Physical Therapy News

HOW TO TREAT AND PREVENT THE 3 MOST COMMON SPORTS INJURIES

Posted on: April 20th, 2018 by Jeremy Wehking

We all want to be healthier and may even want to challenge ourselves to be more active. Whether we are new to exercising, sports, or have been training for a while now, we need to be sure that we are taking care of our bodies and preventing injuries. Below are the 3 most common injuries and how to treat them:

1.Sprains

A sprain is a ligament injury that often occurs when sudden force is applied to a joint or to a bone that forms a joint. A minor sprain occurs when a ligament is stretched, and a serious sprain occurs when a ligament is completely ruptured, or torn. Sprains are very common in the ligaments of the ankle, knee, elbow, shoulder and thumb.

Minor sprains involve some pain, swelling and tenderness, which you usually can treat at home with rest, ice, compression and elevation. Most minor sprains begin to feel better within two days and fully resolve within one to two weeks.

2. Strain

A strain, sometimes called a “pulled” muscle, is a muscle tear often caused by sudden stretching or forceful contraction­, usually during a change of speed or direction. A minor strain involves minimal torn or damaged muscle fibers, and a severe strain is a complete rupture of the muscle.

Strains are very common in the hamstring, quadricep, calf, groin, rotator cuff and lower back muscles. Symptoms include pain when contracting or stretching the muscle, tenderness, swelling and bruising.

Most strains can be treated at home with rest, ice, compression and elevation and should begin to feel better within a few days of injury. You can return to your normal activities after the muscle strain feels better, and when the strained muscle regains the same flexibility and strength as the corresponding muscle on the other side of your body.

3. Overuse injuries

Overuse injuries are the result of repetitive stress on your tendons, bones and joints and can be caused by overtraining, imbalances between strength and flexibility, poor body alignment and incorrect technique. Examples of common overuse injuries include tendonitis, stress fractures, shin splints, bursitis and joint pain, especially in the knee or elbow.

Overuse injuries in adults are often caused by repeated performance of the same activities, such as running or cycling, with no variation.

Some overuse injuries respond to home treatment using  and over-the-counter anti-inflammatory medications.

Preventing Injuries

There are precautions we can take that will make injury less likely. Many injuries are a result of our bodies not being conditioned for the activity we are doing. One of the best ways to prevent sports injuries is to train properly for any athletic activity you’re going to perform. For example, adequately training for a marathon will dramatically decrease your chance for injury. Or, if you decide to take up a new fitness routine, such as CrossFit, start slowly and build up gradually.

You also should wear the appropriate, properly fitted equipment for your chosen activity. Adults should avoid performing the same activity repeatedly and alternate between strength-training and cardiovascular exercise. Children should avoid overspecializing in one sport by participating in a variety of activities. Children and adults also should get adequate rest between training sessions to avoid over exercising.

Remember that every workout should start with a warm up. Getting warmed up increases the blood flow to your muscles and gets you more flexible.

Finally, don’t forget to cool down. Take about ten minutes to slow down and stretch. This helps return your heart rate to normal and reduce soreness in muscles.

If you experience severe pain, swelling, bruising, immobility, or pain that doesn’t go away we highly advise you see your doctor or a local Physical Therapist as soon as possible.

We hope you enjoyed this article. Thank you for reading!

 

Ice or Heat For Sore Muscles?

Posted on: April 13th, 2018 by Jeremy Wehking

Regardless of how active or athletic you are, you have likely experienced muscle soreness, or an injury at one point or another.  The application of ice or heat is a great way to relieve sore muscles and treat pain, but which is best? Below are some tips to guide you to make the best decision and receive maximum benefit.

 Ice

Ice is usually recommended to use on an area that has inflammation. Ice is usually used as part of the initial treatment for sprains, strains and other injuries. We suggest using the application of real ice or a commercial substitute no more than 20 min per hour for the first 48 hours.  So if you are using ice for 20 min make sure you are off for at least 40 min.  

Safety Tip:

Be sure to cover the ice pack with a lightweight cloth so that it does not directly touch the skin. Putting the ice pack directly on the skin for longer periods of time or applying it too often could result in tissue damage, including frostbite!

