What is Tennis Elbow?

Tennis elbow, or lateral epicondylitis, is an overuse condition of the muscles and tendons along your forearm. As its name suggests, tennis or racquet sports can commonly lead to this overuse condition, but so can other more common activities such as weight lifting, painting, carpentry, and repetitive use of a screwdriver or wrench.  The symptoms usually progress gradually and in most cases do not involve a specific injury, with the most common symptoms being pain or burning along the outer part of the elbow and weakness in grip strength. These symptoms are usually worsened with forearm activities such as holding a racquet, shaking hands or twist movement of the forearm. If left untreated, tennis elbow can become a chronic condition and lead to a longer recovery time. Early intervention of this condition greatly improves the speed of a recovery and return to previous activities. Consult with your physician about possible treatment solutions, which may include physical therapy to address postural deficits, improper mechanics of the upper extremity, and muscle imbalances along the elbow and forearm.

 

________________________________

Jason M. Garner, MPT
Physical Therapist-Center Manager
SSM Physical Therapy

St. Louis-Downtown

635 Locust Street

St. Louis, MO 63101

(p) 314-241-1891

What is Plantar Fasciitis?

The Plantar fascia is a  thick connective tissue that runs from the calcaneus (heel) to the heads of the metatarsal bones (to the bases of the toes). When the toes are extended, the PF tenses via what’s known as the Windlass mechanism. When you push-off with your toes when walking or running, the PF tenses, raising your arch, and providing a stable and strong base for your foot. When your foot is flat on the ground when you’re walking, the arch flattens, stretching your PF.  You need just the right amount of “give” and flexibility in your arch to be able to handle the stresses you put on it. The plantar fascia helps support your arch, but small tears can occur in it, especially if you have flat feet (over pronator) or high arches (supinator), if you walk, stand, or run for long periods of time (especially on hard surfaces), if you are overweight, if you wear poor/old shoes, or if you have a tight calf or limited big toe range of motion. Plantar fasciitis is inflammation, thickening, or degeneration of the plantar fascia, depending on how long you’ve had the symptoms and where your tissue is at in the healing process. The pain usually occurs at the base of the heel where the fascia connects to the heel bone.  It is also common to have stiffness in the bottom of your foot. It’s usually worse when you first step out of bed in the morning or after you’ve been sitting or standing for a long period of time. Over time, you may develop a bone spur on your heel, however bone spurs may not be symptomatic. To help prevent plantar fasciitis it’s important to wear proper shoes, stretch your calves and toes as well as to strengthen the small muscles of your feet. Night splints can be helpful as well as rolling your arch on a frozen water bottle. Be mindful to gradually start or return to activities and stay hydrated.

 

 

Ellen Milton, DPT, OCS, COMT

Center Manager

SSM Physical Therapy

219 E. Vandalia St. Edwardsville, IL 62025

Ph: 618-659-9666

How Do I know if I Need Orthotics?

Good question, do your feet hurt? It seems like a simple response but the reality is flat feet, high arched feet, or something in between varies tremendously amongst individuals. A recent study in the military found that static positioning of feet had no correlation to brand recommended shoes to reduce risk of injury. In support of orthotics, though, the Journal of Orthopedic and Sports Physical Therapy (JOSPT) in December 2014 created a consensus statement that the use of orthotics for plantar fasciitis had strong evidence to support it. The research also stated that pre-fabricated vs. custom showed no significant difference at 1 year outcomes and that people experience acute bouts of pain often could be rid of orthotics after 6 months. More confused than ever? Reality is there are many factors that contribute to whether or not a person needs orthotics. An orthopedic surgeon or physical therapist can provide you the necessary evaluation and assessment of biomechanics to determine whether or not intervention is needed. But if you don’t have foot, knee, ankle, hip, or back pain and someone suggests orthotics, perhaps just say no and be thankful you are not hurting.

 

-SSM Physical Therapy Sports Team

How Long Does it Take to Play Sports After an ACL Reconstruction?

This topic is dependent on a few factors. First, is this the 1st reconstruction? Most athletes will return to actual competitive play within 9 months, some a little less and others up to a year. For 2nd or 3rd injuries there could be concern that mechanically an athlete is no protecting their body parts due fast, high paced activity. Second, what sport is that athlete returning to? A sport like baseball can commonly see athletes returning within 6-7 months if diligent with their rehabilitation exercises.  Basketball and volleyball are 8-9+ months since there is a lot of jumping and landing, putting the ACL at risk. Third, how compliant are you with your training regiments? While the first two answers involve the sport and number of injuries the most important factor is whether or not the knee is prepared for competition. Working closely with your physical therapist, orthopedic surgeon, trainer, and coach an athlete that is focused and motivated stands a better chance to return faster and safer. Quad strength, single leg squat, jump/land technique, and knee control while running and cutting are just a few tests done by physical therapists to assess return to sports. These objective tests help determine whether an athlete has what it takes to return to full competition.

