeks when the new bone growth becomes visible. A bone scan or MRI would better detect a stress fracture but are not typically ordered early after pain onset due to the cost. We rely on clinical signs and symptoms to guide the diagnosis if radiographic tests are not conclusive or have not been taken. Typically, stress fractures have more localized area of pain and tenderness to palpation and muscular inflammatory problems tend to have a larger area of pain and tenderness. Stress fractures tend to be painful during the running, walking or jumping and the pain resolves shortly after the activity is finished. Muscular inflammatory injuries tend to hurt early in the morning, and progress in intensity with the...

The Cultural Trend of Sports Specialization in Youth: What You Should Know

The Cultural Trend of Sports Specialization in Youth:  What You Should Know   There is no doubt that organized sports can be a very positive experience for young people offering fitness benefits (greater cardiovascular health, bone mass, strength, prevention of obesity and type II diabetes), improved coordination and athletic skills, self esteem and social interaction skills in addition to just being a healthy outlet for fun!  Youth participation in sports has changed dramatically in the past 3 decades.  Participation has increased by more than sixfold.  Girls have become more involved in athletics and there has been significant study of the female athlete’s vulnerability to specific injuries.   Including both genders between the ages of 5 and 14, sports related injuries have increased to estimated numbers of 3.5 million a year.  Within this great increase of participation in youth sports, has grown a trend of “sports specialization” occurring in younger and younger age groups.  This phenomenon is when young athletes “self select” to focus on a year round single sport participation.  Children and adolescents who choose one specific sport face increasing quantity and specificity of stresses on their growing bodies due to the constant exposure of that one sport or training required for that one sport.  As professionals in the medical field and specialists in the sports medicine arena, we are noting that we have within our community two large populations of children:  Ones who are inactive and face the threat of obesity and another growing large group of increasingly specializing sport youth who are at risk of developing injury due to overuse in a skeletally immature body.  Did you know...

Important Information for Concussion Recovery

Important Information for Concussion Recovery Concussions have become a very common event in sports participation and have been frequently reported in the news media over the past couple of years. This increase in press makes it sound like a relatively new “buzz” in medicine. Unfortunately, concussions have occurred for many years prior to this new focus on them. This is an area of medicine that has made great strides over the past 10 years focusing on the proper recognition, realization on the level of severity and potential future effects and the best treatment options. Physicians, physical therapists, athletic trainers and coaches now receive better education in the recognition and treatment of concussions. It is important that people utilize medical professionals in handling concussions and listen to their advice. We see a number of youth, adolescent and adult recreational and competitive athletes as well as non-athletes in our clinic that unfortunately have sustained a concussion. The goal of this blog is to educate you as the concussion recipient or as a care giver of someone who has sustained a concussion with some information that may lessen the symptoms of a concussion and expedite the brain’s healing process. Many of the grade school through high school students that we treat after a concussion have had to modify their school attendance and receive homework and / or tutoring at home because the hypersensitivity to light and noise and intolerance of sustained activities that require concentration. These patients must try to minimize excessive stimulation of the brain to allow it to heal. Activities such as watching television and playing video games are not...

Physical Therapy for Pediatrics and Adolescents: The Science and Art of Treating Developing Framework

Physical Therapy for Pediatrics and Adolescents: The Science and Art of treating developing body framework Children and adolescents are not “little adults”. Their bodies are still in development as their musculoskeletal and neurological systems are in the process of maturing. The injury patterns that occur in this age group are different than adults in both physical and physiological ways. Most notable is the fact that children and adolescents have open growth plates and their ligaments (tissues that hold bone to bone) are stronger than the bony attachment sites where they serve as connectors. Growth can occur quickly at the growth plate resulting in a rapid change in skeletal length producing longer bones but soft tissues (muscles, tendons, ligaments) that do not grow as fast. With each new body configuration that results from rapid growth, the child/adolescent may experience postural change and a period of incoordination (because the full musculoskeletal system such as muscles and tendons are “catching up” to the new longer bones and the body’s neurological system is relearning to “make internal sense” of the new body for movement and sports participation). This age group also experiences a vulnerability to musculoskeletal injury at these times of development due to the physical activities that they may participate in which stresses the young body system. Physical Therapy treatment of these conditions require specialized consideration and intervention philosophies keeping the growing skeletal system in mind while returning the youth to physical activity and sport. The growth plate portion of bones in this population is vulnerable to injury and growth plate fractures may be more common than a ligament sprain at these...

