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We use our Instagram account to post instructional videos and tutorials on physical therapy and sports performance techniques. Follow us for tips and tricks and learn how you can jump start your recovery.
Prepping for PhysioFit Monday. Modified group training starts following our COVID-19 protocol. The safety of our clients and patients will ALWAYS COME FIRST!! Let’s do this. @n2_health_fitness @nicknate1763 #physioprofamily #circuittraining #beatcoronavirus👊👊👊
This is a great example of patience, persistence and compliance in one of our triathletes. This patient presented with bilateral lateral patella hypercompression syndrome and severe pain in the patellofemoral joint with cycling and running. They had been to several other PT facilities and had not improved. After evaluation, we found minimal strength and motor control deficits needing work. They had great core/pelvic control as well as hip strength. They did present with a hypertonic TFL and severe limitation in rectus femoris mobility and an extremely tight lateral retinaculum. We focused on TFL tone reduction with manual therapy and rectus femoris stretching as well as aggressive patellofemoral glides for medial glide and tilt. In addition we serially taped their patella in a medial tilt over the course of an 8 week period. Not only did their symptoms improve and resumed pain-free training, their repeat sunrise x-ray showed a substantial change in space of the lateral patella facet with its articulation on the throchlea. Pretty cool considering that they were considering a lateral release if this failed.
#kneerehabilitation #kneerehab #patellofemoralsyndrome #physiotherapy #physicaltherapy#athletictraining #physioprofamily #physiotherapy #sportsmedicine #athletictrainer #strengthtraining #strengthandconditioning #strength #conditioning #rehab #athletes #sportsmedicine
BIG BFR BURN TODAY!!! This guys always grinding! Here are a few of the fun ones from today’s session with @trevorbaptiste9 #premierlacrosseleague #atlaslacrosse #lacrossetraining #lacrosse #thatsspeedboi #physiotherapy #physicaltherapy #bloodflowrestrictiontherapy #athletictraining @trxtraining @b_strong_bands @bstrongtraining @pllatlas @pllbeans @pll @natelilleypt
Blood flow restriction training is not just for sports performance. It is a very safe and effective tool to use with the rehabilitation of injuries in a physical therapy setting. @maura_singer is demonstrating this as she begins the long road to get back on the court for @cubuffswbb She is crushing the early stages of her knee rehab rocking the tourniquets!! This makes her quad control work much more fun and difficult. Simple, low-load exercise produces profound muscle “burn” comparable to intense anaerobic training. This strong fatigue triggers the body to release hormones such as human growth hormone (HGH), which in turn produces hypertrophy and strength gains comparable with heavy exercise or traditional weight lifting. The hormones circulating in the blood stream benefit all areas of the body that were working creating a systemic benefit.
Many times patients be limited for several weeks due to restricted motion, muscle suppression, or their weight bearing status. During this time traditional early phase strengthening programs will often plateau with their effectiveness during this phase. By adding BFR to the early stages of rehab we can get the same effect as heavy high load weight lifting without stressing healing structures. All good!!!
Nice work Maura!!!
#physiotherapy
#physicaltherapy #ACLrehab #kneerehab #bloodflowrestrictiontherapy #athletictraining #kneerehab #womansbasketball @cubuffswbb @bstrongtraining
Awesome video depicting how the patella bone itself increases the extensor mechanisms strength. This is pure physics in motion!!! This joint is made to compress and articulate by nature. It’s not a fluke that it has some of the thickest articular cartilage in the body. The patellofemoral joint can be tricky though. It needs a balance of tracking, mobility and strength to keep this joint in optimal condition. We can help you figure this out!! #Repost @rehabscience with @make_repost
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💥𝐊𝐧𝐞𝐞𝐜𝐚𝐩 𝐅𝐮𝐧𝐜𝐭𝐢𝐨𝐧💥
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📚The patella (kneecap) serves a very important function - It makes your quadriceps muscles more effective due to its important function as a sesamoid bone. In fact, the patella makes the quads approximately 30% more powerful!
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🔎The tendon of the quadriceps muscles crosses over the knee joint, attaching on the leg just under the front of the knee. When the muscle contracts, it rotates the knee into extension by pulling up on the lower leg.
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🧠Because the patella lies between the tendon and knee, it positions the tendon farther away from the point of rotation. This distance imparts a major mechanical advantage (the farther away from the center of rotation, the less force/effort needed to lift).
