Julie

Labrum Issues

December 7, 2020 by Julie

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

November 1, 2020 by Julie

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

Osteoporosis: The Silent Disease

October 11, 2020 by Julie

Osteoporosis is a bone disease characterized by a decrease in bone tissue. Low bone mass leads to fragile bones. It also increases your risk of fractures, especially your spine, hips, and wrists. While there is no cure for osteoporosis, it is largely preventable in most people. There are many treatment options available for those affected.

Who gets it?

This condition is most common in older women. Women who experience early menopause or have their ovaries removed before age 45 and don’t undergo hormone therapy are more likely to develop osteoporosis. Cigarette smoking, excessive alcohol, and caffeine intake contribute to the problem. So do problems with calcium absorption in the intestines. There are also some drug treatments that can induce osteoporosis.

The Silent Disease

Osteoporosis is sometimes called the “silent disease”. This is because there are so few symptoms in the beginning associated with bone loss. Many people do not even know they have osteoporosis until they start getting broken bones. In severe cases of osteoporosis, symptoms include aching pain in your bones, especially in your spine. Fractures can occur without any trauma at all. The pain can be severe. But usually you don’t have the radiating pain into your arms or legs as you would with other back conditions. After repeated crush fractures in your spine, you may develop an excessive curvature in your neck or increased mid back forward bending. Hip and wrist fractures are common, especially when associated with minor falls.

Bone density testing and X-rays are the main ways to detect osteoporosis. Your doctor can order them for you.

Treatment

Treatment of osteoporosis includes the following preventive measures:

Exercise – Daily weight-bearing and resistance training exercise helps reduce bone loss. It also helps you maintain good muscle tone. Walking, jogging, hiking, tennis, yoga and strength training are good-weight bearing exercises.

Nutrition – Calcium and vitamin D are needed for healthy bones. Most adults require 1000-1500 mg of calcium and 600 units of vitamin D per day. You should, however, ask your doctor to determine the right amounts for you.

Avoid tobacco, alcohol, excessive protein, and caffeine. All of these increase your risk of developing osteoporosis. Protein is an important part of your diet and is vital for good health, but taking in high amounts of protein can cause your body to lose calcium. Caffeine in large amounts can make it hard for your body to retain calcium. Do not use tobacco. Limit your alcohol and caffeine intake.

Medication – Hormone therapy and medications developed specifically to slow bone loss may be prescribed by your doctor.

Written by Clint Bunker PT

That’s a Stretch

October 8, 2020 by Julie

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

Knee Time

September 22, 2020 by Julie

Back to Sports

The sports world is beginning to return following the pandemic. But, athletes in all sports are finding that they are not in playing shape. After taking several months off, getting back into shape has been more of a challenge than expected. Unfortunately, this has led to several injuries. The knee is one of the most injured body parts not only for professional athletes, but the weekend warriors as well.

Knee Trouble

The meniscus in the knee is a cartilage space that sits between your shin bone, or tibia, and your femur. The meniscus is C shaped and redistributes forces between the two bones. It does this when you are walking, running, or doing other sports related activity. People injure their meniscus when bearing weight and rotating, or twisting. This can lead to swelling and stiffness in your joint. People often complain about a clicking in their knee, as well as the inability to fully extend their knee. A lack of strength and stability in your knee is also common. There are different types of tears, however an X-ray and MRI are most effective to see what the issues are.

Treatment

Treating a torn meniscus depends on the location of the tear as well as the severity or size of the tear. Often, treatment is effective and include cortisone injection and physical therapy to help restore range of motion and strength. If it’s serious enough, you will need arthroscopic surgery, in which the torn area of the meniscus is removed. After the surgery, physical therapy is required to help restore the motion and strength so you can return to normal activity.

Therapy for a torn meniscus focuses on the range of motion, or straightening of your knee. This often limits your motion. This is motion you need for all activities including walking and running for sports related activity and everyday life. Physical therapy will also focus on strengthening and stability of your quadricep muscle as well as stability of your hip and ankle as well. Over time, moving into sports related activity will happen to help you make a safe transition back to on field activity. A meniscus will heal in 6-12 weeks depending on the severity and whether or not you need surgery.

Written by Casey Badder PT

Little League Elbow

September 8, 2020 by Julie

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.

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.
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.

Labrum Issues

The Labrum

Tears

Symptoms

Treatment