Backpacks and Growing Spines

Backpacks and Growing Spines “As the sapling is bent, so grows the tree” From Kindergarten through college, the backpack is a fixture in most children’s lives. Children often choose a backpack based on décor or theme when they are young. Older students also want the backpack to look good. It is important though to evaluate the ergonomic function of a backpack. Good preparation for school besides a good night’s sleep and a healthy breakfast may also be the correct backpack. The average daily load in a sixth grader’s pack is 20.5-27.5 lbs! By the time a student graduates from high school, he/she has carried the equivalent of six full-size cars or 11 tons!!! When worn correctly and not overloaded, a backpack is supported by some of the strongest muscles in our body. Unfortunately, according to the Consumer Product Safety Commission, there are approximately 6,500 ER visits per year because of backpack injuries. Here are four helpful hints to help select the proper backpack and help your child avoid strain or injury. 1. Choose right. The best design options allow for even weight distribution and less strain on the spine. Wide, padded shoulder straps are the best. Narrow straps can “dig” into shoulders causing pain and reduced circulation. Use two shoulder straps at all times. One strap or messenger bags that are slung over one side of the body cannot distribute weight evenly and cause children to compensate with bad postural positions. If vanity rules and your child insists on this design, encourage them to at least alternate sides of their body to carry the bag on an every other...

Life Restructuring: Energy Conservation and Work Simplification

Life Restructuring/Energy Conservation and Work Simplification Have you or someone you care about recently experienced a major health change? Perhaps it was a serious injury with a long recovery time ahead or maybe a diagnosis of a chronic disease that requires some readjustments to the way you are used to living, or maybe it was a surgical procedure that requires some down time. All of these circumstances find us in a place that can leave us tired, overwhelmed and frustrated. We cannot do things the way we used to be able to do. We wonder if we will ever be able to manage things again. Who needs energy conservation? Persons with a chronic condition which may cause fatigue or episodes of fatigue. Persons in temporary situations such as recovery from major surgery or acute illness whose body systems are healing but need time to return to normal function. Persons undergoing treatments that may cause fatigue as a side effect. Persons who are experiencing body changes due to normal aging. Anyone who wants to do things more efficiently. We all have a certain amount of energy to spend on any given day whether we are in perfect health or have a condition or situation which affects our health and therefore, our energy systems and reserves. Every person, regardless of ability or disability has their own mobility and energy expenditure range. Athletes train to use their resources as effortlessly as possible to compete as they perfect their performance. Someone who has a chronic condition such as multiple sclerosis, lupus, myasthenia gravis, COPD (to name just a few), may experience episodes of...

Relaxation Exercises to Help Combat Stress

Relaxation Exercises to Help Combat Stress In my twenty-six years of physical therapy practice, I have often had patients come to me with this question, “My doctor told me that I need to reduce the stress in my life. Do you know of any exercises I can do to relax more?” I certainly have some professional advice to share. I also have enough personal experience with stress to understand as well. You see, we are all human and life is stressful. Yes, even physical therapists struggle with stress. I have seen and treated many places on the human body where stress can physically manifest itself from headaches, jaw (TMJ) problems, neck pain and muscular trigger points to even some kinds of low back pain. Ask a roomful of people in what way they experience stress and some will say “tension headache”. Still others are “gut reactors” and they have stomach aches or GI distress. Still others describe feeling “tired and aching all over.” Stress is unavoidable. Our ancient ancestors had to worry about finding food to eat and whether what they were hunting was going to turn around and start to hunt them! They did not stress over rush hour traffic, the kids overscheduled lives or the looming work deadline but they did have stress. The problem is that although our civilization has greatly evolved since those days, our human physiology is still the same. We are wired for the “fight or flight” response to stress. Our adaptive response to stress remains primitive. This system was highly effective for the ancient “life or death” scenarios and is still our...

