Posted 5/19/2022

Running can be a real rush – a bit euphoric, even!

The health benefits of a good run – long-distance or short runs – do the heart and mind good. That rush – a “runner’s high” – can give you a boost in mood and sense of accomplishment

For race runners, nothing beats that “mission accomplished” feeling after putting in the work and crossing the finish line.

If you run for health or sport, race running might seem like a lofty goal or dream. You can see the finish line banner in your head but then…

POOF!

It’s gone.

But with the right planning and commitment, it’s totally doable!

Our work with runners of all athletic levels gives us a competitive edge in helping keep them safe and running. We can help you, too.

It starts with some basic but important need-to-knows.

In this article we break them down into a series of four S’s of safe marathon training:

• Stress injury prevention
• Standards of progress
• Strength training
• Shoe (yes, shoes!)

If you’ve been thinking about pushing to a next level and running your first half-marathon, read on!

Stress injuries that can stop you in your tracks

Injuries to feet, ankles and legs are common for runners.

If you run on a regular basis, it’s likely you’ll have an injury at some point.

The most common are repetitive stress injuries (RSIs). They’re also called repetitive overuse injuries or repetitive strain injuries.

80% of running injuries are overuse, repetitive stress injuries.

~ PubMed Central (PMC), Injuries in Runners; A Systematic Review on Risk Factors and Sex Differences

 

These happen with movement that’s repeated over and over.

Think about the act of running and your feet hitting the ground.

The constant slap-slapping of shoes on pavement or other hard surfaces. Muscles pulling on bone to propel you forward. All of this works together to make our bones and tendons stronger.

Now add to that any increases in your running distance as you train. This pushes your body past the point of comfort; each bit more adding more stress to tendons and bones. The intensity stimulates collagen growth – the protein that helps joints flex and absorb impact.

But add too much stress and the body can’t adapt quickly enough. The force of running and the extra miles is too much for the bones, tendons and joints and you can end up with micro-fractures or tears.

RSIs include other injuries too, some higher in the Ouch! factor than others. But any of them can all take a runner off course.

Not surprisingly, the knees, legs and feet take the top positions for injury to body parts from running.

Looking at the injuries themselves, RSIs include:

• Sprains - overstretched ligament with pain, swelling or bruising
• Stress fractures - hairline cracks in bone with bruising or tenderness
• Shin splints - pain in front of inner part of lower leg near shin bone
• Plantar fasciitis - pain under heel or bottom of foot
• Achilles tendinitis - inflammation of the tendon connecting calf muscle to heel

These injuries can take weeks of rest to heal, bringing your training runs to a screeching halt.

So slow your training down a bit. Giving yourself a few more weeks to train before adding to your weekly mileage can be the difference to successfully reaching your goal.

Let’s talk about how to do that.

Stress injury prevention that keeps you in running shape

Let’s look at a study.

Okay, maybe a study doesn’t sound fun…

But stick with us here.

We use them because the research helps us be better care providers. Research finds new ways to treat and prevent injury. That means we can better support your training or treat your condition or injury.

So…

A study of risk factors of lower extremity running injuries (van Gent et al.) estimated that 60% of running injuries were attributed to preventable training mistakes. In half these cases, the mistake was excessive mileage.

Breaking that down a bit and it’s all about your training.

That may have you asking, How should I progress my mileage?

Standard of progress for safely increasing you running distance

There’s a rule for how to increase your running distance (we like rules!).

The 10% rule is the most cited standard to progress running distance.

It allows for increasing distance at a rate that gives your body time to adapt to the added stress.

Runners can do this two ways:

• Increase weekly mileage
• Increase total minutes by 10% week over week

Here’s how it looks.

Week 1: Distance - Run three 3-mile runs (a total of 9 miles). Week 2 run two 3-mile runs and one 4-mile run (a total of 10 miles).

Easy. Right:

Here’s an example using minutes.

Week 1: Time - Start with run/walk interval training. Run 20 minutes out of a 30-minute workout. Week 2 increase to 22 out of the 30 minutes.