 Heat

Heat is generally recommended for chronic aches and pains, or new and minor muscular pains. We recommend heat therapy for problems like a stiff neck or a sore back.  Heat is great for relaxing the muscles and can also help improve circulation and reduce muscle spasm. There are many ways to apply heat like heating pads, and reusable gel packs which provide dry heat or using steamed towels, or whirlpools which provide moist heat.

The type of heat treatment relies on professional recommendations and personal preferences. These treatments are generally used for anywhere from 15 minutes to two hours depending on your method of choice, but it is important to remember that warmth is key. Not too hot. Too much heat can harm skin and tissue.

 Safety Tip:

There are many benefits with heat therapy however, the application of heat could actually increase some inflammation issues so use heat therapy carefully. It is not usually recommended for people who have diabetes or peripheral vascular disease. When in doubt, get a professional opinion.

 Ultimately, we suggest you ice for new injuries and choose heat for chronic pain or minor sore muscles to feel better faster. For best results, combine rest, compression and elevation along with the cold/heat application and do this for two days. If the problem worsens or doesn’t show significant improvement in 48 hours, see a doctor or physical therapist.

Remember when in doubt, get a professional opinion.  

 

8 Common Causes of Back Pain and Easy Solutions

Posted on: April 5th, 2018 by Jeremy Wehking

Whether you’re a gym junkie, a mom, an athlete or have a regular 9 to 5 office job, chances are, you’ll eventually deal with back pain. There are many contributors to back pain and it is the simple, everyday activities you do without thinking such as brushing your teeth, sitting at the computer, washing dishes, and crawling into bed at night that can make or break your spine health. Most aches are caused by strains (injured muscles or tendons) or sprains (damage to the tough fibrous tissue, or ligaments, located where your vertebrae connect to joints). These injuries are typically brought on by over­use, a new activity, excessive lifting, or an accident. Other times, it’s due to a compressed (better known as pinched) nerve, such as in a herniated disk.

Here are the 8 leading causes of back pain:

  1. Spending too much time on gadgets.

On average, people spend over 9 hours a day hunched over or slouched in front of a screen. Research shows an increase in texting, and spending time on our smartphones and tablets is what’s creating more aches and pains in our shoulders, necks, and backs.

Solution:

It’s important to take breaks, do neck exercises, and occasionally hold your phone or tablet out in front of you.

  1. Having a desk job.

Sitting all day is hazardous. It puts more pressure on disks and vertebrae than standing or walking. Alleviate the tension with an office makeover. Start with a lumbar-support cushion and adjust your seat so your computer monitor is at eye level, your arms and knees are bent at a 90-degree angle, and your feet rest on the floor.

Solution:

Remember to take breaks at work. Even a 2-minute walk around the office every couple hours will help. 

  1. Ignoring your core.

When you hear the word core, you probably picture six-pack abs. But your core is composed of much more: Back, side, pelvic, and buttock muscles that all work together, along with your abs, to allow you to bend, twist, rotate, and stand upright. Your core is like a crane that supports all of your movements. A bad back is usually a sign of a weak core.

Solution:

Unlike crunches, which focus solely on abdominal muscles, core exercises lunges, squats, planks, and others strengthen several spine-supporting muscle groups at once.

  1. Sleeping on your stomach. 

Sleeping on your stomach places pressure on joints and muscles but sleeping on your side or back keeps your spine elongated and neutral. If you must snooze on your tummy, slide a thin pillow under your hips to alleviate pressure on disks, ligaments and muscles. Regardless of which way you prefer to sleep, go with a medium mattress, a pillow that keeps your head in line with your spine.  Shows that people with chronic low-back pain who sleep on medium mattresses had fewer aches after three months than those who slept on firm beds.

Solution:

Your bed should be not too hard (this wreaks havoc on hips and shoulders) and not too soft (this puts your back and joints out of whack). To make sure you get the right mattress, check the manufacturer’s scale of firmness and opt for the one in the middle range.

