• illustration of glute medius and glute minimus

    Posted on 8/11/2021

    Recently, I had a runner try to increase their pace by 30 seconds from one weekend to the next. The result? Severe pain along the inside of their shin and the start of spending two days a week in physical therapy.

    Many running injuries are due to overuse and/or improper training. Up to 70% of recreational and competitive distance runners sustain an overuse running injury during any one-year period.1 One of my favorite questions to ask runners is, “Other than running, what exercises are you doing?” Usually the response is, “You mean running isn’t enough exercise?”

    Running injuries can be prevented. One of the keys to proper training is cross training. The most important group of muscles to strengthen for runners are those along the side of your hip, mainly your glute medius and glute minimus.

    When people hear glutes, they immediately think of their buttocks. But, two of the smaller glute muscles – the glute medius and minimus – are often overlooked. The glute medius and minimus are vital hip muscles and their main function is to stabilize your pelvis.

    When you’re walking, think about the moment you put your right foot down and swing your left leg through. Does your left hip drop down? If so, then you may have some weakness in these stabilizers along your right side. Now, imagine running more than five miles and this is repetitively happening without you knowing. Imagine the wear and tear this is taking on your body. Weak hips place unnecessary stress along your back, knees and feet. The good news is that this can be prevented.

    How do you strengthen your glutes? Here are some simple exercises that do not require much equipment.

    • Sidestepping: Place a resistance band just above your knees (easier) or above your ankles (harder). Keeping your toes pointing forward, side-step in a mini squat about 20 feet. Then, return to the start without turning around.
    • Jane Fondas: Lay on your left side completely against the wall, head, back and heels. Place a towel behind your right heel and keeping your toes pointing straight forward. Slowly lift your leg up/down. Repeat on other side.
    • Side planks: These can be done from your knees or feet.
    • Knee side plank: Slowly bring your buttocks back then forward to target multiple fibers of the muscle.
    • Hydrants: On all fours, lift your knee out to the side without letting your hips tilt.

    glute exercises

    For more information or to request a complimentary injury screen with one of our licensed physical therapists, please contact the center nearest you today. In the meantime, train smart, run fast and run happy!

    By: Sarah Zayyad, DPT, CMPT, CDNT, Cert-ART, physical therapist with RUSH Physical Therapy 

    RUSH Physical Therapy and Dignity Health Physical Therapy are part of the Select Medical Outpatient Division family of brands.

    1:  Ferber, R., Hreljac, A., & Kendall, K. D. (2009). Suspected Mechanisms in the Cause of Overuse Running Injuries: A Clinical Review. Sports Health: A Multidisciplinary Approach, 1(3), 242–246. https://doi.org/10.1177/1941738109334272 


  • man stretching

    Posted on 7/22/2021

    We have all heard the old adage, “You are what you eat.” The nutrients that you put into your body dictate your overall health, function and performance in any activity you do. A similar motto could be, “You are how you train.” The way you move is important. Allowing your body to move in the correct manner will not only decrease your chances of injuries, but it will also allow you to move in a pain-free manner with all daily activities.

    Rotational athletes move their bodies through high velocity motions that cause increased stress on tissues. This stress then leads to increased strain on the body. Golfers undergo some of the quickest changes in body movement in any sport, and that precision of movement is key in preventing injuries.

    Our bodies are comprised of a system of joints that are either considered a stable joint or a mobile joint. When we confuse the two systems and change a stable joint into a mobile joint, injuries occur. For golfers, low back injuries can occur due to changing a stable joint (the lumbar spine) into a mobile joint because of not conditioning and stretching enough. The good news is that can be changed, and injuries can be prevented if you take the time to stretch.

    By training your body in the proper manner, you can learn to swing your golf club pain-free and improve your overall mechanics. This would allow you to hit the ball farther, and without that wicked slice. Stretching is a key component in any sport and is often overlooked. By allowing your body to stretch certain muscle groups, you are permitting for improved movement. In order to perform your best on and off the links, incorporate stretching into your daily regiment starting from the tips of your toes, to the top of your head. Low back spasms, neck strains and shoulder injuries can all be lessened or even avoided if you stretch properly before your next round.

    Below are body regions that are important to stretch before your next round in order to avoid injuries and enhance your game.