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✅Pain associated with the joint behind the patella (patellofemoral joint) is quite common and can often be successfully treated with hip and knee training and a bit of behavior modification. If you pain in this region, make sure to checkout my ‘kneecap pain’ posts at the hashtag below.
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#rehabscienceknee
He’s finally back from philly for another blood flow restriction training session. Great to have @trevorbaptiste9 back in Denver. Hard push to put in that work for next months PLL Championship Series. July 25-August 9th. Trevor......you are a BFR BEAST!!! #premierlacrosseleague #atlaslacrosse #lacrossetraining #lacrosse #thatsspeedboi #physiotherapy #physicaltherapy #bloodflowrestrictiontherapy #athletictraining @trxtraining @b_strong_bands @bstrongtraining @pllatlas @pllbeans
Another great post regarding the conservative management of lumbar disc herniations. Surgery should be the last option unless progressive neurological signs are present. #Repost @rehabscience with @make_repost
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💥𝐃𝐢𝐬𝐜 𝐇𝐞𝐚𝐥𝐢𝐧𝐠💥
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🧠One of the issues I get the most questions on is low back pain, especially disc herniations. While there is a lot that goes into this question, two things I usually mention are that disc herniations are common in much of the asymptomatic population and that they can heal with time and conservative treatment.
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🔎The following is a case report from the New England Journal of Medicine that documents the resolution of a lumbar herniation without surgery.
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✅IMPORTANT: The details of this individual’s rehab were not given in the case study, but it is important to know that relatively simple programs that include movements like walking, general low back mobility drills and low load resistance training exercises help the majority of people. You can find my low back exercise posts under my hashtag: #rehabsciencespine
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📕Case Study: A 29-year-old woman presented to the spine clinic with new-onset pain in her right leg, accompanied by paresthesia. MRI of the lumbar spine revealed a lumbar disc herniation resulting in substantial spinal stenosis and nerve-root compression (first image).
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📗She elected conservative treatment with physical therapy and an epidural injection of glucocorticoids. A second MRI obtained at follow-up 5 months after presentation showed resolution of the herniation (second image). Her clinical symptoms resolved, and she was discharged from the clinic, with follow-up recommended as needed.
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📘Data from clinical trials suggest that patients who have herniated lumbar discs have similar long-term outcomes whether they undergo surgery or elect conservative management. In addition, the risk of subsequent catastrophic worsening without surgery is minimal.
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📚Reference: Hong J and Ball PA. Resolution of Lumbar Disk Herniation without Surgery. N Engl J Med. 2016.
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#rehabscience
#Repost @natelilleypt with @make_repost
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REHABBING THE THROWING ATHLETE: This is another post focusing on conditioning for the rotator cuff and periscapular musculature for endurance in the overhead athlete. Building resiliency, synergy and endurance of these muscles are imperative for injury prevention.
The ROW->ER->OVERHEAD PRESS is a Physio Pro favorite in late rehab. The combination of early scapular recruitment/posterior cuff engagement with the overhead press is a complex and dynamic movement that packs a big punch. The 90/90 ER (Fast) and 90/90 IR (Fast) are great additions to build cuff endurance. Light resistance is all that is necessary and we usually start with 20-30 second bouts. A shoulder horn is a great tool to begin 90/90 rotator cuff strengthening as it eliminates an over dominant deltoid that is often present. We highly recommend them. ****This video was shot pre COVID-19 hence no masks in clinic!!!**** #physioprofamily #physicaltherapy #physiotherapy #sportsmedicine #athletictrainer #strengthtraining #strengthandconditioning #strength #conditioning #rehab #athletes #sportsmedicine #shoulderrehab #armcareprogram #baseballrehab #rotatorcuff #rotatorcuffstrengthening #shoulderhorn
TREATMENT OF THE STIFF SHOULDER: The following diagram depicts the capsuloligamentous restraints of the glenohumeral joint. Adhesions will form in response to trauma, surgery, or inflammation. Depending on where the adhesions form, you will see a relative loss of motion in the corresponding plane. This knowledge is very important when treating patients. This can help you formulate a maximally beneficial stretching program and direct your joint mobilization direction with these patients. Knowing where to stretch to the most effective means of regaining normal range of motion and capsular mobility. The diagram is color coded. Here are the specific zones surrounding the joint and what motions will be limited if adhesions are present within each zone.