  1. Smoking cigarettes.

Cigarettes aren’t just terrible for your heart and lungs. Research shows that smokers have a higher incidence of recurring back problems than nonsmokers. The cause and effects of this are many. Nicotine restricts blood flow to vertebrae and disks, so they may age and break down more quickly. It may also interfere with the body’s ability to absorb and use calcium, leading to osteoporosis-related bone and back problems. You know what you have to do: Quit.

Solution:

Visit smokefree.gov to customize your own smoking cessation plan; start now!

  1. Being depressed.

Studies have shown that people with back pain are more likely to be depressed.  Research shows that people with major depression were four times as likely to develop disabling low-back and neck pain. Some scientists believe that poor coping skills related to depression, such as withdrawing or avoiding problems, may trigger the release of the stress hormone cortisol, causing back and shoulder muscles to tense up and spasm. The result can be a devastating cycle of chronic pain and depression.

Solution:

Mood enhancers like yoga and exercise, release endorphins, and can help ease stress and make you feel better.

  1. Fashion trends.

Sure, sky-high stilettos are a no-no, but it turns out that flats can cause trouble, too. Sandals and flip-flops often provide little, if any, arch support. Continuous wear can lead to back, knee, and foot problems down the line. But don’t worry, you don’t need to settle for all function and no flair. Alternate styles throughout the week from high to low, sneakers to sandals and avoid wearing a particular pair every day. Shoes should fit properly and offer good arch and heel support. If you walk to work, wear shock-absorbing sneakers, then slip on cuter shoes once you get to the office. Your purse could also be to blame, especially if it’s big and you have it over one shoulder. Try a tote with a wide, padded strap; carry it messenger style; and lighten the load.

Solution:

Keep a nice pair of shoes at work so you don’t have to carry them around with you all the time and be sure your purse weighs less than 10 percent of your body weight.

  1. Too much rest.

Lying down minimizes stress on the lumbar spine; however, staying sedentary for more than a day or two can actually prolong and worsen pain. Studies show pain sufferers who remained active recovered more quickly and felt less depressed than those who took it easy. Low-impact activities like walking and swimming boost blood flow to back muscles while relieving pain and stiffness. Yoga, with its emphasis on stretching and strengthening, may be one of the most effective spine soothers. After three months of weekly sessions, 60 percent of back-pain sufferers reported less discomfort, and 40 percent were able to get off pain meds.

Solution:

Get out of bed. If you must lie down, do so for a few hours and for no more than a couple of days. Light activity is best.

Acute back pain comes on suddenly but improves over time. Chronic pain worsens and can last several months. If you don’t feel better after a couple days, go see a good physical therapist in your area who specializes in back pain. Acupuncture, and exercise such as yoga, stretching, and strength training will also help.

Thanks for reading!

 

Should I Get a Steroid Shot?

Posted on: March 29th, 2018 by Jeremy Wehking

Steroid shots (also known as Cortisone shots) are injections that may help relieve pain and inflammation in a specific area of your body. They’re most commonly injected into joints such as your ankle, elbow, hip, knee, shoulder, spine and wrist. The injections usually comprise a corticosteroid medication and a local anesthetic.

We are not opposed to steroid shots, sometimes they are a good option, but they’re usually used to treat symptoms, not to heal them.  Steroid shots can have some side effects as well.  They’re not good for the health of the joint.  They can cause joint and cartilage damage, and can even lead to a tendon rupture.  Steroid shots will offer short term relief, but it wouldn’t be our best recommendation.

Here’s a common story we hear at the office:  Someone gets a steroid injection, it helps for a while, but the problem comes back.  Once the pain is back, they’ll get another steroid shot, but now it only helps for a day or two, until finally, the injection doesn’t help at all.  They start to get worried that there is nothing they can do about their pain and now their only option is surgery.

We’ve seen many patients with this very same story do extremely well with a good physical therapy treatment plan. They not only treat their symptoms and get relief, but they stay that way, and are no longer dependent on going back for more steroid injections. They no longer feel the pain and are back doing the things they enjoy most.