    • Neck: The neck is a vulnerable body part when it comes to the golf swing, and can be the source of some tissue strains if there is restriction in movement. If you lack proper cervical flex and rotation, that can lead to injury and a poor golf shot. To ensure you have proper mobility and range of motion, complete some cervical flexion and rotation stretches.
      • Curl your chin to your chest until you feel a slight stretch in the back of your neck. Rotate your head side-to-side slowly in small motions. This will help to loosen up your muscles, minimize stress and keep focus on the ball during your swing.
    • Shoulders: When a golfer lacks mobility in the shoulder girdle (the clavicle and scapula), this can lead to poor swing and shoulder pain. A golfer needs good shoulder rotation to ensure a fluid backswing and follow through in order to not compromise both the labrum and rotator cuff. A stretch that can be completed prior to your swing is the standing prayers stretch.
      • Place your golf club in front of you with both hands on top of the handle with the club head on the ground. Lean backward while hinging at your waist until you feel a comfortable stretch across your shoulders. Some players will also feel a stretch across their lumbar spine, so don’t be surprised!
    • Thoracic and lumbar spine (see image): Low back strain and other injuries are common amongst golfers. No matter what phase of your swing, your thoracic spine is one of your main forces for rotation; however, too many golfers learn to rotate through their lumbar spine due to decreased overall core stability. Many golfers also have poor mobility along their thoracic spine (located in the upper and middle part of the back) as a result of improper training. The exercise below retrains your body to rotate through the thoracic spine while keeping your lower abdominals engaged, thus creating a stable base along the lumbar spine and preventing excessive rotation. This stretch can also help minimize injury and improve overall swing mechanics.
      • Start by laying on your side with your arm straight in front of you. Keep your eyes on your hand and allow your chest to open. Lift your arm to your side and keep your abs tight. You will feel a stretch in your middle back, and your low back should be stable with no pain.
    • Hips: Just like the shoulders, the hips are meant to move freely in three different planes. Your hips ensure you have enough mobility to move efficiently with golfing. In order to improve your swing, hip internal and external rotation are important as it pertains to the backswing and follow through. If you do not have enough mobility in your hips, you will pull off early from hitting the ball. This causes many faulty swing mechanics. Stretching your hips will allow you to address the ball better in all phases of the golf swing, and help you strike the ball straight each time.
      • While standing, complete small circles with a straight leg in a clockwise and then a counter-clockwise motion.

    Golf is an amazing sport, but in order to compete pain-free you have to learn to move correctly. Proper body mechanics help to decrease stress on your body and avoid injuries. Remember to stretch first, then swing. And who knows, by doing this you may even add a few more yards onto your drive!

     


  • Posted on 7/8/2021

    Select Medical, Dignity Health Physical Therapy's parent company, was proud to collaborate with the CDC on an important clinical study regarding the long-term impact of COVID-19. The study validates our Recovery and Reconditioning Program to focus on specific deficits in patients recovering from COVID-19 and other debilitating illnesses and conditions.

    Findings of the study indicate that patients recovering from COVID-19 could benefit from additional personalized rehabilitation services aimed at both physical and mental health. As the nation’s largest provider of outcomes-based, innovative physical therapy, Select Medical, along with Dignity Health Physical Therapy, is expertly positioned to guide the recovery of this 33.5 million patient population.

    The Recovery and Reconditioning program launched in June 2020 amid the pandemic and was developed in partnership with leading physicians, including physiatrists, pulmonologists, infectious disease specialists as well as physical and occupational therapists and speech-language pathologists. Following evidence-informed program guidelines, our licensed physical and occupational therapists tailor a plan of care to address patients’ specific needs and goals to resume pre-COVID activities and routine.

    Dignity Health Physical Therapy centers are “direct access” and do not require a physician referral to receive care. If you or a loved one are recovering from COVID-19, please click here to find a center near you and schedule an appointment today.

     


  • Posted on 6/28/2021

    Whether you’re new to the sport of triathlon or jumping back in after a longer break in racing, many are excited to drop any weight gained during the past year. It’s the perfect time of year to get outside and back to racing.

    While triathlons are a great way to push our bodies and are relatively safe for individuals at any age, athletic background or ability level, participants also need to be aware of the:

    • Pitfalls of overtraining
    • Importance of rest
    • Appropriate time to take some time off

    What defines rest and why is it important?

    Rest comes in many forms. It can be as simple as the time between repetitions, intervals or sets or a scheduled day off in your training plan. And, it can be skipping a workout when you are tired and feeling worn down, physically or mentally.

