Farnsworth Orthopedic Physical Therapy

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Hamstrings

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Why are hamstrings important?

The hamstring muscles are a group of three muscles that sit in the back side of your upper leg, or thigh. These muscles often have limitations, either in mobility or strength. This can alter normal biomechanics during your regular daily activity or sports related activity. Some common hamstring injuries include a tear or strain of the muscle or tendon. Your hamstring muscles are also essential in low back health as you age. They are muscles that will constantly need work. They also assist in extension of your hip as well as flexion of the knee.

Issues

The attachment point of the hamstring muscles is the ischial tuberosity, which is part of your pelvis.  Tension is quite common in your hamstrings. This leads to a pulling in your pelvis. This will case a pelvic tilt and consequently, a flat back posture, which affects the normal curvature of your spine. We find this most commonly in the elderly. This can lead to weakness of the lumbar spine when your muscles are not able to contract properly and can lead to further back injuries. Stretching will improve the mobility of your hamstring muscles.  This also decreases the potential for further injury in your low back or legs.

Another common issue for your hamstring includes a muscle imbalance, in which there is a decreased strength of the hamstrings or an increased strength of the quadricep muscles. Research shows that quadricep muscles are often more powerful than the hamstrings. The hamstrings seem to fatigue quicker than the quadriceps. This can often lead to a muscle strain and occurs most commonly in the athletic population. Strengthening the hamstring muscles will help create a 1:1 ratio of strength in these muscles and decrease a risk for injury.

Come in and see us.

There are plenty of issues that occur in the hamstring which can lead to serious injury. It is important to assess the hamstrings and determine if flexibility or strengthening is better for you and to proscribe an appropriate exercise program. If you are experiencing any of these issues or feel that you could benefit from our services, please contact us.

Casey Badder PT

Clavicle Injuries

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Better Know Your Clavicle

The clavicle is the medical term for your collarbone. On one end, the collarbone attaches to the top of your sternum (the “breastbone”). The other end attaches to a bone of the shoulder blade. The clavicle provides considerable support for the shoulder. In fact, the clavicle is the only direct bony attachment that your shoulder has to the rest of your skeleton. The clavicle attaches to the sternum and shoulder blade by ligaments (strong fibrous bands of tissue). It has very few muscles to help contribute to the support.

 

Injuries

Clavicle injuries usually happen because of a trauma such as a car accident. They can also happen when you fall on your shoulder or outstretched arm. The result is either a broken clavicle or a ligament tear.

When a clavicle gets inured, you will feel pain at your shoulder blade attachments or at your sternum. Your shoulder may also have what is known as a “drop off.” This means your shoulder is lower than the other shoulder and has a noticeable step off rather than a rounded appearance. The pain may increase as your shoulder is lifted, especially when lifting over your head.

This clavicle here is broken very badly.  Ouch!

Treatment

In either case, the first treatment is to brace and support the shoulder for a period of time to allow the fracture or the ligament injury to heal. In severe or complete fractures, a doctor will need to set your fracture. The amount of time of immobilization depends on your physician’s opinion and the degree of the injury. In severe injuries, you may need surgery.

After a period of immobilization, you’ll need a more active rehabilitation program. Avoid lifting objects with your injured-side arm. Also, you will need to avoid carrying items such as purses or backpacks. At first, modalities such as ice, ultrasound or anti-inflammatory procedures may be used to help decrease the pain and reduce inflammation. Gentle range-of-motion exercises are helpful, usually in the lower ranges, avoiding overhead activity. As your range improves and your pain is reduced, the exercise program transitions to a strength program with range-of-motion overhead exercises.

Decreasing your pain level is key.

Patience Is a Virtue

Clavicle injuries may be difficult and painful to rehabilitate, depending on the severity of the injury and ligaments injured. Ligaments can be slow to heal, so rehabilitation may be slow and relatively long. It is important to have patience and not become frustrated during this time. In most cases the outcome is good. Consult your doctor or health professional for the details of your injury.