That said, we work with runners individually. We want to learn about their experience and where they are in their running program and training.

It’s a partnership we build with you to reach your ideal parameters for getting to your distance goals. That includes injury prevention.

While it may not be as simple as applying the 10% rule to all runners, it’s a good place to start for an experienced runner.

We’ve created this chart for training with your sports medicine specialist or physical therapist. Click to download a copy of the training chart.

10-Week Half Marathon Training Program:

 

This 10-week schedule roughly follows the 10% rule. It’s a good plan for the runner who can already run a 5k distance at the start of training.

Scheduling rest days in your training gives your bones, muscles and tendons time to recover.

How should I focus my strength training?

Runners only have one foot on the ground at any time. That means you are constantly having to balance on one leg.

This is important for how the ankles and hips work while running. These body parts need to make quick adjustments to maintain balance and have both legs share the shift in your weight evenly.

Your training plan will benefit from working with your therapist’s single-leg balance and strengthening exercises in your workouts.

Examples include: 

• Single-leg heel raises
• Single-leg squats
• Lunges
• Single-leg bridges
• Single-leg Romanian deadlifts

If the shoe fits

You’ve heard the phrase. But for the runner, the wrong size and fit can start all sorts of problems.

The running community has lots to say about footwear, and which type is best for preventing injury.

Some advocate for shoes with cushion and support. Others for barefoot running.

There’s research on both.

One study had Marines in basic training wear different shoes based on the arches of their feet. Each arch type – low, medium, high – got a different type of shoe.

The results, when compared to a control group who wore only one type of shoe, regardless of their arch type, showed no difference in injury between the groups. Now, if you like research, like we do, check out the full article on the Marine Corps shoe study.

The concept of barefoot running is based on the theory that, well…barefoot is best. The jury is still out on this one.

There’s also the argument that wearing shoes changes the way we run. Barefoot enthusiasts say that the human foot evolved to handle the forces of running without the need for the support of shoes.

But running on hard surfaces, like concrete or asphalt, barefoot may cause a higher amount of stress fractures.

With either choice, the best option is to choose what’s right for your run – what feels best to you and what keeps you safe.

If choosing a shoe, go a half size bigger than your walking or dress shoe. This will give room for your midfoot and toes to spread out as you push off. There’s also room if your feet swell a bit on longer runs.

Running shoes should be replaced every 300-500 miles or every six months to a year based on how much they are used.

Fun Tip!

Write the date on the inside tongue of your new shoes to track how long you’ve used them.

You might consider a gait analysis when you’re looking to buy running shoes. This can identify any movement patterns or bad running habits that could result in injury. You can schedule an analysis from one of our outpatient physical therapy centers or a local running store.

There you have it!

Four steps to build a training plan that helps you avoid injury, build up your strength and distance, choose your shoes and get out there and run toward race day.

Article research courtesy of Jasmine Fisk, P.T., DPT

Treating hand, wrist, arm, elbow and shoulder injuries in athletes

Posted 4/29/2022

When you've got an injured athlete, what's your move to get them back in the game?

For some sports organizations, athletic trainers and team doctors are on deck to treat most sports injuries. But there's a variety of health professionals who help players get their pitch, swing or throw back.

Did you know that occupational therapists play key roles in athletic injury treatment? With all the throwing, lobbing, pitching and twisting that comes with playing sports, the need for therapy is big.

Upper extremity injuries in athletes are common, sidelining them from play. As many as one in four injuries are to the hand or wrist.

Occupational therapists (OTs) specialize in these types of injuries and more. Their goal is to help the athlete recover and safely return to play.

How occupational therapists help athletes

Occupational therapists (OTs) work with all kinds of individuals to overcome physical setbacks from illness or injury. For athletes, this is key for a return to play after injury.

Just as athletes are unique in their play with their sport, injuries are unique to them. For example, athletic injuries can occur in all ages, from Little Leaguers to Silver Sneakers. Treating a specific type of injury, like a broken arm, will be different for a patient who's 7 and another who's 70.