    If you sustain an injury or have an illness, rest may mean prolonged time away. However, rest doesn’t mean you have to completely stop all activity. You can take time off from typical training to work on mobility, participate in a yoga class, go for a walk, spend extra time on nutrition or enjoy a hot bath and relax.

    Whether planned or forced, rest allows the body to adapt to the stressors and changes in demand being placed on it. It allows muscles to recover and gain strength, our nervous system to adapt to changes and regenerate and our body to replenish our energy stores. Rest ultimately decreases the risk of overtraining, overtraining syndrome and overuse injuries.

    Triathlon training naturally allows our muscle groups to get some rest. When training in one discipline, the muscles involved in the other disciplines naturally get some time off. Spending the day in the pool gives your body a break from the repetitive pounding on the pavement from running, and with cycling or spinning, your shoulders get some needed time off from the resistance of the water.

    When is it time to take off, skip a workout and push training to another day?

    What are the signs of needing a break?

    As you dive into your training plan and are weeks out from the year’s first event, here are some important signs and symptoms that your body is telling you to take a break:

    • You are suffering through workouts that were previously done with ease
    • Notice your form is deteriorating or you are slower in any of your disciplines
    • It is harder to wake up
    • Increased irritability
    • Decreased motivation to train or in your daily life
    • Decreased concentration during work-outs
    • Increased sleeping
    • More frequent soreness or injuries (and it’s not due to an increase in intensity level of working out)
    • Increased illness

    If we don’t listen to these signs, our bodies may just force us to rest. If this happens, we can end up overtraining or sidelined with an injury.

    What is overtraining?

    Overtraining, simply put, is doing more than your body can handle at any given time. There is an imbalance between training, nutrition and rest leading to a decrease in performance, increase in fatigue and a decline in mood. For a well-trained athlete, overtraining may occur when putting in extra training sessions on an already full schedule. If you’re a rookie, it might mean jumping in too quickly with one or two extra days of training.

    Overtraining can be influenced by outside workload when we are stretching our personal schedules and sleep routines too thin. You may see you are underperforming with little to no change in your training program. Or, you may find you have more difficulty sleeping - falling asleep or staying asleep despite fatigue from working out.

    Once this stage or overtraining is reached, athletes will often find an elevated heart rate, especially first thing in the morning as well as deficiencies in vitamins B12 or D, lower iron levels and increase in creatine kinase levels in the blood. All of these can be serious signs of overtraining syndrome and can force an athlete into three-to-eight weeks off from training and treatment by a medical professional.

    What are overuse injuries?

    The most common overuse injuries in triathletes and athletes in general are from overtraining or overuse. Overuse injuries represent the largest percentage of sports-related injuries that require medical attention and are most common in runners and endurance athletes (triathletes).

    Approximately 50-70% of triathlete injuries occur when running, and the majority of those are overuse. These injuries most often occur in the knee, Achilles, foot or back or the shoulder from swimming. They can occur due to a breakdown in tissue that doesn’t have adequate time to repair itself before more use.

    If you are seeing aches and pains that don’t subside in approximately three days in the well-trained athlete or seven days in a new participant (due to new muscles being trained,) it is time to take some time off and seek out your local physical therapist for guidance. A physical therapy plan of care can help you heal, regain/increase strength and flexibility and reduce pain. It can also help you prevent future injury and optimize your sports performance.

    Author: Melissa Bryant, P.T. Melissa serves as the center manager for Select Physical Therapy’s Colorado Springs facility, located in the USA Triathlon headquarters building.

    Select Physical Therapy and Dignity are part of the Select Medical Outpatient Division family of brands.

    Resources

    • Vleck, V., & Alves, F. B. (2011). TRiathlon injury review. British journal of sports medicine, 45(4), 382-383.
    • Koutedakis, Y., Budgett, R., & Faulmann, L. (1990). Rest in underperforming elite competitors. British Journal of Sports Medicine, 24(4), 248-252.
    • Gosling, C. M., Forbes, A. B., McGivern, J., & Gabbe, B. J. (2010). A profile of injuries in athletes seeking treatment during a triathlon race series. The American journal of sports medicine, 38(5), 1007-1014.
    • Budgett, R. (1990). Overtraining syndrome. British journal of sports medicine, 24(4), 231-236.
    • O'Toole, M. L., Hiller, W. D. B., Smith, R. A., & Sisk, T. D. (1989). Overuse injuries in ultraendurance triathietes. The American journal of sports medicine, 17(4), 514-518.
    • Collins, K., Wagner, M., Peterson, K., & Storey, M. (1989). Overuse injuries in triathletes: a study of the 1986 Seafair Triathlon. The American journal of sports medicine, 17(5), 675-680. 