GREEN: Limited early range Flexion, Abduction, Extension and ER @ 0 degrees of Abduction
BLUE: Limited External Rotation @ 45 degrees of Abduction
PINK: Limited External Rotation @ 90 degrees of Abduction
RED: Limited End Range Elevation and Flexion
YELLOW: Limited Internal Rotation @ 90 degree of Abduction
ORANGE: Limited Internal Rotation @ 0 and 45 degrees of Abduction
#shoulderrehab #jointmobilization #jointmobility #shoulderrangeofmotion #physiotherapy #physicaltherapy #glenoh #glenohumeral #glenohumeraljoint #denverphysicaltherapist #physioprophysicaltherapy #sportsmedicine #athletictraining #frozenshoulder #physiotherapy #physioprofamily #assessdontguess
REHABBING THE THROWING ATHLETE: This is another post focusing on eccentric control/conditioning for the posterior rotator cuff.
The arm deceleration phase begins at ball release and ends at maximum shoulder internal rotation. This phase puts the highest stain on the shoulder. This phase requires decelerating the forward progression of the arm through eccentric control of the posterior rotator cuff. Due to the high forces generated in this phase, the posterior muscles are highly susceptible to tensile overload, articular sided cuff tears, Long head of the bicep/labrum pathologies as well as internal impingement. Building resiliency to these loads are imperative for injury prevention.
The PRONE ER CATCH and ECCENTRIC SCAPTION exercises eare great additions to a throwers arm care program.
****This video was shot pre COVID-19 hence no masks in clinic!!! We miss those days.
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TREATMENT OF THE STIFF SHOULDER: Adhesive Capsulitis or a frozen shoulder can be difficult to manage. In these cases, adhesions form around the capsule and can form contractures that severely limit the accessory glides and overall mobility of the shoulder. Joint contractures resulting in shortening of the capsular or periarticular tissues occur from structural damage to the joint caused by trauma, inflammation, surgery or prolonged immobilization.
One method used to reduce contractures is low-load long duration stretching (LLLD). This requires the use of an apparatus that holds the joint in a position of stretch for a given duration. This form of stretching is done briefly at the start of treatment and for progressively longer periods as the treatment advances.
@physiopro we like to position the shoulder at 90 degrees of abduction and put the shoulder at the end range of external rotation. A fixed rope attached to a solid anchor holds this position in place. This puts maximal stress on the anterior/inferior capsule which is the most common site for capsular adhesions to form. At the same time we like to use moist heat in the axilla to help the patient relax and to promote tissue creep. We start with the stretch for 3 minutes and progress up to 10 minutes. We follow the LLLD with joint mobilization and passive ROM to end range. We have had great results with this intervention. Your apparatus should be a fixed rope or a belt. Tubing or theraband will not work as they will increase the tone of the shoulder. Give this a try if you have a stiff and stubborn shoulder you are managing. #frozenshoulder #stiffshoulder #jointmobility #shoulderrecovery #shoulderrehab #shoulderphysio #shoulderrehabilitation #physiotherapy #physio #athletictraining #sportsrehab #sportsrehabilitation #lowloadlongduration #physicaltherapy #physicaltherapy
This is an awesome video depicting the huge footprint the subscapularis has on the humerus. It’s ability to internally rotate and depress the humeral head is amazing. No wonder it’s tough to balance with the Infraspinatus and Teres minor. That coupled with the Pec Minor and Latissimus Dori adding IR strength and humeral head depression makes us think to check their mobility and balance with the posterior cuff first before conditioning this hyper dominant complex. #Repost @ericcressey with @make_repost
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Here's a cool visual of the subscapularis, the largest of the rotator cuff muscles. In this video, you'll see its ability to internally rotate the humerus. More importantly, though, you have to appreciate what isn't seen here: the pectoralis major and latissimus dorsi muscles. You see, these powerful internal rotators (and others) attach further down on the humerus, which means that they don't have any direct control over the head of the humerus as they create that internal rotation, whether it's in a throwing motion, dumbbell bench press, or some other IR movement. The subscapularis absolutely has to be the largest of the rotator cuff muscles because it has to "keep up with" the largest muscles of the upper body to maintain keep the humeral head (ball) centered on the glenoid fossa (socket) during internal rotation. If it doesn't do its job, the humeral head glides can glide forward and irritate the structures at the anterior aspect of the joint: long head of the biceps tendon, glenohumeral ligaments, nerve/vascular structures, etc.