Written by Travis Rohner PT

Labrum Issues

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The Labrum

The labrum is a cup-like structure in the shoulder that reinforces the socket portion of the ball-and-socket joint. The joint in the shoulder is rather shallow. This causes it to rely on the labrum as well as the surrounding rotator cuff muscles. It is composed of fibrocartilage which doesn’t easily regenerate on its own.. Damage to the labrum occurs from repetitive stress to the area. An injury to the bicep which attaches to this part of the shoulder, as well as dislocations to the shoulder joint can cause damage as well.

Tears

A labral tear is most commonly seen in overhead athletes. These are athletes such as volleyball or baseball players, or to those who have repetitive dislocations of the shoulder. A SLAP tear happens when you tear the upper part of your labrum from forward to back. This high energy, quick movement  can cause this to happen as it puts unwarranted stress on your bicep and labrum. A Bankart tear happens when there are recurrent dislocations of the shoulder joint. This can tear the lower portion of your labrum. This causes shoulder instability over time, which causes the shoulder to dislocate multiple times.

Symptoms

Symptoms of a labral issue include shoulder instability and weakness. You may also experience pain in the shoulder joint. Other symptoms can include grinding, clicking, or catching when you move your shoulder. Depending on the severity of the injury, you may need surgery to help correct it. As mentioned before, there is little to no regeneration of this part on its own. However, physical therapy and cortisone injections will help restore the mobility and strength. If physical therapy fails or if the initial injury is severe enough, surgery may be warranted to correct the torn labrum. This surgery can include arthroscopic cleaning of the joint, removing the torn areas, and/or relocating the bicep to prevent further stress to the area. The surgeon will determine that based on the patient situation and injury severity.

Treatment

Physical therapy is an integral part of rehabilitation of a labrum injury. This is true whether surgery is needed or not. If you have had a sports related injury, multiple shoulder dislocations or any of the symptoms above, please do not hesitate to contact our office for further evaluation.

 

Written by: Casey Badder PT

Sever’s Disease

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Sever’s Disease

Sever’s disease is a painful condition that can happen to children as they grow. It happens when the tendon that attaches to the back of the heel (your Achilles) pulls on the growth plate of the bone of the heel. The stress over and over again on the growth plate causes pain and inflammation.

It happens most often to physically active children between the ages of 8 and 14. This pain is often made worse by lots of physical activity or when the Achilles tendons are tight. Pain can also be worse during a growth spurt, when the bones grow faster than the tendons. This increases how much the tendon pulls on the heel.  While it is painful, Sever’s disease is not a serious condition. It doesn’t cause long term damage or arthritis and often resolves once the growth plates close.

How do I know if my child has it?

The following are some signs that your child may have Sever’s disease:

  • Heel pain in one or both heels, which often comes and goes
  • Pain that gets worse when doing activities activities, especially with new or strenuous activities
  • Pain may cause limping or walking on toes to avoid putting pressure on the heels
  • Pain that is worsened by running or jumping
  • Pain with pressing on the back of the heel
  • Pain is worse upon waking

What helps Treat it?

Ice: Ice their heel for 15 to 20 minutes when the have pain or after activities. Remember not to put the ice directly on skin. Use a towel or other cloth between the ice and their skin.

Rest: Rest from physical activities, especially running and jumping, while having pain. Take rest breaks between activities.

Shoes: Always have your child wear a well-cushioned pair of supportive shoes. Don’t allow them to walk around in bare feet. In some cases, special gel inserts for the shoe called heel cups may help.

Pain Relief: Anti-inflammatory medicines, such as ibuprofen can be used as needed for pain and swelling. Be sure to read the directions on the bottle in order to give the correct dosage for your child’s height and weight.

Stretching: Stretching their calf muscles can help loosen tight Achilles tendons and help decrease the pull of the tendons on the growth plates.

Road to Recovery

In most cases, Sever’s disease goes away on its own. The important thing is to make sure your child gets rest, treatment, and time to heal. Symptoms might get worse if your child tries to play through the pain.  Your child can gradually increase the amount of activities they do when they don’t have symptoms. Remember, this is a disease that can come and go.  Sever’s disease usually goes away completely when their growth plates close.