So how do you get a good physical therapy treatment plan?  First, find someone that specializes in your problem, whether it’s neck, back, knee, or a shoulder issue, and has a great track record treating problems like yours.

Be sure to find a well-trained Physical Therapist that will spend a good amount of one-on-one time with you, and not hand you off to a tech or assistant.

If you try this way, instead of taking a steroid shot you will have a much better chance at treating your pain, and you will be happy you did.

Chiropractic vs Physical Therapy

Posted on: February 26th, 2018 by Jeremy Wehking

 

If you’re suffering from acute or chronic back pain whether it’s been caused by an injury or some type of medical condition, chances are, you’re interested in finding relief as quickly as possible but you may be confused as to which kind of doctor you should you see, a Chiropractor or a Physical Therapist? Different types of doctors tend to approach their work in particular ways because of basic differences in their training and clinical experience. 

  This means that it’s worthwhile for a back pain patient to understand at least a little bit about how a clinician’s chosen discipline can influence his or her perspective and priorities when it comes to treatment.

Depending on the circumstances, your primary care doctor may recommend a chiropractor or a physical therapist. Some cases may also benefit from a multidisciplinary or integrated care approach that draws on the expertise of multiple specialists. Many people get confused about the differences between a chiropractor and a physical therapist. While the two are somewhat related in the conditions and injuries they treat, they are separate and distinct areas of treatment.

The most obvious difference between chiropractors and physical therapists is many chiro’s utilize some form of manipulation and adjustments to treat issues and injuries associated with the spine, whereas Physical Therapist utilize stretches, exercises, and hands on manual physical therapy to balance muscle issues, flexibility, range-of-motion problems and treat injuries not only associated with the spine but associated to the entire musculoskeletal system such as neck, jaw, shoulders, elbows, ribs, and knees. Physical therapists may also utilize joint mobilization as part of the treatment for the patient in front of them.

The biggest difference between chiropractic and physical therapy is that Physical Therapy is meant to help patients recover, and learn how to prevent injuries in the future. By contrast, often times chiropractic adjustments must be performed by a chiropractor again and again.

At Advanced Physical Therapy Specialists, our physical therapist Jeremy Wehking, has been treating patients with all kinds of injuries from chronic back pain to foot pain for the last 14 years.

We work very differently from most clinics where you have 5 patients squeezed into one time slot and are treated by aids and assistants, put on countless machines and barely get 10 minutes with the actual specialist.

At Advanced Physical Therapy Specialists, you’ll get a full hour of one on one, hands on manual physical therapy, and you will be treated with quality, personalized care.

We offer direct access to physical therapy, so you can set up an appointment even if you don’t have a prescription from your physician. We offer a free consultation with our Physical Therapist where he will evaluate and examine you to see what’s causing your pain. We then can let you know ahead of time exactly what your treatment plan will entail and allow you to decide if this is the best decision for your health without any commitment. Call (305)433-1172 or visit www.advancedpts.com now to schedule your free consultation. 

Postural Restoration Treatment Works

Posted on: December 18th, 2017 by Jeremy Wehking

We all know slouching doesn’t look very flattering but most of us find ourselves hoovered over our computers for hours at a time not knowing the damage we are causing. We’ve heard how important it is to have good posture a couple times before but do we really know why?  

Good posture entails distributing the force of gravity through our body so no one structure is over stressed. Good posture helps with the proper positioning of the spine and as a result leads to the proper functioning of internal organs.

Jeremy Wehking PT, FAAOMPT, OCS, PRC is a physical therapist in Miami FL who is certified by the Postural Restoration Institute who recognizes these imbalances with system disuse which develops because of dominant overuse caused by bad posture.  

This dominant overuse of one side of the body can develop from other systems unilateral overuse and cause harm to one’s body as a result. Jeremy uses PRI’s (Postural Restoration Institute) training to explore and explain the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles. Through his certification with PRI he uses innovative treatments that address the primary contributions of postural kinematic movement dysfunction.

