I was getting ready for my shoulder surgery?

The COVID-19 virus has really thrown us all for a loop. As a Physical Therapist, we are trying to do what we can for our patients, while staying safe ourselves.

What if you were scheduled for surgery during this time and now it is cancelled? You were looking forward to the day you returned back to a pain free life, but now your surgery date is unknown! While you are waiting, here are some tips to try to alleviate the pain in preparation for surgery.

Range of Motion

Keep your range of motion as best as you can:

  1. Lie on your back and use a golf club, broom handle, or a cane and lift it overhead. Use your good arm to help your bad arm. Extend upward ONLY as far as your pain will allow and lower back down (Try 10 reps and 2-3 sets)
  2. Next, use the cane and rotate your arm to the side and back to stretch the front of your shoulder (Try 10 reps and 2-3 sets)
  3. Lastly and this one is slightly; use your good arm and attempt to help the arm that hurts by reaching up behind your back. Proceed slowly and go ONLY as far as you can, go to the point of pain, and back down (Try 3 sets of 10 reps)

Strength

  1. You need to work on keeping your scapular muscles strong and your posture straight/good (as straight as you can)
  2. While sitting or standing squeeze your shoulder blades together. Hold for 2-3 seconds and then relax (Try this 10 times and 3 sets)
  3. Isometrics on the wall: most patients having surgery experience pain with any movement, so getting stronger may be challenging. Gentle isometrics can be the answer. Gently pushing into/against the wall can be helpful. Push very gently forward, into the wall and hold for 3-4 seconds and repeat 8 times. You can do this in multiple directions as well. Pushing out to the side and pushing in as well

Pain

Pain is more than likely the main reason for having surgery. Here are a few movements that you can try while you are waiting for your procedure:

  1. Heat or Ice: Either may work. If you don’t have access to ice, use frozen peas or corn, either can be an excellent substitute. If you don’t have access to heat, taking a warm shower which can help
  2. Take some pressure off your joint by holding your elbow up a bit while it is at your side. Placing/putting your elbow on the table may help and if your shoulder does not like this, it may like distractions. You may have to pull down on your elbow and increase space within your shoulder to take some pressure off

We hope these suggestions help. If you need clarification regarding any of the suggestions or movements please send us an email at clinic@proptgroup.com; you don’t need to be a current patient to ask questions or for help.

Stay healthy and take care,

Dave Nissenbaum MPT, MA, LAT, OCS

PRO Physical Therapy

Cross Plains: (608) 413.0550 | Middleton: (608) 841.1290

As we head towards the spring sports season, it’s time to start pre-season assessments. The first step to increasing the intensity and intent of your off-season baseball and softball development plan is to assess the raw material you’re working with.

The OnBaseU screen identifies mobility, stability, and strength variables that affect the ability of a player to train for the upcoming season and beyond. The screen allows you to find the most efficient way to swing and throw for each individual. Take the guesswork out of training plans and safely push your athletes to the next level by identifying the bottlenecks unique to each athlete.

Of the 1000 OnBaseU certified instructors, 500 are working for Major League Baseball organizations. Jeff at PRO PT is the only certified instructor within 80 miles of Madison, WI. Capitalize on this opportunity to schedule your high level OnBaseU pre-season assessment screening by calling the Middleton clinic.

Or, click here to schedule an assessment today!

Why Proper Bike Fit is Important

Mountain Biking
We see a lot of cyclists here at PRO Physical Therapy. Let’s face it – we live in Madison! The biking community here is incredible. The trail system is far better than a lot of American cities, and you can pop outside the city quickly and be in the beautiful hills of the Driftless region in no time. How lucky are we? If you’re an avid cyclist, then you’ve probably at least considered getting a professional bike fit. People swear by them. After all, how much time do you spend on your bike? If you’re commuting or road riding, it’s probably a significant amount of time. If your bike hasn’t been properly fitted to you, chances are you’ll want to bike less, and you’ll hurt more afterwards. A proper bike fit is the difference between loving your bike even more, or never using it.

How to Get a Proper Bike Fit

Basically, if you hurt while riding, something needs to change. A proper bike fit can make you so much more comfortable, and even faster on your bike! Bike fits are for everyone – avid cyclist or new riders. A proper fit will help prevent overuse injuries from improper position, and varies from person to person. Depending on your age, style of riding, and physical attributes (flexibility, etc), your bike fit will be different than the next persons fit. While we know a bit about bike fitting and proper position here at PRO Physical Therapy, we always recommend taking your bike to a bike fit professional. In Madison, Stacey Brickson is our go to gal. She’s a Physical Therapist and PhD in Exercise Physiology, and has tailored her work to encompass her passion for cycling. She has a private niche practice here in Madison in a bike shop where she specializes in therapeutic bike fit. We often send our patients to her when they come in with bike fit questions or concerns.