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This is a perfect illustration of arthrokinematics (subtle motions at joint surfaces: rolling, rocking, gliding) vs. osteokinematics (larger movements between bones: flexion/extension, abduction/adduction, ER/IR). Every gross movement of the body relies heavily on a finely tuned interaction between these two kinds of movement - and you'd be hard pressed to find a better example than subscapularis.
REHABBING THE THROWING ATHLETE: This is another post focusing on eccentric control/conditioning for the posterior rotator cuff.
The arm deceleration phase begins at ball release and ends at maximum shoulder internal rotation. This phase puts the highest strain on the shoulder. This phase requires decelerating the forward progression of the arm through eccentric control of the posterior rotator cuff. Due to the high forces generated in this phase, the posterior muscles are highly susceptible to tensile overload, articular sided cuff tears, Long head of the bicep/labrum pathologies as well as internal impingement. Building resiliency to these loads are imperative for injury prevention.
The SUPINE ECCENTRIC ER and SUPINE PNF D2 PATTERN are great additions to a throwers arm care program.
****This video was shot pre COVID-19 hence no masks in clinic!!! We miss those days.
#physiotherapy #shoulderrehab #baseballarmcare #overheadathlete #physioprofamily #rotatorcuffrehab #rotatorcuffexercise #exercises #shoulderpain #performancehealth #rehabilitation #litecure
#normatec #nterecovery #physicaltherapy #sportsmedicine #athletictrainer #strengthtraining #strengthandconditioning #strength
#performancetraining #conditioning #rehab #athletes
WEEK 6 TABATA is finally here. This is a good one!! Tabata training is a high-intensity interval training (HIIT) workout, featuring four exercises that last four minutes total. This is the last of a six week series we have been running. Enjoy!! EXERCISE 1: SUPERMANS
EXERCISE 2: SUMO HOPS
EXERCISE 3: PLANK JACKS
EXERCISE 4: CURTSY LUNGES
The structure of the program is as follows:
* Work out hard for 20 seconds
* Rest for 10 seconds
* Complete 8 rounds
You push yourself as hard as you can for 20 seconds and rest for 10 seconds. This is one set. You will go through each exercise twice for a total of 8 sets. Tabatas can easily be adapted if you are injured or recovering from injury in the later parts of your rehab.
A timer is very helpful for this type of Training.
Great post regarding imaging and pain. Imaging has its place but let’s not devalue a comprehensive orthopedic clinical exam. This is often the only way to uncover the true pain generator. The world is full of symptom free individuals with “dysfunctional” findings on their MRI. We as clinicians need to focus on the abnormal clinical exam findings we uncover through examination and not formulate our plan of care simply based off the pictures provided by imaging. #Repost @physiocity with @make_repost
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💥𝐈𝐦𝐚𝐠𝐢𝐧𝐠 & 𝐏𝐚𝐢𝐧💥
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🔎This new study (citation at bottom of post) examined bilateral shoulder MRI findings in people with unilateral (one-sided) shoulder pain. This study matches up with others on the topic, which show that ‘dysfunctional’ findings are often seen in body regions where no pain is present. The MRI results in this study showed that issues like tendinopathy (see image) and partial rotator cuff tears occurred in almost equal numbers when comparing the painful side to the non-painful one.
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📊Studies like this remind us that clinical decision making must not revolve around imaging alone. If more sinister conditions are not a concern and the clinical exam does not warrant further testing, then it may be best to wait on pursuing imaging studies and proceed with rehabilitation.
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✅Thanks for reading and please let me know if you have any questions.
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📚Barreto RPG, et al. Bilateral magnetic resonance imaging findings in individuals with unilateral shoulder pain. J Shoulder Elbow Surg. 2019.
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Credit:- @rehabscience
#physiocity #anatomy #pt #neet #physiotherapy #medical #medico #medicine #sportsphysio #pt #sportsphysio #physio #Biomechanics
#supraspinatus #muscle #RehabScience #rehab #physiotherapystudent
#physiotherapyindia #delhi #banglore #Sportsmedicine #nurse #medicalschool #medicalwomen
#Repost @natelilleypt with @make_repost
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REHABBING THE THROWING ATHLETE: This will be a multi-post topic for the next few weeks focusing on the rehabilitation of the throwing athlete. Once full passive joint mobility of the glenohumeral joint and a balance of periscapular and rotator cuff strength are established we shift our focus to conditioning the shoulder for the specific phases of throwing.