An OT's role is to assess the impact of injury and the limitations it causes.

Therapy is then based on the skills the individual needs to recover to overcome those limitations.

OTs are specialists in assessing the impact of injury on many parts of the body's framework such as:

• Bones
• Muscles
• Tendons
• Ligaments
• Nerves

The level of an injury can vary from acute to chronic.

For example, an acute injury is sudden, like breaking a wrist.

A chronic injury is one that happens over time, like tendonitis of the wrist. Tendonitis builds up after long periods of overuse, doing the same movements over and over, like serving a tennis ball.

Whatever the injury, OTs are highly-skilled in treating a variety of injuries.

For the weekend warrior or a pro athlete, your path to recovery from a sports injury will be unique. And just like the role you play on the court, the track or the field, you'll play a major league role in your healing process.

Here's some inside baseball on what that will look like.

Expect your doctor and OT to talk with you about your goals for recovery. This is key for planning your way back to play and any restrictions you'll need to follow.

Your local physical therapy center will be your home base for therapy sessions. This is to ensure your safety during treatment.

Your therapist will guide you in proper movement and the use of any equipment to make sure you are doing each exercise right. This helps improve your range of motion and stay on track for healing.

Your therapy may include strength training with resistance bands or weights to improve dexterity and build strength.

If your therapy includes doing exercise at home between scheduled appointments, you may benefit from having your OT take a look at your personal equipment and how you use it. They can spot if it's appropriate for your use and goals for healing. They can also see if you're using it right and, if not, help you to correct it.

Each step of your treatment is planned to help you heal from the injury and get back to your goals.

Brace yourself for orthotic devices

For serious injury or bad breaks that take you out of play, your OT may want to restrict the motion or movement of your injury to help with healing.

The terms – splint, brace, wrap or cast – are pretty common, so, it's likely you've heard them before. In medical terms, though, you might hear your therapist refer to them as an orthotic device or orthosis.

The bottom line, whatever the device looks like, is that it will be fairly rigid or stiff to keep a joint or broken bone in place as it heals.

Orthotics can be made and fitted for:

• Fingers
• Wrist/hand
• Elbow
• Shoulder

For a less serious level of injury, there are a host of orthoses we can provide to support and protect to keep you in the game, no matter your game!

These upper extremity orthoses can be fit for thumb, fingers, hand, wrist, forearm and shoulder.

These are custom-fitted and made onsite at our center so you can leave your appointment with what you need.

Your therapist will ensure it fits right for comfort, support and protection.

At the ‘core’ of your injury

Your core is a complex series of muscles extending far beyond your abs. So if you’re thinking “six-pack” or “washboard” abs, think bigger!

The core is made up of 20-plus muscles at the center of the body. It includes major and minor muscles of the stomach, hips and low back. They all work in tandem, making the core part of nearly every movement we make.

Having a strong core (diaphragm, abs, glute and pelvic muscles) and good dynamic balance plays a large part in athletic activities. Weakness in either of these areas may be flagged by your therapist for you to get a movement screen assessment.

The core helps:

• Stabilize movement
• Transfer force from one extremity to another
• Initiate movement

If your core strength is weak, the strength and coordination of your upper extremity isn't at full potential.

Occupational therapists who work with patients on upper extremity recovery consider the whole body during treatment. Your OT will work on improving core strength as well as leg and hip strength as it applies to your sport.

The power of occupational therapy

Getting back to a well-loved sport or activity is important to anyone who's sidelined by injury.

It doesn't matter if you’re competing at an elite level or just want to retain an active lifestyle to get the benefits of occupational therapy. Our OTs know how to create a rehabilitation plan to meet your goals.

Our occupational and hand therapists can help you:

• Avoid injury
• Perform better
• Recover from injuries quickly and safely

We're here for you. Our proven therapies, along with compassionate care, offer the best outcome for your injury.

Take a look at all the sports medicine and injury prevention services we offer. Then click on any of our pages' blue Request an appointment buttons and come see us!

