Weekly Summer Scoliosis Open Gym!

Scoliosis Open Gym

Does your daughter or son need a way to stay consistent and motivated with their scoliosis home exercises over the summer? Spinal Dynamics & Body Dynamics of Wisconsin will be offering a special weekly open gym to help our patients to keep up with their scoliosis management program.

One of our resident scoliosis experts, Meg Gogin, MPT, will direct open gym on Fridays from 11:00 a.m. until noon beginning on June 16, 2017.

Participants will be able to:

  • Check in to make sure they are performing their exercises correctly
  • Use all of our equipment, including ladders, bands, rollers, and more
  • Experiment with new exercises to advance their home program
  • Answer questions about exercises and scoliosis
  • Socialize with others with scoliosis for motivation and support

Interested in learning more? Chat with your PT to determine if this would be a good fit for your child. You can also call our office at (414) 302-0770 or send our front office an email for more details. Each open gym session will cost $25. We require preregistration to ensure that there is enough equipment for all participants.

 

Meg Gogin, MPTMeg Gogin, MPT

  • Bachelor of Science in Kinesiology from Indiana University, 1996
  • Master of Science in Physical Therapy from UW-Madison, 2000
  • Certified in the Schroth Scoliosis Rehabilitation Method, 2007
  • Lab assistant for Barcelona Scoliosis Physical Therapy School.
  • Completed the Scientific Exercise Approach to Scoliosis (SEAS) Accreditation Program, 2012
  • Specific interest in foot orthotics, scoliosis, vertigo treatment, and spinal and lower extremity conditions.
  • Certified in dry needling techniques through Myopain Seminars.
  • Unique golf expertise in collaboration with her husband, Dan Gogin, PGA

 

Baseball Injuries

Monday was Opening Day for the Brewers, which means that spring is finally here. In our physical therapy clinic, this is also about the time we start seeing an uptick in the number of high school and college baseball players who come to see us for elbow or shoulder pain.

So, why are shoulder and elbow pain so common in baseball?

Baseball pitch

 Baseball players, especially pitchers, typically have shoulders that are very flexible in external rotation (see picture to the right), which allows them to generate speed as they throw. Over time, they may develop stiffness into internal rotation (the opposite direction) due to tightness through the rotator cuff and other shoulder structures. This can lead to irritation and pain in the shoulder, as well as compensations at the elbow. In the cocking position (see picture to the right), the shoulder is stretched into maximum external rotation and there is also a lot of stress transmitted to the inside of the elbow. To tolerate this position hundreds or thousands of times over the course of a season, the arm needs a good balance of mobility of the joints and stability of the surrounding muscles. 

Overloading the arm with too many throws or throwing with poor mechanics can lead to injuries, especially in a growing athlete. Bones grow more quickly than muscles and this imbalance often leads to injuries near the growth plates of elbow or shoulder. Overuse can also lead to irritation and gradual tears of the rotator cuff muscles or labrum (cartilage) in the shoulder. Excess strain through the elbow can overstretch or tear the ligaments that stabilize the inside of the elbow. This is known as a “Tommy John” injury in baseball circles. If not caught early, some of these injuries may require surgery and a very long recovery.

How someone throws can also be a risk factor for shoulder or elbow injuries. Poor mechanics can lead to increased torque and strain through the shoulder and the inside of the elbow. A good pitching coach can identify throwing flaws and address them in order to prevent problems down the road. Learning good mechanics early on is much more effective–and safer–than waiting until there is a problem.

Preventing Injuries

Current research shows that a high number of pitches is one of the biggest predictors of having either shoulder or elbow pain. Baseball players between 9 and 14 years old were more likely to have shoulder pain if they threw more than 600 pitches throughout the course of the season and elbow pain with more than 800 pitches. In response to this research, Little League instituted pitch counts based off of the player’s age to avoid overtaxing growing joints. The following chart shows the maximum number of pitches allowed by age, as well as the recommended days of rest following a start.