At Home Bike Fit

While we think that it’s important to get fitted by a professional, that’s not always necessary for everyone. We recommend that you make the following adjustments if you’d like to try an at home bike fit first:

  • Size: make sure you’ve chosen the right size frame to fit your height/leg/torso length. There’s only so much a bike fit can do if you’re riding an improperly sized bike.
  • Seat Height: this is an easy one to mess around with. If your seat is too low or too high, this can cause major discomfort. A seat that’s too low can put a lot of strain on the knees, while a seat that’s too high can add unwanted pressure points on the saddle.
  • Reach to the Handle Bars: if this is too far or too short, this can result in a lot of upper body pain. You should be able to sit comfortably on your saddle, and reach the bars/hoods. Your elbows shouldn’t be locked, and your core should be slightly engaged.

Riding shouldn’t be painful. If it is causing you pain, consider getting a bike fit! Any pain, numbness, or tingling are signs of an improper bike fit. Some of these at-home fixes are simple, but if they don’t seem to be working, we definitely recommend calling in the pros!

Dave Playing Pickleball

I know this isn’t a basketball image, but it’s a picture of me as a practicing “aging athlete” so I thought it’d do!

As an aging athlete, I know what it is like to have aches and pains. I exercise regularly so I’m used to some daily discomfort. But this time was different. Here’s what happens when the PT gets injured.

I was playing basketball with some friends and our kids recently while we were out of town. I saw a 7-foot tall hoop, and knew I had to try to dunk the ball. I took off on 2 feet, touched the rim, and then felt the worst thing I have ever felt in my life… my quad rip. After I landed, I knew exactly what I had done. Immediately, I felt for my quad tendon, because if it was torn I’d have to have surgery.

This scenario is a common thing that happens to us as we age. People get injured all the time. What I want to talk about is how I managed this. After an injury, getting into Physical Therapy RIGHT AWAY is one of the most important things you can do. I was out of town when this happened, but needed to be treated right away. Since this was a musculoskeletal injury, it was right up my alley to treat. I didn’t think there was any need to go a doctor. That being said, you may often feel the need to go to a doctor for an overexertion injury like this. That’s ok too! This hurt more than anything I’d ever done before. This time, however, I decided that I could manage it myself.

First, I used ice (right away) for 20 min on, 20 min off. I did this three different times that first night. Icing with my leg bent could keep it from scarring too much. The next thing I needed was some compression. I went to the pharmacy to find an ace bandage and crutches. They did not have an ace bandage so instead I bought some Coban Wrap. Compression can help keep the bleeding to a minimum. I used a sock and wrapped my leg with Coban Wrap.

Two days later, I returned home and started to work on it. I did a lot of soft tissue work, kept using ice, taped it, used pulsed ultrasound, and I even dry needled myself (please don’t try that at home)!

I’m about two weeks out and doing better. I’m not there yet. I can walk and bend my knee but still can’t go up or down steps very well. However, the daily treatment has helped immensely. I know that this injury may take 8 weeks to fully heal, but if not for early intervention I would be in trouble.

So, what is the morale of this story? Get in to see a Physical Therapist RIGHT AWAY after an injury. We have been through this, and we are here to help!

David NissenbaumStay well and happy healing,
Dave

We’re seeing more and more people itching to get back out on the trails as spring approaches. This can mean that we will start to see a lot of people coming in with hip pain or hip injuries…

If you’ve taken the winter off from running – be careful when jumping right back in. We recommend you prepare for running season again with some basic strength training exercises to keep yourself injury free!

In the video below, Jaime takes us through 3 exercises that we use to treat hip injuries. These exercises cover mobility, strength, and endurance.

First, you need good flexibility or range of motion. Exercise 1 above is called “the couch stretch.” Make sure your hips are square, your pelvis is tucked, and your glutes are engaged. Do this exercise morning and night.

Second, you need strength and control through that range of motion. The second move focuses on hip extensor strength and power. It also engages the core, and uses rotational control in the hip. Do these 3x a week while watching TV!

Third, you need endurance. This last exercise is a single-leg dead life variation. It focuses on hip control and endurance.  It integrates the whole limb – some people will feel it even more in the feet and ankles than in the hip! You can do these 3x a week – hold for 20 seconds and repeat 3-6 times on each side. If you’d like to wake up the hip a little before a run, you can also use this one as a warm up!

Each of these exercises starts with basic movement, but has variations that you can build to as you gain strength. Watch Jaime’s video above for a demonstration of each variation, and tips on how to get the most out of these exercises.

What is proximal hamstring tendinopathy?

Proximal hamstring tendinopathy (PHT) is a common injury among distance runners and endurance athletes. It is especially prevalent in those whose jobs involve long periods of sitting. It presents as deep gluteal (butt) pain that worsens with running and accelerating. This would show up when sprinting on foot or bike, as well as ascending hills on foot or bike. Additionally, sitting on hard surfaces is often a trigger.1 If this type of pain persists greater than 3 months it is generally considered to be a tendinopathy.

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