 

-SSM Physical Therapy Sports Team

What is Shoulder Impingement?

Now that spring is upon us, you may hear the term “shoulder impingement” more often. It is commonly seen in athletes who participate in overhead sports such as softball, baseball, tennis, swimming, and volleyball but can occur in those who perform repetitive overhead activities at work or home as well. The term “impingement” refers to a pinching of soft tissue structures such as tendons and bursa between the shoulder blade (scapula) and the upper arm bone (humerus). This mechanical compression can occur due to rotator cuff weakness or injury, a structural abnormality such as a curved acromion, or an imbalance in the flexibility or strength of the shoulder muscles. The rotator cuff consists of four muscles surrounding the scapula that attach to the humeral head and pull the head down into the socket to allow the arm to move unimpeded during overhead motion. When the rotator cuff is not functioning properly, the humeral head glides instead of rolls upward, pinching the soft structures between it and the acromion (tip of the scapula). With repeated pinching, the bursa and tendons become irritated and inflamed creating bursitis and tendonitis. Symptoms include pain when raising the arm out to the side then overhead, pain can occur during midrange and is known as a painful arc. Pain is usually located at the top of the shoulder but can radiate down the upper arm to the elbow and is worse when reaching overhead, behind the back or when reaching out to the side as when reaching into the back seat while sitting in the front seat. Pain is usually worse during movement and better at rest but may hurt when lying on it at night. When left untreated, the condition may deteriorate and result in a more serious rotator cuff injury. Consult with your physician regarding a diagnosis as treatment may consist of rest from the aggravating factors, injections to reduce inflammation, taping to reduce pain and promote healing, or physical therapy to restore normal shoulder mechanics.

What is Iliotibial Band (ITB) Syndrome?

Pain along the outside of the knee can be debilitating to an athlete causing severe pain during running, squatting, stair climbing, or cycling activities. The iliotibial band (ITB) is a thick connective tissue that runs from the outside of the iliac crest (pelvic bone), down the thigh and past the knee joint and has attachments to the shinbone, kneecap and surrounding muscles. ITB syndrome occurs commonly during activities such as running and cycling that involve repetitive bending and straightening of the knee. The ITB functions to assist in stabilizing the knee; however, inflammation occurs if repetitive bending and straightening of the knee leads to irritation of the underlying bursa or to the ITB itself due to rubbing against a bony portion of the femur or thigh bone. ITB syndrome can occur as a result of training errors, structural abnormalities, or mechanical imbalances. Running on a canted surface creates a leg length discrepancy placing more stress on the hip and pelvis. Overtraining or poor shoe wear can contribute to onset of symptoms as well. Structural issues such as a leg length difference caused by scoliosis or a degenerative process can cause pain, and mechanical issues such as a weak core or imbalances in strength and flexibility in the lower extremities can result in tightening of the ITB. Cyclists with poor posture or those who ride a bike that is not properly fitted often develop ITB syndrome. Symptoms include pain along the outside of the knee that is worse when the heel hits the ground when walking or running or when swinging the leg through during gait. Tenderness and swelling may occur at the lateral knee. Conservative treatment includes rest, physical therapy designed to address the mechanical imbalances, and adjustments to current training program. Physician consultation may be needed to rule out other injuries such as lateral meniscus tear or lateral collateral ligament injury.

Cindy Shimamoto, PT, OCS, COMT

Center Manager – Creve Coeur

SSM Physical Therapy

12382 Olive Blvd.

Creve Coeur, MO  63141

314-453-9675 (phone)

 

What is Shoulder Impingement?

Now that spring is upon us, you may hear the term “shoulder impingement” more often. It is commonly seen in athletes who participate in overhead sports such as softball, baseball, tennis, swimming, and volleyball but can occur in those who perform repetitive overhead activities at work or home as well. The term “impingement” refers to a pinching of soft tissue structures such as tendons and bursa between the shoulder blade (scapula) and the upper arm bone (humerus). This mechanical compression can occur due to rotator cuff weakness or injury, a structural abnormality such as a curved acromion, or an imbalance in the flexibility or strength of the shoulder muscles. The rotator cuff consists of four muscles surrounding the scapula that attach to the humeral head and pull the head down into the socket to allow the arm to move unimpeded during overhead motion. When the rotator cuff is not functioning properly, the humeral head glides instead of rolls upward, pinching the soft structures between it and the acromion (tip of the scapula). With repeated pinching, the bursa and tendons become irritated and inflamed creating bursitis and tendonitis. Symptoms include pain when raising the arm out to the side then overhead, pain can occur during midrange and is known as a painful arc. Pain is usually located at the top of the shoulder but can radiate down the upper arm to the elbow and is worse when reaching overhead, behind the back or when reaching out to the side as when reaching into the back seat while sitting in the front seat. Pain is usually worse during movement and better at rest but may hurt when lying on it at night. When left untreated, the condition may deteriorate and result in a more serious rotator cuff injury. Consult with your physician regarding a diagnosis as treatment may consist of rest from the aggravating factors, injections to reduce inflammation, taping to reduce pain and promote healing, or physical therapy to restore normal shoulder mechanics.