Age                 Daily Max (Pitches) Required Rest (Pitches) Required Rest (Pitches) Required Rest (Pitches) Required Rest (Pitches) Required Rest (Pitches)
    0 Days 1 Day 2 Days 3 Days 4 Days
7-8 50 1-20 21-35 36-50 N/A N/A
9-10 75 1-20 21-35 36-50 51-65 66+
11-12 85 1-20 21-35 36-50 51-65 66+
13-14 95 1-20 21-35 36-50 51-65 66+
15-16 95 1-30 31-45 46-60 61-75 76+
17-18 105 1-30 31-45 46-60 61-75 76+

Information from http://www.momsteam.com/sports/baseball/safety/2014-little-league-baseball-pitch-count-limits-and-mandatory-rest-periods#ixzz4bPUpySeo

It is also important to gradually increase the amount of work the arm has to tolerate, especially at the beginning of the season, after injuries, or after time off. Gradually increasing the distance, speed, and number of throws over several weeks is important to avoid overtaxing the joints as they get used to the stress of throwing.

Along with gradually increasing the work on the arm, it is important to make sure that players, especially pitchers, have adequate rest. Pitching with a sore or tired arm is a significant risk factor for injuries. It is essential that pitchers have days off after starts to allow their arm to recover. Players that play on multiple teams may play year-round, never giving the arm sufficient time to rest and recuperate. It is recommended that athletes play their main sport a maximum of 9 months a year, as specializing in any sport year-round has been associated with a higher incidence of injuries. Players should have a 6-8 week recovery period following their season and focus on rest, off-season conditioning and injury prevention. This may also help with avoiding burnout.

Given the high demands on a baseball player’s arm, every player should have an exercise program that addresses their need for shoulder and elbow mobility and stability. A physical therapist can check for adequate range of motion and strength, take a look at the structures around the shoulder or around the elbow and develop a specific, individualized program to help keep the arm happy and healthy throughout the course of a long baseball season.

Sources:

Brotzman SB, Manske RC. Clinical Orthopaedic Rehabilitation: an Evidence-Based Approach – Expert Consult. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011.

Straus LB. 2017 Little League Pitch Count Limits and Mandatory Rest Rules. MomsTeam. http://www.momsteam.com/sports/baseball/safety/2014-little-league-baseball-pitch-count-limits-and-mandatory-rest-periods#ixzz4bPUpySeo. Published February 27, 2017. Accessed March 23, 2017.

Temporomandibular Joint (TMJ) Pain & What to Do About It

Temporomandibular joint (TMJ) or jaw pain is a very common condition – actually the second most common musculoskeletal condition after low back pain. It affects around 12% of the population or 38 million people.1 It typically affects more women than men, often between the ages of 35-45 years of age, but may occur at any age. Interestingly, 70% of patients with TMJ pain also have neck pain2 and there is a lot of overlap between both conditions and treatment.

The temporomandibular joint is where the mandible (or jaw bone) meets the temporal bone (part of the skull, forms the temple). You can find the joint on yourself by gently pressing just in front of the ear below the bony ridge of the cheekbone. There are a lot of muscles that attach in this region that help you open and close your mouth. They can become tight or irritated. There is also a small disc of cartilage that lies between the two bones of the temporomandibular joint and moves with the joint. In some people, the disc can cause clicking as the person opens and closes the mouth. This may or may not be painful.

Common Symptoms:

  • Pain or stiffness in the jaw, often first thing in the morning
  • Pain through the temples or frequent headaches
  • Pain with chewing gum, hard or tough foods
  • Pain opening mouth or moving jaw forward or to the side
  • Pain with talking, kissing or yawning
  • Frequent clenching or holding the back teeth together
  • Ear fullness or ear pain

If you are experiencing TMJ pain, there are several things that you can start working on to reduce your pain.

  1. Be aware of clenching your teeth during the day. Your back teeth should only be touching when you are chewing, as holding your back teeth together all day overworks the muscles and may cause pain.
  2. A good, relaxed position for the jaw is with a slight space between your top and bottom front teeth with your tongue gently resting (not pressing) on the roof of your mouth. This allows the muscles to relax.
  3. Posture has a huge effect on your jaw pain. A slumped position with a forward head changes the position of your jaw and increases how much the neck and jaw muscles have to work. Check your posture frequently during the day, especially while sitting.
  4. People often clench their teeth when they are stressed. Frequently take a look at how you’re holding your teeth and consciously work on relaxing the muscles of the face and jaw.
  5. Avoid sleeping on your stomach or resting your head on your hand during the day or while on your phone. The increased pressure directly over the jaw can cause pain.
  6. Focus on soft foods and avoid things that are excessively hard or chewy (including gum) to allow your muscles to relax.

