Who: Advance Physical Therapy clinicians will be teaming up with Fleet Feet of Carrborro to provide a 1 day 4 hour running in-service. The goal is to help you be an educated stronger runner through maximizing body position and muscle function during running. Running performance concepts related to Postural Restoration will be used. “Postural Restoration’s asymmetrical model fits perfectly into a runner’s program because running is an asymmetrical event”. For example, understanding how to train for left initial foot contact versus midstance phase of running on the right, concepts like these and more will be discussed. Learn more about Postural Restoration at www.posturalrestoration.com.
Where : Advance Physical Therapy, 77 South Elliott Road Chapel Hill, NC 27514
When: Saturday November19th from 10:00am to 2pm.
How you can register: Registration can be done on–line at http://www.fleetfeetcarrboro.com/recent-news/postural-restoration-clinic
About the presenter:
Matthew Harwood PT, DPT, OCS has been practicing at Advance Physical Therapy since September of 2010. He is a board certified Orthopaedic Clinical Specialist by the American Physical Therapy Association. Prior to moving to Durham in March of 2010 with his wife, he was living and practicing physical therapy in the Northern Virginia area. He has been practicing physical therapy for 8 years. He has completed 2 half marathons, most recently in Charlottesville, VA in Spring 2011, his first half was in Columbus, OH in 2008 “I began using Postural Restoration in my training for Charlottesville. I saw differences between my two races in regards to improved time and running performance. These concepts are valuable for any runner which is why I want to share them with you”. He is current in training with Fleet Feet for the Richmond Virginia 2011 full marathon.
At our last staff meeting we were sharing the variety of orthopaedic concerns which we as a group have been treating over the past half year. It turns out to be a huge variety.
Our client base is as varied, including people of all age ranges and activity levels, from school aged adolescents to working professionals and athletes.
Here is our list::
• Carpal tunnel syndrome
• Wrist fracture
• Dequervain’s Tenosynovitis
• Tennis elbow
• Biceps tendonitis/osis
• Rotator cuff tendonitis/osis
• Post surgical rotator cuff repair
• Rotator cuff strain
• Calcific tendonopathy
• Frozen shoulder/ Adhesive capsulitis
• Inflammatory arthritis of the shoulder
• Cervical radiculopathy
• Motor vehicle accident related neck and shoulder pain.
• Temporomandibular joint dysfunction
• Pectus
• Thoracic spine kyphosis
• Scoliosis
• Osteoporosis
• Fibromyalgia
• Chronic pain
• Low back pain
• Lumbar Radiculitis
• Lumbar HNP (Herniated Nucleus Pulposus)
• Sciatica
• Sacroiliac joint dysfunction
• Post surgical ORIF of hip joint
• Post surgical Total hip replacement
• Trochanteric hip bursitis
• Anterior hip impingment
• Iliotibial band syndrome
• Hamstring strain
• Post surgical ACL reconstruction
• Post surgical knee meniscus repair
• Post surgical knee arthroscopic debribedment
• Patellofemoral pain syndrome
• Anterior knee pain
• Genu Varum
• Genu Valgum
• Gastrocnemius muscle strain
• Shin splints
• Lateral ankle sprain
• High ankle sprain
• Distal fibular fracture
• Plantar fascia tear
• Pes planus
These beginner classes are a series of 8 classes, beginning and ending with an individual assessment.
Each class is attended by two physical therapists. Class size is limited to 8, the cost is $170 for the series.
The Monday class is scheduled for 6pm, led by Susan Henning and Matthew Harwood.
The Wednesday class is at 9am, led by Joe Belding and Jean Genova.
Please call to reserve a space 932 7266
By Matthew Harwood, PT, DPT, OCS
Postural Restoration trained therapists implement tests which assess for asymmetries in posture and muscular strength. These asymmetries can lead to overuse of certain muscle groups over others and patterning of movement. For example, right shoulder pain may result from the right ribcage being restricted during inhalation; this positions the scapula to rest forward on the ribcage. Thus, when the person goes to raise their arm, it will be limited.
Is it the forest or the tree? Postural Restoration gives our physical therapists a global picture (the forest) of the individual we are working treating. It helps us to identify how the interactions of one part of the body can influence another part of the body. In the example above, the tree was the shoulder pain and the forest included the ribcage and scapula. Other global influences we look at involve the position of the pelvis, feet, and spine. We identify the resting length of the abdominals and other muscles that attach from the legs and thighs onto the pelvis and spine. We look at movement patterns which may contribute to the development of local (tree) issues. A thorough physical therapy evaluation including medical screening and differential diagnosis testing helps us to identify underlying impairments, functional limitations and appropriateness for physical therapy services.