Written by Travis Rohner PT

That’s a Stretch

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Stretch Yourself

When life gets crazy, it’s easy to forget to take care of ourselves.  Setting aside a few moments to do something to better your health and the way you feel can make a big impact on your day.  One quick and simple thing you can do for your health is stretch. There are many effective stretches that target certain muscle groups and issues.  Below you’ll find a couple common stretches that you can do daily that target muscles that often get overworked and strained in our day to day lives.

Neck

First on the stretch list is the neck.  Let’s face it, you probably do things throughout your day that are not very kind to your neck. Whether it’s hunching over your phone, cleaning up after the kids, or straining over your work computer, your neck puts up with a lot.   Give your neck a stretch by tilting one ear towards your shoulder while standing upright.  Once you’ve stretched you neck as far as feels comfortable, open your hand on the side you’re tilting away from, turning your palm outward.  This allows your neck to stretch a little bit further.

Calf

Next, is a calf.  For those of us who spend a lot of time on our feet this stretch can be a lifesaver.  Sore feet are caused in part by tight calf muscles.  And for those who may suffer from plantar fasciitis this stretch can be especially helpful.  You’re going to need one extra item: a towel.  Place your heel on a soft but stable surface like a rug or yoga mat. Roll up a towel and place the ball of your foot on it. Step forward with the other foot. Do this with your knee straight instead of bent.  Hold it for a good half a minute and then switch to your other foot.

Give yourself a few minutes to stretch.  You’ll feel better.

Written by Tom Farnsworth PT

Little League Elbow

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As a state, Arizona is beginning to see a decrease in numbers of people who are diagnosed with the Corona Virus. There are beginning to be less restrictions and people are cautiously returning to activities. One activity my children participate in is youth baseball. They are between the age of 10 and 13, and children in these ages are normally pretty healthy. There have been several instances that have come up with my children’s friends and teammates which can be extremely painful and reduce their ability to participate in athletics. These are problems in the growth plate. I have witnessed this mostly in one body part: the elbow.

What is it?

The issue at the elbow almost exclusively occurs due to the repetitive action of throwing. This is why this is commonly called Little Leaguer’s Elbow. The medical term for this is Medial Epophysitis. This is basically an irritation on the inside of your elbow joint caused by repetitive motions. Excessive throwing causes a lot of stress on the inside part of the elbow which can be sometimes too much for growing bones and muscles. In extreme cases, part of the bone can actually break off. This typically happens in youth athletes between the ages of 8-17, when bone and muscle growth is most likely to occur.

Does my kid have it?

Typically, there is no specific incident that leads to this injury, but there can be. Usually, the young athlete will begin feeling pain on the inside of the throwing elbow where the bump is. This is where several muscles attach. The pain will worsen with the activity and if it gets bad enough, they will not be able to throw anymore. It will be fairly tender to the touch and you may notice swelling.  Pain when extending their elbow or wrist flexion is also a common occurrence.

What do we do about it?

If you notice your child has this, there are two things to immediately do.

  1. STOP THROWING!!! With repetitive stress injuries, the very first thing is to stop doing what is causing the pain. In this case, throwing. It is very important to not push through and play with this injury as it can lead to a much more serious condition.
  2. ICE: Ice at the initial stages can reduce swelling and irritation.

With all injuries that deal with soft tissues (muscle, tendon, ligament) there are several stretches and exercises which can be done. Almost always, the muscles on the palm side of your athlete’s forearm will be very stiff, and most times weak. These muscles should be stretched lightly and strengthened. The two stretches which are important are these:

With your elbow extended, gently extend your wrist to where you feel a gentle stretch on the palm side of your forearm. Hold for about 30 seconds and repeat 3 times.

Now, do the exact opposite. Hold for the same amount of time about 3 times.

Strengthening the forearm, wrist, and shoulder muscles of your throwing arm is extremely important. These should be prescribed specifically for the individual athlete.

How long does it take to heal?

The answer to this question really depends on the severity. It can be anywhere from a few weeks, to 1-3 months.  Coaches and leagues take special care with pitch counts depending on ages and this is an excellent thing to do, however any position player who throws often can be at risk. If you want to prevent this, a doctor or a physical therapist can identify the most important activities to do in order to prevent.

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730 N. Greenfield Rd.
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Phone: (480) 633-0666

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Mesa, AZ 85213
Phone: (480) 325-3310