     


  • Close up of female hand while playing the piano

    Posted on 6/9/2021

    The first week of June has been annually designated by the American Society of Hand Therapists as Hand Therapy Week. It’s a time for raising awareness of hand, wrist, arm, elbow and shoulder injuries and conditions and the therapists who have specialized training to treat them. This week is also a great time to spotlight the individuals who most benefit from hand therapy, individuals like musicians.

    Playing a musical instrument is emotionally, mentally and physically demanding. Musicians, like athletes, are at risk for career-ending injuries in the neck, shoulder, wrist and hand. In a musicians’ lifetime, 63-93% will experience musculoskeletal symptoms related to their instrument play. Even the most conscientious musician can begin with symptoms or injury at various times through their play and performance season.

    The challenges musicians face are practice and rehearsal patterns established by others (an orchestra conductor, for example) in large segments of time, without rest or stretch breaks. There is also fierce competition for work, and musicians may be reluctant to complain of injury or new symptoms for fear of losing out on an opportunity. Additional injury risk factors include inadequate physical conditioning, poor posture, abrupt increase in play time and patterns, poor techniques or a change in the instrument.

    Symptoms, whether intermittent or persistent, are seen most often when learning to play over the age of 50. In professional musicians, symptoms can present when increasing the complexity or time spent playing.

    Common symptoms include:

    • Pain
    • Muscle cramping
    • Tremors/spasms
    • Inability to control motion
    • Headaches
    • Numbness/tingling
    • Stuck, catching or locking joints
    • Inability to straighten fingers

    Hand therapists have the important skills needed to evaluate musicians and identify abnormal sensation, poor posture and other causes of symptoms.

    A therapist identifies risk factors and develops a rehabilitation program specific to the musician’s instrument, goals and play demand. The plan may start with an active rest period, avoiding activities that cause symptoms while mentally rehearsing and initiating new normal movement patterns. During this stage, the therapist modifies the play/practice schedule and explores pain control techniques and strategies including diet, exercise, sleep and posture.

    When the active symptoms quiet down, the hand therapist begins the advanced rehabilitation phase with a goal to return to play. The therapist monitors play and rest cycle and a home program is developed to provide visual feedback using imagery and mirrors. The advanced rehabilitation phase also involves aerobics and fitness, strengthening, postural exercises and increased duration and complexity of play.

    The hand therapist works with the musician to develop a return to normal play schedule that is timed incrementally. The schedule starts with a slow and easy repertoire and passages, increasing to fast and more challenging passages for up to 10 minutes. Activities that help with return to play include warm-up with brisk walking, cycling and stretching.

    The musician will warm-up with their instrument using easy scales, long movements, slow and quiet play. As rehabilitation progresses, 50 minutes is generally the maximum play time before rest is suggested. The therapist also instructs the musician on symptom management techniques during rest and after play. These management techniques include ice, hydration and stretching.

    Hand therapists identify the root cause of injury, provide a whole-body approach to care and work in collaboration with music instructors to ensure continuity with proper technique and posture. Education and early intervention is key, as early treatment leads to better outcomes.

    If you or a loved one are a musician and suffering from pain or discomfort while playing, request an appointment today and experience the power of hand therapy. Our certified hand therapists will help you get back to doing what you love – creating beautiful music!

    By: Rob McClellan, OTR/L, CHT. Rob serves as the hand program coordinator for Physio.

    Physio and Dignity Health Physical Therapy are part of the Select Medical Outpatient Division family of brands. 

     

     


  • woman wearing covid protection mask

    Posted on 5/25/2021

    Have you ever heard the term “mask jaw”? Well, guess what? It’s a thing!

    Mask jaw is the jaw pain and pressure many of us experience as we wear our masks for an extended period of time since the start of the COVID-19 pandemic. Now, while the Centers for Disease Control and Prevention recently put out new masking guidance for vaccinated people, masks will still be part of most of our lives for the foreseeable future. And, all that mask wearing can take a toll!