Posted 2/25/2022

How to stay in play and on the court

What is pickleball? And why are people raving about it?

Pickleball is an improvisation of badminton and ping-pong. The game is played on a court using a softball-sized, hard-plastic ball with holes - like a Wiffle^® ball - and paddles similar to table-tennis paddles.

Conceived in 1965 as a game that families could play together, pickleball grew in popularity. By 1972, a corporation was founded for the sport.

While there is debate around the origin of its name, there is none about how fun, fast, competitive and entertaining the game is.

With a smaller court size than its cousin sport of tennis, it’s an ideal way to stay active and fit for just about anyone.

And pickleball has taken the country by storm.

The first pickleball tournament was held in 1976 in Washington State. And while not what’s called an overnight sensation, the explosive growth of the game in the years since has led to pickleball courts popping up everywhere, and the formation of amateur and professional leagues.

There’s even a professional pickleball tour.

When injury puts you in a pickle

With the rise in popularity of pickleball, physical therapists throughout the country are seeing an increase in injuries that are similar to those found in other racquet sports.

New pickleball players sustain approximately 50% of injuries during their first year of play.

The most common pickleball injuries include:

• Pickleball elbow
• Ankle sprains
• Knee sprains
• Shoulder sprains
• Achilles tendonitis
• Wrist fractures
• Concussions from falls

In the case of older players, many are predisposed to injury, often due to prior injury, limited flexibility and range of motion and deterioration of balance, or have recurrent injuries.

So if you are looking to start playing the game … or stay in the game … keep these prevention tips in mind to reduce your risk and avoid injury:

Warm up   Pickleball is a fast-paced game, and the excitement starts right away. So it's important that you warm up before you get on the court. Try a light 5-minute jog, a slow walk with high knees or some side shuffles to loosen up.

Stretch   As part of your warm-up, make sure to stretch. Shoulder stretches, calf stretches, hamstring/quad stretches and wrist and neck stretches are all important to incorporate into your routine.

Choose proper footwear   Pickleball requires moving side to side and back and forth. Choose a good fitting athletic shoe for this type of movement.

Pivot   Similar to tennis and other racquet sports, you will be executing groundstrokes, volleys and serves. Remember to pivot your hips and shoulders as you face the approaching ball.

If you are injured, stop playing!

Don’t try to tough it out, especially if it is a head injury.

Contact a physical therapist to help you heal and recover before you return to play.

Pickleball is as fun as it sounds, and you’ll want to play for years to come.

If you’re in a pickle with pain or injury of any sort, click now to request an appointment to find one of our centers near you.

NovaCare and KORT are part of the Select Medical Outpatient Division family of brands.

Select Medical is proud to be the official physical therapy partner of the PPA Tour.

Posted 2/15/2022

If you clicked to read this, it's likely because you or someone you know has long COVID. Or maybe you’re now hearing people talk about long-lasting symptoms of COVID-19.

With research now being published, millions of people having a COVID diagnosis will experience "long" COVID - post-COVID syndrome or long-haul COVID, earning some who experience it the nickname of “long hauler."

Putting aside that bit of levity, long COVID is no joke.

So if you are struggling to read this because you’re dealing with "COVID brain fog," you may be thinking, How did I get so unlucky?

It's a fair question to ask.

But in reality, long COVID is more common than most think.

According to Penn State College of Medicine researchers, more than half of the 236 million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience post-COVID symptoms.

Months after recovering from COVID-19, millions of people are still suffering one or more debilitating symptoms like:

• Brain fog
• Difficulty breathing
• Muscle weakness
• Fatigue
• Joint pain
• Dizziness and more

If you or a loved one is suffering, don't give up. There is hope and help.

Physical therapy is medicine for long COVID

Professional physical therapists, like me, understand what you are going through. Indeed, if you have long COVID, physical therapy can help.

Yes, physical therapy.

As physical therapists, we are specialists who are trained in identifying the clinical symptoms and effects of long COVID. For example, the profound fatigue you’re feeling? Reminiscent of chronic fatigue syndrome, it’s a post-acute leftover of the viral COVID infection, and we can help.