I love my mother. I have learned, and continue to learn, more from her than from any other source in my life. One of her favorite expressions, now at 80, is that “if you can change your mind, you can change your life”.
As an established orthopaedic therapist, my practice and mind were pretty well fixed on rehabilitating bones, joints and muscles in various states of disrepair. Things were going along just fine, then I took a course in Postural Restoration. Now, I have to change my mind. I’ve come to realize that I’m not just an orthopedic therapist, but I must be a neurologic (brain) therapist as well.
Bones, joints and muscles are nothing without the powerhouse of the brain that tells them when they are too tight, too long, too loose or too close together. If I don’t teach my patients what it feels like to be in balance, to know where their body is in space, they will never stop being on my orthopaedic caseload. This year a knee, next year a shoulder and so on…… But, if I can teach my patients to know when they are in “balance”, to change their mind about what feels “normal”, they will be able to manage and prevent the common chain of bone, joint and muscle problems that come from years of faulty habits and patterns of imbalance.
If I can help you “change your mind”, to get better and stay better, you can thank my mother.
Jean
Running Injuries: Injury Prevention Check-List
Before an airplane leaves the airport for its next destination, the pilot, ground crew and mechanics run through a check-list to identify how the plane is functioning and if there is any reason the plane should not take off. Running, whether for training for a goal race or as a form of general exercise, can be approached the same way.
Below is a check-list which you can complete that helps you organize your running program, identify areas that could lead to potential injury and help you identify characteristics about an injury before it gets worse. Questions 1-12 are helpful in organizing your running program, 13-16 can be used when an injury is starting; take this information with you if you need to seek medical care for a running related issue. It will assist in getting right to your issue and getting you back running!
If you have questions about one of the questions or about injury prevention let me know. I check the blog regularly.
Injury Prevention Check–List
1. What are your running goals?
2. How long have you been working to achieve this goal?
3. How many miles do you run per week?
____ days/______ week
4. How much time do you spend with non-running training/cross training?
5. Have you had a musculoskeletal exam to identify functional fitness?
Yes / No
6. What is your running schedule?
_____days/ _____ week
7. Do you maintain a running log?
Yes / No
8. Are you following a specific running and cross-training program?
Yes / No
9. What type of surface have you been running on?
(Road, trail, grass, rubber track)
10. Do you know your foot type? High/Average/Low Arch
Yes / No
11. How old are your running shoes:
Years/months
12. Do your shoes show an observable wear pattern on them? Look at your older shoes if you have a new pair.
Yes/ No
13. Are you currently running with an injury?
Yes/ No
14. Where is your injury?
(Foot,ankle,knee, hip,etc.)
15. When do you experience the pain or discomfort? (During the run, after running, on days you are not
running)
16. Has there been a recent change in running program? Intensity/ Duration/ Frequency
I recently spoke to a local running group sponsored by Fleet Feet in Carrboro. I talked about injury prevention for runners. Specifically, I talked about identifying variables which can help identify causes for injury such as: changes in running surface, increasing mileage too fast, following an unstructured running program. I will be posting more on this topic and will provide you with more information. For now though, here is a summary of common injuries, causes and what to do about them.
Common Overuse Injuries in Running
- Patellofemoral pain syndrome
- Stress fractures
- Shin splints/Tibial stress syndrome
- Iliotibial band syndrome
- Adductor strains
- Hamstring strains
- Ankle sprain
- Plantar fasciitis
- Achiles tendon syndrome
- Patellar tendonitis
Causes of Overuse Injuries
- Limited flexibility and range of motion
- Muscle strength imbalances
- Postural asymmetries
- Abnormal running biomechanics
- Training errors
- Old running shoes
- Irregular running surfaces
Previous Injury Can Lead to Future Injury
- Research has demonstrated that prior injury to any area of the foot, ankle, knee, hip and back can promote weakness throughout the lower extremity.
- Weakness can lead to altered running form, overuse and a new injury.
How Can I prevent injuries and improve my running?
- The science behind athletic performance training and injury prevention is based upon the biology of tissue healing, identifying variables which may predispose a person to having an injury and completion of a training program.
- The first place to start is to have a running and musculoskeletal evaluation to obtain a baseline of your specific function. This evaluation should be performed by a healthcare provider with a background in running injury prevention, sports medicine and rehabilitation.
- From this evaluation variables will be identified and a formal training program can be created. This personalized running program should include cross training, resting and of course, running.
Matthew Harwood, PT, DPT
Marlene and Paul Zweig, MD, are going to come again this year from Colorado to visit us to offer a one day course in Sensory Awareness, on Sunday November 14, from 10am to 4:30pm at our clinic. Cost is $60. Call us to register. On Saturday they offer similar work at the Chapel Hill Zen Center.