    If you jut your chin forward or tense your jaw muscles to hold your mask in its proper position over your nose and mouth, you are likely experiencing jaw tightness. Headaches and muscle tension can also be caused by stress, something we’ve all felt more of since March 2020!

    Let’s take a closer look at how your jaw works. Your jaw bone connects to your skull on both sides of your face, and is referred to as the temporomandibular joint, or TMJ. It is a rounded bone, with a disc that provides a cushion to support the joint, much like the discs in your spine and meniscus in your knee.

    When you first open your mouth, your jaw hinges and rotates. As you open further, it glides and translates until you open it fully. This action happens with large muscles from your temples and cheek, to smaller muscles deep within the jaw. At least that’s how it works normally. When there is an issue with the disc, the muscles or the joint itself, it is referred to as temporomandibular joint dysfunction, or TMD.

    TMD includes a wide range of symptoms, such as pain in the jaw or neck, headaches, locking of the jaw in an open or closed position, clicking noises and pain or difficulty with speaking, eating or chewing. TMD symptoms are widely reported by many people, but become troublesome when they start limiting your day-to-day activities.

    Now, let’s dive into how your mask may be the culprit to any lingering jaw pain you may be experiencing.

    1. Maybe you are breathing through your mouth while wearing your mask. Did you know that this places more stress on the jaw from it being constantly open?

      Wearing a mask can feel like you are not getting enough fresh air, but it should not alter how you breathe. Each inhale and exhale should pass in and out of your nose. Your jaw muscles are relaxed in this “resting” position. This means that the tip of your tongue is gently touching the roof of your mouth while your back teeth, the molars, are not quite touching.  

      If you breathe in and out of your mouth, your jaw remains open. To keep your jaw open means your muscles are doing extra work. When you breathe with a mask on, focus on the air passing in and out of your nose.
    2. Maybe the ear loops are too tight. This creates tension and can throw off the alignment of your jaw and, in some cases, cause headache. 

      Masks come in all shapes and sizes, and the fit is important. Whether made of fabric or disposable, it should never feel like it is pulling your ears forward or your chin backward. These compressive forces can easily trigger a headache. Consider a mask extender or “ear savers” to keep the ear loops from tugging and avoid a potential headache altogether.
    3. Are you clenching your teeth more because of stress? This is an easy trigger for TMJ pain and dysfunction. 

      Remember the resting jaw position? This is the most relaxed position for the muscles. When you clench your teeth and hold that bite position for extended periods of time, the jaw muscles can go into spasm. Avoid gum chewing or biting your nails, which can make symptoms worse. Exercise is a key component to overall health and managing stress. Take a walk or jog, meditate or find another way to get moving. Your body and your jaw will thank you.
    4. Chances are, you are moving your jaw in altered positions to adjust how your mask is resting on your face. 

      With a proper fitting mask, you will avoid overusing your jaw. Use a mask that has some moldable wire that can be shaped around your nose. Additionally, avoid masks that are too big and sag on your face, or that are too small and tug on your ears. You should be able to speak and breath through your mouth (wink, wink) comfortably. To avoid jaw pain, make sure your mask is molded to your face and does not slide or move easily.  

      If you are feeling pain or clenching in your jaw, experiencing headaches or are having difficulty with chewing or eating, physical therapy can help. To learn more about our TMD program or to schedule an appointment at one of our centers, please contact us today.

      By: Nicole Romaine, P.T., MPT. Nicole is a physical therapist for Kessler Rehabilitation Center in West Orange, NJ. 

      Kessler and Dignity are part of the Select Medical Outpatient Division family of brands.
     

     


  • Posted on 5/12/2021

    “Am I Injured?”

    This is a question I get asked by many runners.

    “How do I know if I’m injured and not just sore from running/training?”

    Short of a physical examination, this is what I tell them...

    There is good pain and bad pain. Good pain stops when you stop. It is generally mild, diffuses and doesn’t affect quality of movement. Bad pain does not stop when you stop. It can get worse during or after activity. It can be sharp in nature, and significant enough to force you to change your gait whether you realize it or not.

    If you have rested or taken time off from running, and the pain has decreased or gone away only to return when you start running again, there is most likely some underlying issue that needs to be addressed. There could be an issue with muscle imbalances, running form, footwear, training schedule, joint mechanics or any combination of these.