That joint pain? We're trained also to understand musculoskeletal conditions that can be causing your pain. We can assess the pain and determine the appropriate treatment for it.

I work in an outpatient physical therapy center and help treat patients with long COVID. Our parent company Select Medical collaborated with the Centers for Disease Control and Prevention on an important clinical study regarding the long-term impact of COVID-19.

The study validates our Recovery and Reconditioning program which focuses on specific deficits in patients recovering from COVID-19 and other debilitating illnesses and conditions.

Our Recovery and Reconditioning program helps, specifically, with:

• Fatigue
• Labored breathing
• Weakness
• Headache
• Dizziness
• Joint and muscle pain

Our program was developed in partnership with leading physicians, infectious disease specialists, physical and occupational therapists and speech-language pathologists to help those impacted to heal, gain strength and return to an active, full lifestyle.

We hear all the time that people suffering with long COVID don't feel heard. Feel misunderstood. Feel like giving up.

If that sounds like you, then trust me, we understand.

We are proud to offer the Recovery and Reconditioning program to you, your loved ones and/or friends - anyone who may be dealing with lingering effects of having COVID-19.

Together, we will address your specific post-COVID symptoms and create an individualized treatment plan for your road to recovery. During care, you will learn ways to pace yourself throughout the day and move your body so that you don’t tire so quickly.

As part of your treatment, we will track your vital signs and symptoms to ensure your safety and progress. We will be there every step of the way back to a healthier you.

You deserve a medical professional who understands you. If you’re tired of feeling alone in your recovery from long COVID, let a physical therapist help.

Schedule a consultation with a physical therapist trained in treating long COVID. Click the blue Contact Us button below to request an appointment at a center near you today.

By: Corey Malone, P.T., DPT, OCS. Corey is physical therapist, center director and Recovery and Reconditioning program champion with KORT in Kentucky.

KORT is part of the Select Medical Outpatient Division family of brands.

Posted on 10/25/2021

Did you know that knee osteoarthritis affects nearly 14 million adults in the United States¹ per year? Or that meniscus tears are present in 60-90%¹ of those with knee osteoarthritis? With symptoms ranging from knee pain, swelling, stiffness and limited range of motion, medication, injections, surgery and physical therapy are all commonly prescribed to manage knee pain. Medication and injections, however, may simply serve to mask your pain. Surgery can be costly and taxing on your body. Physical therapy, on the other hand, emphasizes a more holistic approach to the body with emphasis on education, pain management and strength and conditioning.

At first glance, it can be frustrating when you are referred to physical therapy for management of knee pain related to structural issues like osteoarthritis or a knee joint tear. Is the physical therapist going to magically reverse your arthritis or heal your meniscus? Shouldn’t you address the structural problem head-on instead of just “strengthening around it?”

Not necessarily.

Surgery or osteoarthritis physical therapy?

If we dig deeper, a better question to consider might be, “Do I need to change the structure of my knee in order to resume the activities I enjoy?” There are several studies to suggest that abnormal findings on X-rays and MRIs can be common, even in persons without knee pain. In fact, a 2020 study² of a population with a median age of 44 and no knee pain found that an astounding 97% of knees had abnormalities on MRI. In addition, when comparing physical therapy management to surgical intervention, there are many cases with similar outcomes.

Now, this is not to say that everyone with knee pain should get physical therapy instead of surgery. Sometimes, surgery is exactly what’s needed to improve your overall quality of life. However, including a physical therapist on your health care team – before and after surgery – is beneficial, even without changing the structural abnormalities that are often presumed to be the problem.

If physical therapy isn’t changing the “structural problem,” what exactly is the benefit?

People are more than pictures, and pain is far more complicated than what that picture shows. X-ray and MRI findings can absolutely be helpful in developing a plan of care; however, they are only one piece of the puzzle. While physical therapy is unlikely to result in a change in the X-ray or MRI findings, it can identify and help modify factors contributing to your knee pain and functional limitations.