Treatment:

Your dentist or physical therapist can help you with improving your jaw pain and function. Other treatment strategies may include:

  • Soft tissue mobilization, massage, dry needling and other manual therapy techniques to the neck and jaw musculature and joints to improve mobility and decrease feelings of tightness and pain.
  • Exercises to improve mobility and strength for improved posture and body mechanics.
  • Gentle electric stimulation, heat and relaxation exercises.
  • Oral appliance or a night splint to decrease clenching or grinding at night.

Pain through the jaw can be exhausting and affect someone’s personal, social and work lives. Most people will improve with treatment, so if you are experiencing frequent pain through your jaw, don’t hesitate to call your physical therapist. Spinal Dynamics & Body Dynamics of Wisconsin has several physical therapists that are specially trained in treating this condition. We can help you with strategies to reduce your pain and improve your function. We can also assist you in finding a dentist experienced in treating temporomandibular dysfunction if needed. Let us know if we can help.

Sources:

  1. Dworkin SF, Huggins KH, Leresche L, et al. Epidemiology of Signs and Symptoms in Temporomandibular Disorders: Clinical Signs in Cases and Controls. The Journal of the American Dental Association. 1990;120(3):273-281. doi:10.14219/jada.archive.1990.0043.
  2. Ciancaglini RG, Testa M, Radaelli G. Association Of Neck Pain With Symptoms Of Temporomandibular Dysfunction In The General Adult Population. Scandinavian Journal of Rehabilitation Medicine. 1999;31(1):17-22. doi:10.1080/003655099444687.

New Therapeutic Laser!

Our goal at Spinal Dynamics & Body Dynamics of Wisconsin is to continuously evolve to offer you the very best care possible.

Staying true to this mission, we are currently testing LiteCure’s LightForce EXP Class IV Laser. Because a therapeutic laser is a large investment for a private practice, we want to give it a trial run to see if it is a good long-term fit for our practice. 

Learn more about laser therapy and our free trial of treatments or give our office a call at (414) 302-0770 to schedule.

Plantar Fasciitis – What is It & What Can You Do About It?

By: Lauren Hogan, PT, DPT, OCS, ATC

Plantar fasciitis is one of the most common foot-related conditions that we see in the clinic. Around 10% of people will experience plantar fasciitis at some point in their lives. It can be incredibly painful to put weight on the foot and walk, making it a very challenging injury for patients to deal with.Plantar fasciitis is irritation of the plantar fascia as it attaches to the calcaneal tuberosity, or heel bone. (https://en.wikipedia.org/wiki/Plantar_fasciitis)

What is Plantar Fasciitis?

The plantar fascia (or aponeurosis, as labeled in the picture above) is a thick band of connective tissue that attaches from the heel bone up through the toes. As we walk, the plantar fascia works to help support the arch, along with muscles in the foot and ankle. When we sleep or sit, our feet are often in a pointed toe, relaxed position, so the plantar fascia may be resting in a shortened for a prolonged period of time. When we get up in the morning or stand after sitting for a while, the plantar fascia is suddenly stretched as we put weight on the foot. For people that have irritation of the plantar fascia, the attachment at the heel can be painful for several steps until the tissue starts to loosen up.

Anyone can get plantar fasciitis, but there are several factors that can put someone at risk for developing pain through their heel. Tightness through the calf and limited ankle range of motion are common causes. Runners and workers that spend a lot of time on their feet on hard surfaces are more likely to be diagnosed with the condition. Patients with a higher body mass index also may be at increased risk. Poor footwear can also be a triggering factor.

There are several things you can start doing if you are experiencing heel pain.

  1. Wear supportive shoes consistently throughout the day. Adequate arch support and cushioning are necessary to help avoid irritating the plantar fascia.
  2. Stretching the calf muscles is extremely important. The more mobile the calf muscles and ankle are, the less strain there is through the plantar fascia with walking.
  3. Rolling through the bottom of your foot with a golf ball can help massage the arch and surrounding muscles.
  4. Icing or rolling the foot over a frozen water bottle can help relieve pain.
  5. Sitting with your feet flat on the ground helps to maintain a little bit of a stretch through the calf and foot, making it less painful when you first get up and start walking.

