Whether you are a professional athlete, high school player, weekend warrior, or working on a New Year’s resolution, you are likely to experience a sprain or strain in your efforts to improve.  When that happens, what you do next is easy as pie, or as we say in sport medicine, easy as “RICE”.

That stands for Rest, Ice, Compression and Elevation.

REST: First, if it hurts badly when you do something, don’t do it.  Rest the painful body part as much as possible until the inflammation has calmed down, then you can begin to stretch and gently exercise without pain. Rest is not always a bed thing, our bodies need it to heal and repair damaged tissue.

ICE: As soon as you start to feel the pain, ice the injured body part.  What we recommend is ice for 15 minutes every 2-3 hours or immediately after an activity that aggravates the pain.  Never put heat on an inflamed joint or muscle as this will only make it worse in the long run.

COMPRESSION: I am mixed on the long term use of braces however early on in the healing process; a compression sleeve, elastic brace or ace wrap will help you control the pain and swelling. Following an injury, controlling the swelling should be your number 1 goal.

ELEVATION: And finally elevation of the body part throughout the day, but especially at night or after activity. Try and elevate the injured body part above the heart to reduce any swelling that may have occurred during the day, this will make a big difference in how you feel the next day.

Once the inflammation and swelling have subsided, it’s time to begin a program of gentle stretching and strengthening to get you back in the game or yard.  Start slowly and if you have any questions on how best to return to the activity that injured you, contact one of the sports medicine experts at SSI Physical Therapy and we’ll have you back in the game in no time.

– Lance Owens MS, PT, ATC, MBA, SCS 

A good exercise program incorporates stretching, strengthening, and aerobic conditioning.  Stretching is a very important part of exercising, but is often overlooked.  Many people either skip stretching completely, or only spend a couple of minutes stretching.  Ideally, everyone should spend time stretching daily.

There are many benefits to stretching.  Stretching helps to avoid injury.  Many types of pain and injuries are caused by poor flexibility.  These include plantar fasciitis, headaches, tendinitis, muscle cramps, pulled or torn muscles, low back pain, and shoulder impingement.  Stretching also improves posture, improves flexibility and joint range of motion, maintains normal length of muscles, releases tension in muscles, and improves circulation.

Be sure to stretch safely.  Start with a gentle stretch and progress as your muscles become more flexible.  The longer you hold a stretch, the more your muscles will adapt to the new length.  It is recommended to hold a stretch for 30-60 seconds and repeat 3-5 repetitions.  DO NOT BOUNCE.  Find a position where you feel a pulling or stretching sensation, but not pain, and hold that position.  Remember to keep breathing throughout the stretch.

Should you stretch before or after you exercise?  Stretching can be part of your warm-up routine; however, be sure to start slowly and be careful not to overstretch.  Once you are done exercising, your muscles will be warm and more flexible so you can be a little more aggressive in your range of stretching.  If you need motivation to start a stretching program, consider finding a friend to join you, work with a personal trainer, or take a yoga class.

Every major muscle group in the body needs to be stretched.  Click the link below for some flexibility stretches to get you started!

Flexibility Stretches from SSI!

As always, contact a physician or physical therapist before initiating a new exercise program.  If you have any question, contact us!

- Holly Mader, PT, OCS

You’re a few weeks into your New Year’s Resolution to walk or run, but you have noticed your feet have started to hurt.    Assuming it was because you were doing something new, you keep going- 2012 is the year!   But now when you wake up in the morning and step on the floor you have sharp pain.  It even takes you a few steps before you can walk somewhat normally.   You don’t want to stop exercising, but this pain is making you miserable.    Why is this happening and what can you do?

Foot pain can be caused by several things, but many times if you develop foot or heel pain after initiating a new exercise program it is because you have developed plantar fasciitis.    Plantar fasciitis is an inflammatory process of the plantar fascia which is a thick, connective tissue that runs from the heel to the toes.    Pain from plantar fasciitis can be located at the heel or in the arch of the foot and typically occurs with the first few steps in the morning or going to walk after a long period of sitting.

To treat plantar fasciitis you must stretch the plantar fascia and your Achilles tendon.    To stretch your plantar fascia,   place your fingers at the base of your toes, pull your toes back towards your shin until you feel a stretch in your arch.    Hold this stretch for 30 seconds and repeat 3 times.

To stretch your Achilles tendon, place a belt around the ball of your foot with your knee straight.    Pull your foot towards your shin, you should feel a stretch in your calf.  Hold for 30 seconds and repeat 3 times.    Repeat the same stretch with your knee slightly bent to isolate your deeper calf muscle the soleus.    Repeat all 3 of these stretches 3 times per day.    Stretching will improve the flexibility of the Achilles tendon and plantar fascia and decrease your pain at your heel.