The main goal of Posture Restoration is to help correct skeletal issues and heal back pain once and for all. Jeremy best describes this treatment as correcting the alignment and muscular imbalances in a very specific and personalized way.  The ideal patient for Postural Restoration treatment is anyone from the high level athlete to people who are completely inactive. Especially those who have severe back pain, a loss of flexibility or mobility. The Postural Restoration approach has proven an effective treatment plan for those who haven’t had success completely eliminating back pain in the past.  If you are taking painkillers or considering surgery we highly recommended to try Postural Restoration treatment first. You could be one of thousands of patients who have successfully healed their back pain for good with Postural Restoration treatment. Call us today to schedule an appointment (305)433-1172. 

Knee Pain

Posted on: August 3rd, 2016 by Jeremy Wehking

Knee Pain, A Few Things to Ask

I wanted to talk about patellofemoral syndrome. This is one of the common issues I see in the clinic.  It’s an issue that can cause pain along the front of your knee, often surrounding or underneath your knee cap.  There are lots of things that can cause pain in the knee; this is just one of the more common issues I run into.  Your knee cap is getting pulled just a little too far to the outside part of your leg, which causes increased stress around your knee cap. image of knee

The nice thing is that this is often times very treatable.  So let me tell you what you want your healthcare provider to be looking at, or at least considering.  These are usually things that will get overlooked.

First Thing To Ask About

First thing: pelvic alignment.  If your pelvis is tipped and rotated, even a little bit, your hip muscles won’t be able to fire as efficiently as you want them to.  This means you can be strengthening the snot out of your glut muscles, and still have an issue with knee pain.  L-AIC-picThe majority of these issues will have a pelvic component.  So you want your provider to start out with exercises that not only get your pelvis in a good position, but that will keep it that way.  Then it’s ok to work on glute and hip strength.

Second Thing To Ask About

The second thing to look for is how your femur (or thigh bone) and tibia (shin bone) are rotated.  There can be a few combinations here, but if you get that pelvis in a good position, the femur rotation will often be on a good path.  Your femur can be rotated slightly inwards or outward facing.  Same goes for your tibia, it can be rotated slightly in or out.  If this rotation is left unchecked it can continue to contribute to excess strain on and around your knee cap.

Third Thing To Ask About

Last thing to look at is the mechanics of the foot, specifically the mobility of the subtalar joint.  subtalar joint  This joint can be overlooked and if it is stiff will keep the foot locked up, and if the foot is locked up…you guessed it, increased strain on the knee.

This post is a little on the technical side, but if you have any questions about what can be done for your knee pain, shoot me an email at jeremy@advancedpts.com or give me a call at 720-357-4079.

You Don’t Know Sit

Posted on: July 14th, 2016 by Jeremy Wehking

I mean you don’t know how to sit.

In this video I talk about two quick and easy things you can do to sit in a better position to help avoid low back pain.  Nowadays we do a huge amount of sitting, whether it’s at work, at home, in the car.  We tend to sit a lot.  More than we were designed to sit.

Posture Can Contribute to Low Back Pain

This unfortunately can often cause some discomfort and tightness, in the spine.  I wouldn’t expect this to fix all back problems, and I would recommend you get checked out by your physician or physical therapist if you’re having a back issue, but these can be some nice habits to get into.

If you sat five minutes out of your day, you could sit on your head and it probably wouldn’t matter.  But the combination of sitting at work, on the commute to work, and when you get home to watch Netflix, can really add up to a lot of sitting.

 

 

(wow, that is some great smile)

The first tip is easy: Get up.  So if you have an option for a standing desk…great.  I like the ones you can easily switch from sitting in a chair, not a stool, to a standing position.  And in most cases I wouldn’t want people to spend all day standing either.  But the option to switch back and forth is ideal.  If you’re not one of the lucky ones and don’t have a standing desk (you might want to ask yourself what you did to piss off your boss so bad that they don’t want to get you a standing desk) it will be ok.  You can still get up and take a lap around your desk every 20 minutes.  It will seem strange at first, and may be difficult to get into the habit in the beginning.  I recommend setting an alarm on your phone to remind you to get up.