The arm deceleration phase begins at ball release and ends at maximum shoulder internal rotation. This phase puts the highest strain on the shoulder. This phase requires decelerating the forward progression of the arm through eccentric control of the posterior rotator cuff. Due to the high forces generated in this phase, the posterior muscles are highly susceptible to tensile overload, articular sided cuff tears, Long head of the bicep/labrum pathologies as well as internal impingement. Integrating deceleration training is imperative at this this point of rehab.
The HALF KNEELING EXTERNAL ROTATION DECELERATION and HALF KNEELING PNF DECELERATION are great additions to a throwers arm care program. Light med balls (1-2 pounds) are ideal and the focus should be on control throughout the whole range. More to come.
****This video was shot pre COVID-19 hence no masks in clinic!!! We miss those days.
#physiotherapy #shoulderrehab #baseballarmcare #overheadathlete #physioprofamily #rotatorcuffrehab #rotatorcuffexercise
“I find your lack of faith disturbing “. We are trying out a new COVID-19 respirator on Star Wars day!!! #maythe4thbewithyou #darthvader #starwars #physiotherapy #physioprofamily #beatcoronavirus👊👊👊
Is psyched for our new tabata circuit!!! WEEK 5! We have been using this form of training for years with our Wintervention classes. Tabata training is a high-intensity interval training (HIIT) workout, featuring four exercises that last four minutes total.
EXERCISE 1: LATERAL SKATERS
EXERCISE 2:THREAD THE NEEDLE SIDE PLANK
EXERCISE 3: BRIDGE KICKS
EXERCISE 4: JUMPING JACKS
The structure of the program is as follows:
* Work out hard for 20 seconds
* Rest for 10 seconds
* Complete 8 rounds
You push yourself as hard as you can for 20 seconds and rest for 10 seconds. This is one set. You will go through each exercise twice for a total of 8 sets. Tabatas can easily be adapted if you are injured or recovering from injury in the later parts of your rehab.
A timer is very helpful for this type of Training. #tabataworkout #hittworkout #physiotherapy
#Repost @rehabscience with @make_repost
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💥𝐊𝐧𝐞𝐞𝐜𝐚𝐩 𝐃𝐢𝐬𝐥𝐨𝐜𝐚𝐭𝐢𝐨𝐧💥
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👉Great video demonstrating what increased patellofemoral joint (PFJ) mobility and a subsequent lateral dislocation looks like.
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🔎Kneecap dislocation: Occurs when the triangle-shaped bone (patella) covering the knee joint moves or slides out of place. The dislocation usually occurs towards the outside (lateral side) of the leg, most commonly after a sudden change in direction when your foot is planted on the ground. Dislocation may also occur as result of direct trauma.
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🧠Treatment includes immediately stabilizing the knee with a splint and seeking medical attention. Your primary health care provider will examine your knee and attempt to straighten it out through distraction if warranted. This may confirm that the kneecap is dislocated. A knee x-ray and, sometimes, MRIs will be done to make sure that the dislocation did not cause a broken bone or cartilage damage. If tests show that you have no damage, your knee will be placed into an immobilizer or cast to prevent you from moving it.
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🏋🏼♂️After this time, physical therapy can help build back your muscle strength, motor control and improve the knee's range of motion. If there is damage to the bone and cartilage, or if the kneecap continues to be unstable, you may need surgery to stabilize the kneecap.
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#RehabScience
TABATA TIME!! WEEK 4. Tabata training is a high-intensity interval training (HIIT) workout, featuring four exercises that last four minutes total.
EXERCISE 1: Bronco Jumps
EXERCISE 2: V-Ups
EXERCISE 3: Prone Plank With Hip Extension
EXERCISE 4: High Knees
The structure of the program is as follows:
* Work out hard for 20 seconds
* Rest for 10 seconds
* Complete 8 rounds
You push yourself as hard as you can for 20 seconds and rest for 10 seconds. This is one set. You will go through each exercise twice for a total of 8 sets. Tabatas can easily be adapted if you are injured or recovering from injury in the later parts of your rehab.
A timer is very helpful for this type of Training. #tabata #hittworkout #physiotherapy #physioprofamily
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