“Handy Advice” for Preventing Hand Injuries

Our hands are a remarkable part of our human body.  They permit us to do so many things.  Just think how nice it is to hold hands with someone you love or to touch the face of  your child.  Your hands allow you to work both inside and outside the home.  If you are like most people, you may just take your hands for granted.  At Optimal Physical Therapy and Sports Performance, we often help persons who have experienced hand injury.  It is the hope of this blog to give you some prevention/protection tips to guard those precious possessions.  Here are some tips to avoid the most common causes of hand injuries: 1.  Proper form for carrying groceries  Trying to carry multiple plastic bags at once creates a challenge for fingers, wrists and elbows.  When you do this, you are putting strain on many delicate finger joints by lifting too much weight in an awkward manner.  It is better to carry from the bottom of the bag or opt for paper so that the larger muscles of your arms can assist with the carry.  Remember to balance the loads between both arms to prevent back injury as well.  It is always a better option to choose a cart over a basket at the market even if you are just running in for a few items.  A basket can easily become very difficult to grasp as the weight of its contents increase.  Also keep in mind that when you go to lift heavy gallon jugs or bottles, you should try to use both hands rather than finger grasping the handle.  This avoids significant...

Winter Wisdom for fall prevention

WINTER WISDOM Snow and ice are a reality for all who live in Western Pennsylvania.  For those who have osteoporosis, limited mobility due to age, arthritis or injury, the winter conditions can prove dangerous for falls.  Here are a few simple hints to help you stay safe and healthy through the winter months: Walk this Way:  Wear appropriate footwear.  Use boots or shoes with sturdy winter treads.  Use road salt, sand or kitty litter on sidewalks and driveways. Carry a small bag of this in a coat pocket or keep some in your car so that you can have access to it if needed. For example, you come out of a restaurant and it has become icy.  Ask for help with errands or shopping if it is too slippery for you to think of going outside. Stay Connected:  For many, depression is common in the cold, cloudy months of winter.  Bad weather can mean social isolation to many older people.  Make an effort to get together with friends, family and neighbors.  Invite someone over for tea or coffee, take someone you know who does not get out much to a trip to the store or restaurant.  Give someone a call and connect on the phone.  A little conversation can go a long way.  If approved by your physician, think about adding a vitamin D supplement to your diet to offset the limited sunlight for the winter months.  Vitamin D is vital for many body functions and without direct sun light, it is difficult for the body to make it on its own. Keep your heat on:  Many persons but particularly the...

Snow Shoveling Safety Tips

  SNOW SHOVELING SAFETY TIPS With the first major snow fall of the season, we have already had our first patient who injured their back while shoveling snow.  Here are some helpful hints that physical therapists wish more people understood before they try to clear the driveway, and walkways around their home: Snow shoveling is considered moderate physical activity.  It is aerobic in nature placing a strain on the cardiovascular system.  It is also weight lifting in nature particularly depending on the type of snow, how deep the snow is laid down before beginning and if there is ice on top or under the snow.  Snow shoveling is also repetitive in movement.  Not using proper body mechanics while completing this activity can lead to muscle strain and injury.  The good news is that snow shoveling can be very good exercise if completed properly.  The bad news is that snow shoveling should not be completed by certain persons as it places them at risk for fatal heart attacks.  Who should never attempt to shovel snow?  Anyone with a history of heart attack, heart disease, high blood pressure or high cholesterol should consider hiring someone to shovel for them.  Also smokers and persons who lead a sedentary lifestyle can be at risk.  If you question if you should attempt to shovel, you need to talk with your physician to get medical approval. If you are in good health, there are several things you can do to complete this task safely:  Prior to going outside, do a warm up activity in the house just as you would if you were working out...