Focusing on your unique condition, a physical therapist can work with you to determine the following:

• Health and lifestyle factors contributing to your knee pain
• Activity modification so you can safely perform activities of daily living
• Stretches and strategies to improve motion and strength
• Swelling and pain control
• How and when to appropriately get back to activities that cause you pain/discomfort

This combination can help patients to better understand their condition and develop a plan that assists in recovery. Doing all of this may greatly enhance your quality of life and ease the pain and symptoms you are currently experiencing.

Now, if you and your doctor determine that knee surgery is necessary, remember, physical therapy is a vital part of preparing for your procedure and recovering after it. Before surgery, we will work together to get you as healthy and strong as possible, which will enable your post-surgical recovery to be that much more successful and faster. Following surgery, we will focus on helping you to restore your strength, balance and flexibility.

No matter what, physical therapists are committed to helping you be as mobile, independent and pain-free as possible. Our goal is to build a relationship in which you feel comfortable asking us questions, are an active partner in your care and we’re able to work together to ensure the best outcomes possible.

If you have knee pain, contact us today and experience the power of physical therapy.

References:

1. Bhushan R. Deshpande, BS, Jeffrey N. Katz, MD, MSc, Daniel H. Solomon, MD, MPH, Edward H. Yelin, PhD, David J. Hunter, MBBS, PhD, Stephen P. Messier, PhD, Lisa G. Suter, MD, and Elena Losina, PhD. The number of persons with symptomatic knee osteoarthritis in the United States: Impact of race/ethnicity, age, sex, and obesity (2017)
2. Horga, L.M., Hirschmann, A.C., Henckel, J. et al. Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiol (2020)

By: Patrick Smith, P.T., DPT. Patrick is board-certified clinical specialist in sports physical and orthopedic physical therapy, a fellow of the American Academy of Orthopedic Manual Physical Therapists and a treating physical therapist with NovaCare Rehabilitation in Philadelphia, PA.

KORT and NovaCare are part of the Select Medical Outpatient Division family of brands.

 

Posted on 10/1/2021

At KORT, we believe movement is medicine. So, what moves you? Physical activity is key to good health, vitality, energy, strength and might even make you laugh more.

If pain or a medical condition is holding you back, we’re here to help. Physical therapy is a moving experience.

Physical therapy gets you back to life and the things that are most important to you. Whether it’s running a marathon, playing with the grandkids or simply cooking dinner pain-free, the benefits of physical therapy can change lives for the better.

That’s why we’re excited it is October, one of our favorite months of the year. Why, you may ask? October is National Physical Therapy Month. For 31 days, we get to celebrate all things physical therapy and the many ways our dedicated physical therapists and physical therapist assistants help improve the quality of life.

There is so much to share about the benefits of physical therapy, including the highly-trained clinicians who provide it. Did you know that physical therapy helps people manage pain and chronic conditions? How about the power of physical therapy to help heal from recent injury and reduce the risk of future injury? Or prepare the body for surgery and successful recovery or avoid the need for surgery altogether? Well, physical therapy does all this and more.

Physical therapy is also a safe alternative to taking prescription medication. It treats common aches and strains, sprains and fractures, and helps with many other issues and conditions, including:

• Back sprain/strain
• COVID-19 fatigue and other debilitating illnesses
• Headaches and concussions
• Vertigo, dizziness and balance
• Disc injury and pinched nerves
• Rotator cuff tear, bursitis and frozen shoulder…and more

So, what moves you? That marathon? Those grandkids? That culinary masterpiece? Whatever it is, physical therapy, and our compassionate team of licensed therapists, can help get you moving.

Request an appointment today and see how physical therapy can physically, emotionally and mentally enrich your life.