    If you are taking non-steroidal anti-inflammatory drugs (NSAIDs) daily or after every run for pain, you may have an overuse injury. Overuse injuries account for the majority of running injuries. They occur when a tissue is loaded beyond its threshold. In bone, this can result in a stress fracture. In tendon, this usually manifests as tendonitis or tendinosis. Excessive stress to a ligament can result in a sprain.

    Overuse is relative and not always obvious. It can be a result of “too much, too soon” with regard to training or mileage. It can also be due to cumulative stress from non-running activities and/or compensation. When a structure takes on additional stress to unload another, it can break down.

    How can physical therapy help? A thorough evaluation by a physical therapist can help identify the underlying problem so that you’re not just treating symptoms.

    A progressive loading program can assist the injured tissue regain the strength needed to resume running and training. Hands-on therapy can also help restore normal joint mechanics so that muscles are functioning more efficiently and inert structures are not unnecessarily stressed.

    Physical therapy can you build strength, endurance and minimize running injuries, so you can achieve your personal best.

    By: Martine Marino, MPT, COMT. Martine is a physical therapist and the center manager for NovaCare Rehabilitation in Bethel Park, PA.

    NovaCare and Dignity Physical Therapy are part of the Select Medical Outpatient Division family of brands. 

     

     


  • Posted on 3/19/2021

    What is an athletic trainer? Often confused with personal trainers, athletic trainers are allied health care professionals recognized by the American Medical Association trained to handle the prevention, examination, diagnosis, treatment and rehabilitation of emergent, acute or chronic injuries and medical conditions. That’s important work! Athletic trainers work primarily in the field of sports medicine and are trained to handle injuries and conditions affecting the neuromuscular (nerve and muscle relationship) and musculoskeletal (bone and muscle relationship) systems.

    Now that we have a better understanding of what an athletic trainer is, you might be wondering what an athletic trainer does day-to-day. At Dignity Health Physical Therapy, we employ many athletic trainers to provide services to local middle schools, high schools, colleges and professional teams as well as club and league tournaments. Within these settings, our athletic trainers provide services ranging from:

    • Taping
    • Education on injury reduction and management
    • Emergency care and triage
    • Stretching, and other hands-on therapeutic techniques
    • Develop exercise/rehabilitation programs
    • Mental health and nutrition needs and refer appropriately when necessary
    • Create and implement emergency action plans and return to play protocols

    The goal of an athletic trainer is to prevent the athlete from getting injured in the first place. In the event that an injury occurs, they examine and treat the athlete/individual and if the injured party requires further diagnostic testing or follow-up of any sort, they refer to the proper specialist and work in tandem with them to ensure proper care.

    When the time comes to rehabilitate an athlete’s injury, our athletic trainers create a treatment plan and collaborate with one of the many wonderful physical therapists that work for our organization. They are also integral in being one of the first on scene when an athlete suffers a concussion. Athletic trainers provide both sideline and full concussion evaluations. They are able to conduct baseline tests which primarily measure the neurocognitive and/or vestibular-ocular (eyes and balance) motor system and help direct care to the proper specialist, communicate with parents, the school nurse and advisors/teachers when needed. As the athlete continues post-concussion treatment, athletic trainers help them progress through the return-to-play protocol to ensure a safe return to sport.

    Developing and implementing emergency action plans and other important procedures regarding return to play is an important part of an athletic trainer’s role. These procedures and policies include acclimatization, inclement weather including heat management, COVID-19 and others to help keep athletes safe. In addition, they maintain inventory and assist with budgets and provide ongoing communication to coaches, school administration and parents.

    It’s also important to note that while the focus here is the athletic trainer’s role with athletes, they also provide the same clinical expertise to many companies working with the “industrial athlete.”

    By: Josh Cramer, LAT, Germantown Academy, Philadelphia, PA



  • pediatric e-learning ergonomics

    Posted on 2/17/2021

    Is your child’s e-learning set-up ergonomically correct? Poor ergonomics can lead to poor posture, resulting in neck pain, low back pain, tightness of muscles and weakening of other muscles. It can also cause headaches, tendonitis in the hands/wrists and carpal tunnel syndrome.

    With COVID-19 presenting new ways in which schools are conducting class, it is important to maintain proper sitting posture to prevent muscle straining and improve attention. Age does not discriminate against poor ergonomics, especially if long periods of time are spent sitting in front of a computer. Our physical and occupational therapists offer five simple tips that can help you ensure that your child is maintaining the proper sitting posture during e-learning.