Cindy Shimamoto, PT, OCS, COMT

Center Manager – Creve Coeur

SSM Physical Therapy

12382 Olive Blvd.

Creve Coeur, MO  63141

314-453-9675 (phone)

314-469-1294 (fax)

shimamoc@ssm-select.com

How Do I know if I Need Orthotics?

Do your feet hurt? It seems like a simple response but the reality is flat feet, high arched feet, or something in between varies tremendously amongst individuals. A recent study in the military found that static positioning of feet had no correlation to brand recommended shoes to reduce risk of injury. In support of orthotics, though, the Journal of Orthopedic and Sports Physical Therapy (JOSPT) in December 2014 created a consensus statement that the use of orthotics for plantar fasciitis had strong evidence to support it. The research also stated that pre-fabricated vs. custom showed no significant difference at 1 year outcomes and that people experience acute bouts of pain often could be rid of orthotics after 6 months. More confused than ever? Reality is there are many factors that contribute to whether or not a person needs orthotics. An orthopedic surgeon or physical therapist can provide you the necessary evaluation and assessment of biomechanics to determine whether or not intervention is needed. But if you don’t have foot, knee, ankle, hip, or back pain and someone suggests orthotics, perhaps just say no and be thankful you are not hurting.

-SSM Physical Therapy Sports Team

How Long Does it Take to Play Sports After an ACL Reconstruction?

This topic is dependent on a few factors. First, is this the 1st reconstruction? Most athletes will return to actual competitive play within 9 months, some a little less and others up to a year. For 2nd or 3rd injuries there could be concern that mechanically an athlete does not have the mechanical and core strength to protect their knee. Second, what sport is that athlete returning to? A sport like baseball can commonly see athletes returning within 6-7 months if diligent with their rehabilitation exercises.  Basketball and volleyball are 8-9+ months since there is a lot of jumping and landing – putting the ACL at risk. Third, how compliant are you with your training regiments? While the first two answers involve the sport and number of injuries the most important factor is whether or not the knee is prepared for competition. Working closely with your physical therapist, orthopedic surgeon, trainer, and coach an athlete that is focused and motivated stands a better chance to return faster and safer. Quad strength, single leg squat, jump/land technique, and knee control while running and cutting are just a few tests done by physical therapists to assess return to sports. These objective tests help determine whether an athlete has what it takes to return to full competition.

-SSM Physical Therapy Sports Team

Do you have any tips to enhance performance while outside in the cold weather?

The weather during this time of year poses a challenge to those who practice sports or run outside for several hours.   One of the most important things to do prior to the workout is to check the weather forecast.  If you will be outside for 2 hours, find an hourly weather report online and determine the temperature and conditions both at the start of the workout and the prediction for the end of the workout.  If there is a 10-20 degree or higher difference between them, you will need to prepare with the right gear.  Typically you need to dress as if the temp is 10-20 degrees warmer than it actually is at the start of your exercise.  For example, if it is 20 degrees, dress how you would if it were 30 deg.  Then add a layer or more until you are comfortable but not too hot.  Remember that you will be working out and will increase your body temperature quickly depending on your activity.  Thin layers can be shed as you warm up, this includes sweat pants, long sleeved shirts or jackets.  Prepare for the wind by using a wind-breaker and always dress in moisture-wicking material to absorb sweat and ensure that as you begin to cool down your skin is as dry as possible.  Accessories are very important.  Gloves to protect hands and fingers, hats or headbands to protect ears, and wool socks are good options and can be removed quickly if body temperature rises.  Be aware of signs and symptoms of frostbite and hypothermia.  Frostbite occurs when a body part freezes and becomes injured.  Warning signs are numbness, tingling, loss of sensation and occur more frequently on exposed areas such as fingers, toes, and the nose and ears.  Hypothermia occurs when the body temperature dips abnormally low and can be signified by increased shivering, slurred speech, impaired coordination, and lethargy.  Commonly  cold temps combined with wind speeds up evaporation of sweat from the skin and can lower the body temperature,  resulting  in a greater danger of both of these conditions so be aware of the windchill factor when checking the weather report.   Don’t forget to hydrate as you will still sweat and lose fluids during exercise even in the cold.  Drink sports fluids and water to retain electrolytes and avoid dehydration.

Cindy Shimamoto, PT, OCS, COMT

Center Manager – Creve Coeur

SSM Physical Therapy

12382 Olive Blvd.

Creve Coeur, MO  63141

314-453-9675 (phone)

314-469-1294 (fax)