#ThePowerOfPhysicalTherapy #WhatMovesYou #ChoosePT

 

Posted on 9/22/2021

Sports and exercise are part of the lives of many young individuals. Typically, people who participate in sports are known to be healthier and less likely to partake in outside negative distractions compared to people who do not play sports. However, for some adolescent girls, when they only focus on the sport and not their bodies, consequences can arise. 
Many girls who participate in sports are at risk for an issue called the female athlete triad. This triad consists of three conditions, and the athlete can have one, two or all three. The three conditions include disordered eating, amenorrhea and osteoporosis.

Disordered eating

Disordered eating is a term that refers to an individual having unhealthy eating behaviors and worrying about body image. Some of the most common forms of disordered eating include extreme dieting and restrictive eating. On the top end of the spectrum are eating disorders, which involve things such as self-induced vomiting, binge eating and laxative abuse. An individual can have disordered eating and not be diagnosed with an eating disorder. Most girls with disordered eating are trying to lose weight to help them improve their athletic performance. For these specific athletes, this eating pattern can range from not eating enough calories to sustain the amount of activity that they are participating in, to trying to avoid “bad” foods, all the way to eating disorders such as anorexia nervosa and bulimia nervosa.

Amenorrhea

Amenorrhea is the lack of menstruation, or one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea, as well as girls who have not started their periods by the age of 15. Intense exercise accompanied with not eating enough calories can lead to a decrease in the hormones needed for menstruation. As a result, a girl’s period may never come, become irregular or stop altogether. Some girls who have been participating in sports since a young age may never get their first period, because they have been training so hard. On the other hand, some girls may have gotten their period, but it disappears as their training intensifies or their eating habits change. On one hand, dysfunction of the menstrual cycle can lead to infertility. And on the other hand, it can lead to unplanned pregnancies in young women recovering from the triad. While the cycle is being restored, an egg may be dropped early and, without contraception, pregnancy can occur.

Osteoporosis

Osteoporosis is translated as porous bone. It is a disease in which the density and quality of the bone are reduced. For people with osteoporosis, boss loss overtakes the growth of new bone. Consequently, over time the bone becomes more porous and fragile, and the risk of fracture greatly increases. This typically happens silently, and there are usually no symptoms until the first fracture occurs. In girls with the triad, estrogen is typically lower. Low estrogen accompanied with a poor diet, especially low calcium, can lead to osteoporosis. During the teen years, a lot of bone growth is supposed to happen and the peak bone mass should be reached. An athlete with the female athlete triad will have a hard time getting to her peak bone mass, and it can affect her greatly later in life.

Takeaway: Diagnosing and treatment

Girls who have female athlete triad are typically invested in their sports and would do almost anything to be the best athlete possible. Girls in particular sports have more of a risk than others. Sports with a weight class like wrestling, martial arts and rowing, and sports where being thin is more optimal for performing like gymnastics, diving, figure skating, cross country and ballet, have a higher risk. However, the truth is, being very thin, and losing those last few pounds, doesn’t typically improve performance at all.

If a female athlete is suspected to have the triad, a wide-ranging physical examination is needed for diagnosis. A doctor will likely ask questions about her period, diet, exercise habits and overall feelings about her body. From there, blood test will be ordered to check for vitamin deficiencies and to rule out any other reasons for a lack of period and weight loss. A doctor may also order a bone scan to check for osteoporosis, since the athlete will be at a higher risk for bone breaks.

Doctors will not work alone to help treat a girl with female athlete triad. Coaches, athletic trainers, parents, physical therapists, nutritionists and dietitians and mental health specialists all work together and play a role in the recovery of this athlete. They focus on both the physical and emotional issues that the girl is likely facing to help prevent long term issues.

References:

• https://kidshealth.org/en/teens/triad.html
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435916/
• https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/06/female-athlete-triad
• https://www.iofbonehealth.org/what-is-osteoporosis

By: Wyneisha Mason, MAT, ATC. ‘Neisha is an athletic trainer with RUSH Physical Therapy in Chicago, Illinois.

RUSH and KORT are part of the Select Medical Outpatient Division family of brands.

 

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.

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 KORT 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 

Posted on 7/8/2021

Select Medical, KORT'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 KORT, 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.

KORT 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 KORT 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.