If your symptoms are not improving within a few days with self-treatment, a physical therapist can help. Treatment may consist of hands-on massage to loosen up tissues in the calf and foot, joint mobilization to improve foot and ankle mobility, as well as work on strengthening the foot and ankle muscles, balance, and working on gait. Some patients may benefit from an orthotic insert to further support the foot, or a night splint to help gently stretch the calf at night to minimize pain first thing in the morning. You can ask your PT how to use these tools to help with your recovery.

Early treatment is important, as chronic plantar fasciitis can be challenging to treat and take longer to resolve. If you are in pain for more than a few days and it is not responding to the ideas above, talk to your physical therapist to get on the road to feeling better.

Cindy & Chris Go to Vegas

By: Cindy Marti, PT

52 years old and I’ve never been to Vegas! I didn’t win big (actually, I didn’t win at all!) but I had a great time with 1,600 other people attending the American Physical Therapy Association Private Practice Section meeting, with my very own employee extraordinaire…Chris Hahn!

Cindy & Chris in Las Vegas

Cindy Marti, PT & Chris Hahn, office & business manager, in Las Vegas for the APTA Private Practice Meeting.

Here are a few of our takeaways…personal and professional!

Personal:

  • The fountains at the Bellagio are cool, going off to Elton John’s “Lucy in the Sky with Diamonds”
  • It is hard to walk in Vegas with an injured foot that requires a boot and a cane (yes, me)
  • Hotel rooms should always have coffee pots
  • Don’t trust the airport shuttle to pick you up at 6 a.m. at your hotel. Take an Uber.

Ok…now for some PT takeaways:

Back Pain:

I attended a presentation on low back pain treatment and costs. Musculoskeletal pain is the 3rd largest healthcare cost in the US, and 70% of that is related to low back pain. Research clearly shows that the “point of entry” for patients with back pain should be a physical therapist. Not a primary care doctor. Not a chiropractor…but a physical therapist. If patients go DIRECTLY to a physical therapist when they hurt their back, they typically spend less on their total care, recover faster, and have better outcomes. On average, patients that get physical therapy within the first 14 days of experiencing low back pain save around $2,700 over patients that wait. Luckily, Wisconsin is a “direct access” state for physical therapy, meaning patients can see us right away for any musculoskeletal problem — no referral necessary. So, do yourself and your wallet a favor and choose PT first when you have pain. We can typically schedule patients in on the same day or next day to get you started toward feeling better. Give us a call.

Osteoporosis:

1 in 2 women and 1 in 4 men over 50 will have an osteoporosis-related fracture in their remaining lifetime. WOW! I had no idea the rate was that high. The good news is that research shows physical therapy can help reduce bone loss, falls and fractures. If you are concerned about your bone density or risk of fractures or falls, let us evaluate you and design a prevention program to keep you healthy. We will coordinate any necessary bone density assessments with your physician and get you started.

Opioids:

The APTA states “According to the Centers for Disease Control and Prevention (CDC), sales of prescription opioids have quadrupled in the United States, even though there has not been an overall change in the amount of pain that Americans report.” I am proud that our profession is participating in consumer education about the overuse of opioids. Check out #ChoosePT for Pain Management to learn more about the opioid epidemic and what you can do about it. Although opioids can be an important short-term part of a patient’s overall care plan, overuse or long-term use can have unintended and dangerous consequences. Be informed and work with your medical team to create an overall treatment plan that minimizes the use of medications when possible.

Gratitude:

I left the conference grateful. Grateful…

  • To be in an extremely rewarding profession
  • To be in private practice
  • For my very talented and devoted staff
  • To be inspired by my fellow private practice owners
  • To my clients and community that support our practice. That means you. Thank you.

Thanks for reading about our trip to Vegas. Mention this blog post and get either a 30-minute free injury consultation for new patients OR a 30-minute free dry needling session for existing patients.* 

Cindy

*Appointment offering based upon therapist availability. Offer expires Dec 1, 2016.