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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.

My Knees HurtWe get this question all the time. “I’m in my 40’s and want to exercise but the next day I am miserable” or “I played tennis and basketball and now my knees are really sore” or “I can’t go upstairs easily, and I’m really sore when I’m sitting for any length of time.” You may think you need knee surgery or to have a knee replacement to get this pain to go away. But this is not necessarily true. Let’s take a look at your options.

Why do my knees hurt?

Before we talk about why we hurt, we need to talk about normal anatomy first. Our knee joint contains 2 parts: the tibial/femoral joint and patellofemoral joint. The tibial/femoral joint connects the femur and the tibia together and the patellofemoral joint is the kneecap in front. We have different ligaments that connect the bones together, and a meniscus that sits between the tibia and the femur. These can get injured with trauma. The biggest thing that we have on each part of the bone is called articular cartilage. Articular cartilage is usually what wears away with age and intense physical activity. It acts as a coating for our joints just like coating on our pots and pans when we cook to protect food from sticking. As we age the articular cartilage wears down and can start to cause pain. (Ahh=articular cartilage – that’s the reason why I hurt!) So, here is the question I always get: should I stop exercising? The answer is NO – that will do the opposite of help in this situation. Instead, there are things we can do to hopefully keep you from needing surgery. Staying active with Physical Therapy is very important. With the right treatment plan and exercises, we can help you get back on track.

What can PT do to help?

There are a number of things that Physical Therapy can do to help those achy knees. Here are a few:

  • Manual Therapy – our focus is on unloading the knee and taking pressure off your joints
  • Exercises that won’t aggravate the knee
    • these include hip drills: clams, clam lifts, band walks, RDLs, planks, etc (we give examples of these on social media and in our monthly recommended exercises)
    • try to avoid exercises that will aggravate the knee (deep squatting, stepping down from something, etc)
  • Wearing a Knee Sleeve – this can be helpful during activity to keep your knee warm and calm down your symptoms
  • Taping – this is a great way to help your symptoms as well
    • we can be specific to just your kneecap, or your tibial/femoral joint too, depending on the areas affected

If you have knee pain and have been avoiding getting treatment/diagnosis, come see us. Our job is to get you back to where you belong – as quickly as possible! Schedule an appointment here.

In-Season Training

Boys and Girls high school basketball seasons have kicked off and teams are into their conference schedules. Questions often arise concerning how often and how intense in-season training should be for teams. This is a topic that is worth hours of discussion.

Here are a few key things to consider:

  1. BasketballHopefully the players trained hard in the off season to build up strength, speed, and reactiveness. This will better prepare them for the season. Athletes need to be stressed in the off-season so they can adapt to handle the new workload once the season starts. It’s almost like building up a strength ‘reserve’. Players that stress themselves to the point of adapting in the off-season will likely have a larger reserve to draw from as the season begins. However, the qualities built during off-season training need to be trained in-season as well. In order to maintain qualities in-season, players need to train their bigger strength lifts every ten days. That means finding a time within the game schedule to program intense strength sessions. The players will need to lift > 90% of their maximum lifts.
  2. Recovery and response to injury drives everything. For the players getting lots of game time, overall volume needs to be lower. For players not getting as much playing time, coaches need to be careful not to let them become deconditioned. The individualization of workouts within the team will really spread out as the season progresses. There will be players who can continue to progress strengthening during the season, and others that need to be dialed down.
  3. Sleep, diet, academic stress, and mood should all be monitored for each player during the season. The best strength training plan in the world will fall apart if these four areas are draining a player’s reserve.
  4. Track RSI (4 hop test), maximum vertical jump, and even how players are handing some of their bigger lifts (squat, dead-lift). This will give a coach a decent measurement of where the team stands in terms of neuromuscular readiness. If these numbers start diving, workload needs to be adjusted.

Overall, teams that enter the season having been properly stressed to handle demands will be the strongest. Those that are given managed stress during the season to help maintain important athletic qualities are the ones who are most fresh in late February and March. They’ll likely be less injured and closer to their peak physical ability as tourney time begins.