    Tip 1: Ensure that your child’s feet are planted firmly on the ground. If their feet do not reach the ground, use a text book, plastic container or cardboard box for them to rest their feet on.

    Tip 2: Adjust the height of the chair to ensure that there is a 90 degree bend at the knees and hips while sitting. Changing the depth of the seat can alter the angle at the hips. Consider using a pillow or rolled towel to keep the hips bent.

    Tip 3: Elbows should rest gently at the side with forearms reaching just forward to the computer, allowing your child’s back to remain against the backing of the chair. If the elbows and shoulders are elevated, try lowering the height of the desk or increasing the height of the chair.

    Tip 4: Elevate the screen of the computer so that your child is looking straight forward. Place your device on textbooks, laundry baskets or couch cushions. When it comes time to type, lower the device back to the desk or table. Remember, there should be a 90 degree bend in the elbows to allow the arms to rest close to thigh height while typing.

    Tip 5: Kids are wired to play and move! Have your child get up and move around when given breaks during class. Encouraging these movement breaks will improve your child’s attention, regulation and body awareness to help maintain good posture during learning.

    If you have questions or concerns about your child’s posture or development, please contact our Kids pediatric therapy centers today to request an appointment.

    By: Courtney Engel, M.S., OTR/L, and Meredith Krifka, P.T., DPT, c/NDT. Courtney is an occupational therapist and Meredith is a physical therapist with RUSH Kids Pediatric Therapy in Fullerton, Illinois.

    RUSH and Dignity Health Physical Therapy are part of the Select Medical Outpatient Division family of brands. 


  • concussion - soccer players

    Posted on 1/22/2021

    While sports might continue to look a little differently this year due to the COVID-19 pandemic, the safety for our athletes remains a top priority. Our athletic trainers and physical therapists provide crucial education for the protection of our athletes while they are participating in their long-awaited sports seasons, as well as provide comprehensive therapy to aid in the recovery of any injuries sustained.

    One of the most prominent, but often less understood, sports injuries is the concussion. There are many myths and misconceptions about concussions, but they can occur from any impact to the head, neck or body. A concussion starts with a physical impact and can be a direct hit to the head or an indirect hit, such as the rebound of the head/neck in a football tackle. The obvious hits are the easiest to recognize; however, the less obvious hits are harder to catch and may lead to missed symptoms.

    While not all hits lead to a concussion, it is important that we are on the lookout concussion symptoms. Parents, coaches and teammates should be educated on common symptoms in order to prevent the athlete from playing through injury. Symptoms can include:

    • Headache
    • Dizziness
    • Fatigue
    • Feeling foggy
    • Difficulty thinking
    • Imbalance
    • Sensitivity to light or sound
    • Blurred or double vision

    The presentation of these symptoms may start showing immediately or be delayed up to 24 hours.

    It is also important that a thorough assessment be performed to rule out that an injury has not occurred before returning to play. Playing through a possible concussion or missing concussion symptoms overall is a safety concern and could delay return to sport. Always think, “When in doubt, sit them out.” This assures the athlete rests initially for 24-48 hours to allow the body and brain to rest and heal.

    During this resting period, to the athlete should avoid mental and visual strain as well as excessive activity. This includes anything that increases your symptoms, such as watching television, playing video games and being on the computer and/or phone.

    Most concussions will resolve themselves within 7-10 days, but approximately 15-20% of patients present with lasting symptoms – most notably headaches – which may be the result of delayed healing. Initially, resting the brain helps decrease prolonged symptoms and extended healing times. After the initial resting phase, best practice is to begin an active recovery. Physical therapy intervention can set athletes up with an appropriate exertion program that is safe for the brain.

    Our centers offer a variety of opportunities to work with therapists specializing in concussion rehabilitation who help to establish the underlying cause of prolonged symptoms. Each comprehensive examination focuses on the most common factors that may lead to delayed healing, including physiologic recovery (Is your brain healed enough to tolerate activity) and visual and vestibular involvement (Are your eyes or inner ears playing a role in your symptoms? Is the neck involved?).

    Our evaluation and treatments are backed by evidence that will help patients recover more quickly in order to safely return to symptom-free participation in their respective sports.

    By: Megan Brainerd, P.T., DPT, COMT. Megan is a physical therapist with Select Physical Therapy in Summerville, SC.

    Select Physical Therapy and Dignity Health Physical Therapy are part of the Select Medical Outpatient Division family of brands.