The second tip is almost as easy, and involves a pillow.  You can use a pillow from home, or if you prefer a more professional look you can get some online.  I recommend that the pillow is relatively thin and not too big and bulky.  The one I like is about $20.  Start out with the pillow just below your shoulder blades.  This way your back is supported.   Feel free to move the pillow up or down a little, but it shouldn’t be right behind your low back in the majority of cases.painful-sitting-350x241

Figuring out ways to decrease the strain on your neck and back when at work can make a really big difference, and sometimes something simple can help.  If you have any questions shoot me an email at jeremy@advancedpts.com or give me a call at 720-357-4079.

TMJ Presentation for Dental Study Group

Posted on: February 11th, 2016 by Jeremy Wehking

IMG_5079

I have to admit I was a little nervous.  I was presenting to a group of really great occlusally minded dentists.  This was for the International Partnership for the Study of Occlusion (IPSO) study group.  These people are awesome, they really know their stuff.  I was excited to talk to them about my approach to TMD (temporomandibular disorder) patients, and how physical therapy can help.  They were really welcoming and I enjoyed presenting.

It can be difficult treating complex patients, especially when there is a need for good communication between professions.  It’s common for patients with craniofacial pain and TMJ issues to need help from multiple professions, and this can be helped with good communication.  These patients have usually been through the ringer and have looked high and low for help.  That’s why they are some of the most rewarding patients to work with.

IMG_5084

I have found it extremely helpful to pull from multiple schools of thought when it comes to helping out on the physical therapy side of things.  It is really amazing how much one part of the body can, and often times does, influence another part of the body.  That’s why I was really honored to be presenting to this great group of dentists.  They treat folks like this on a regular basis and I was pleased to be presenting to them.

What if you really could live with much less back pain?

Posted on: December 2nd, 2015 by Jeremy Wehking

Are you tired of the pain in your back?  Have you been trying to ignore your pain and hoping it goes away?  Have you just become accustomed to always having back pain, and decided that it is something you just have to deal with?

older woman

So many of my patients who started out just like you are now pain free and back to their old life.  I love it when a patient comes in and tells me something along the lines of:  “you know my wife noticed I’m walking better, and I don’t complain about my back anymore”, or “my husband just told me I’m back to my old self.”

I don’t think we realize what a strain (no pun intended) chronic back pain can put on not only ourselves but those around us.  Often times we think of only the physical strain, but not the emotional impact it can have on our lives.  What would it be like to be able to get back to playing with the grandkids, or going to Pilates class without that nagging pain, or avoid that next injection or injections all together?

Most people think they have no choice but to suffer with back pain.  Which can lead down a bad path, not only are you having to deal with pain in your back, but it can and often times does become worse, or more frequent, or lasts longer.

I had a patient who had been suffering with pain for the last 20 yrs.  Here is what she had to say about her treatment:

“I’ve been to dozens of health care providers including 5 other Physical Therapists. I feel so extremely fortunate and grateful that a pain specialist sent me to Jeremy. After all these years he is the first one to successfully treat me. My pain has been cut in half and it’s only been a short time. I can move much better and more easily and have so much less pain, I can enjoy my life again! Jeremy has listened carefully and created a path for healing specific to my problems. The exercises he has given me me to do are very subtle and easy to do, the results have been nothing less than remarkable, and my prognosis is good. Jeremy is always positive, upbeat and happy and that along with his gentle and kind manner make it a great experience. Thank you Jeremy!”

This is a great example of why I started the practice.  I want to help people just like you, give you another option besides injections, pills, or surgery.  That’s why I created the discovery visit.  The discovery visit is in your best interest, it is absolutely free, no risk, it allows us to have a conversation.  We can discover what is going wrong with your back, you can discover more about physical therapy and you get a chance to make a better, more educated, more informed decision about your health.

Here’s what I want you to do next.  Call 720-357-4079 or shoot me an email at jeremy@advancedpts.com today to inquire about your free discovery visit.  Let’s get you back to your old self again.

Take Care,

Jeremy Wehking PT, FAAOMPT, OCS, PRC

Fellow-American Academy of Orthopaedic Manual Physical Therapists

Board Certified Orthopaedic Clinical Specialist

Postural Restoration Certified