For information on Sensory Awareness go to: www.SensoryAwareness.org
A common condition I have treated over the past several years has been arm and hand pain originating for the neck and upper back. Often patients will report no mechanism of injury to the arm or hand and are confused as to why their elbow and hand are hurting. They may remember waking up one morning with stiffness in their neck or an inability to move their neck in one particular direction. These neck symptoms may have improved over the next few days, but then they started to notice the arm and hand symptoms. Other complaints patients may experience are pain at night, changes in sensation in the arm, forearm, and specific fingers of the hand. Specific postures may be associated with provoking the symptoms: sitting at a computer, looking down to read a book and driving.
My role as a physical therapist is to identify where the symptoms are stemming from. Pain that is originating from the cervical spine and radiates into the arm, elbow and or hand is termed cervical radiculopathy. This type of condition is possible because the nerves which supply motor control and sensation to our upper extremities originate from the cervical and upper thoracic spine. Impingements and obstructions of nerve regions will cause symptoms to be felt in more distal joints. This is why when we hit our “Funny Bone” we feel numbness in our 4th and 5th fingers; it is not that we hit a bone, but we hit our Ulnar nerve which is located one the medial side of our elbow. Sometimes a cervical component to a patient’s pain may be overlooked. Common conditions which may have a cervical component are lateral epicondylitis “ Tennis Elbow”, medial epicondylitis “Golfer’s Elbow”, Carpal Tunnel Syndrome and tendonitis of muscles in the shoulder, forearm. From listening to a patient’s history I can discern where to start my evaluation. If the patient reports a history as in my first example, I will consider the neck and spine as the most likely cause. If the patient reports a trauma to the shoulder, elbow or hand, then I will consider those regions as the most likely cause. Regardless of the history, a thorough screening of the neck and upper extremity is necessary to rule out possible suspects.
Recent research has allowed physical therapists to better diagnose a cervical spine origin for pain in the upper extremity. In a 2003 article in the Journal Spine, a group of researchers looked at 82 persons with symptoms of either carpal tunnel syndrome or cervical spine radiculopathy. The authors performed a rigorous diagnostic work up of each patient including nerve conduction studies, needle EMG, historical intake questions, self assessment questionnaires, neurological screening including reflex testing, sensation testing and resisted muscle testing, 5 provocation tests and measurements of neck range of motion in all directions; they left no stone unturned! The authors concluded that using a cluster of tests gave a higher probability for determining the source of a person’s pain than any one test. The tests identified were: Restricted neck rotation range of motion towards the involved side of less than 60 degrees, Positive reproduction of arm pain with a neural tension test, Positive reproduction of arm pain with a compression test known as Spurling’s Test and Reduction of referred arm pain with manual traction. If 4 of 4 tests were positive then the probability of having a cervical spine radiculopathy increased to 90%! If 3 of 4 tests were positive then the probability increased to 65%. These findings have allowed physical therapists to more accurately determine the cause for a patient’s pain, thus allowing proper determination of the best treatment intervention. In a time of increasing health care costs, use of this type of research can save money in avoiding more expensive testing such as needle electromyography.
The course of physical therapy for a cervical radiculopathy is to centralize or decrease the frequency, duration and intensity of symptoms in upper limb. This can be achieved through taking stress or compression off the involved nerve tissue. Specific manual treatments associated with relieving muscle tension, increasing circulation to affect healing and restoring joint mobility in the middle and upper thoracic spine can be effective at centralizing symptoms. Specific exercises designed to promote range of motion, inhibit muscle tone and correct posture also help achieve this goal. Patient education is paramount to helping centralize symptoms. Sometimes specific exercises will be initially limited to repeated movements in only 2 or 3 directions to allow time for tissue healing to occur. As symptoms become less irritable, then further progressions can be made. If pain is the patient’s primary complaint then modalities to decrease inflammation and the acuteness of the condition will be the focus of physical therapy. Referral to a primary care physician may be needed if conservative efforts to manage pain and inflammation are not helping. From past experience, I usually allow 2-3 visits to determine benefit. If a patient is having significant pain at night, then referral may be made at our first visit.
Matthew Harwood PT, DPT
Finally, we can announce that the beginner classes are scheduled. The evening class with Susan Henning will be happening on Wednesday evenings at 6pm. This class is already full. The morning class with Joe Belding will start on Monday, October 4th at 9am. For this class there are still a couple of openings.
Both classes will be for 8 weeks, beginning and ending with an assessment. Cost is $ 120.00.
Please call us at 919 932 7266 or email : myadvancephysicaltherapy@gmail.com
announcements | advaNce November 15, 2011 | 
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