 In addition, you should also use ice to decrease the inflammation of the plantar fascia.    Fill up a water bottle, freeze it, and then roll it from the ball of your foot to your heel for 8 minutes.    The cold from the ice will help decrease the inflammation and rolling your foot on the bottle will help stretch out the plantar fascia.

If you continue to have pain after stretching consistently for a week or more, see your Physical Therapist for treatment.    A Physical Therapist will evaluate your foot and develop a treatment plan that may include soft tissue mobilization, manual stretching, therapeutic exercises, and modalities to decrease your pain and keep you walking or running so you can keep your New Year’s Resolutions!

Contact us if you have any questions!

- Rachel Daubenmire DPT, ATC

New Year’s Resolutions can be thwarted for many reasons, but don’t let pain be one of them!   Common places for overuse injuries include the shoulder and the elbow.   Could one of these be one of your New Year’s pains?

Shoulder pain:
Shoulder pain towards the front or outside of the shoulder that cannot be attributed to any particular injury is often cause by muscular imbalance or decreased flexibility.   Either of these can contribute to a decrease in the space between your humerus (the upper arm bone) and the outer aspect of your shoulder blade (the shelf at the top of your shoulder).   When people refer to the rotator cuff, they are talking about four muscles whose job is to hold the ball in the socket.   One of the muscles of your rotator cuff runs in the space between the ball of your humerus and the bottom of the shelf, and when this muscle gets pinched, it is called impingement.   This is a common source of shoulder pain.

As previously mentioned, impingement is often caused by a muscular imbalance or by decreased flexibility.   Many people who work out their shoulders (bench press, military press, etc) do not often stretch their shoulders.   This causes a decrease in the flexibility of the muscles and the joint capsule that surround the joint.   See a physical therapist to learn healthy and appropriate ways to stretch your shoulder.

A muscular imbalance means that muscles at one aspect of a joint are significantly stronger or tighter than the muscles on the other side of the joint.   In the shoulder, many people tend to emphasize their chest workouts to the neglect of their upper back workouts.   In reality, everything we do happens out in front of us, and the muscles on our front sides tend to be stronger and tighter than the muscles on our backsides.   Everyone has seen an older person who is hunched forward but who has ever seen any person who is hunched backward?   Along this line of thought, we should emphasize upper back workouts more than chest workouts to compensate for the fact that everyday life and gravity are pulling us back in the direction of being four-legged!   By increasing the strength in our upper backs, we are able to balance out the natural strength in our chests and more appropriately center the ball of the shoulder joint in the socket so nothing is being unnecessarily pinched.

Elbow pain:
One of the most common overuse injuries in the elbow is tendinitis.   This can occur at the thumb side of the elbow (tennis elbow) or at the pinky side of the elbow (golfer’s elbow) and is more common with using a lot of free weights or increasing to heavier weights too soon.   To treat your own tendinitis, hold your affected arm straight out in front of you at shoulder height.   If your pain is thumb-side, turn your hand palm down (palm up if your pain is pinky-side). Using your unaffected side, take hold of your fingers and hand on the painful arm and bending at your wrist, pull your fingers back toward your elbow.   A stretch should be felt in your forearm. Hold this stretch for 30 seconds and repeat 3-5 times.   If this does not significantly improve your elbow pain, seek further attention from your physical therapist.

If you have any questions, contact us!

-by  Betsy Harris MSPT, OCS

Back pain during the holidays is enough to turn anybody into the Grinch.  It is estimated by the Centers for Disease Control and Prevention (CDC) that over 50,000 people each year sustain a winter and/or holiday related back injury.  This could range from shoveling snow, slipping on ice, and pulling the dreaded artificial tree out of the attic.  It could also be the less obvious such as the excess weight gain from all the holiday cookies.  Here are some helpful tips to keep your back pain-free:

• Watch your posture: When decorating, pulling out boxes, or carrying in bags – avoid the heavy lifting – make more trips with less weight, avoid the twisting and the awkward positions.  Extra weight that is anatomically correct can put undue stress on ligaments, muscles, and discs in your low back
• Cook with sense: At home, if you spend a lot of time with cooking or baking holiday meals and treats, be sure to use a work surface at a high enough level to avoid hunching over. Stand on a cushioned mat or non-slip rug to avoid muscle fatigue and back ache. When removing heavy pans from the oven, lift from the knees, not the waist.
• Prevention:  Maintaining a regular exercise program that includes both cardiovascular activity and flexibility training, and keep your back and core muscles strong. Maintain a healthy weight, or take steps to lose weight if you have excess.

-  Chris Cobb MS PT, COMT, DPT

Physical therapists are movement specialists! Whether you want to return to a sport or be able to play with your grandkids… physical therapy gets YOU MOVING!

Hands on! Manual therapy is more than just massage and can be a very important part of your physical therapy treatment. SSI Physical Therapists are trained in using their hands for stretching, mobilizing stiff joints and massaging tight muscles to help with your treatment.

Young and old! SSI Physical Therapists work with people of all ages. From infants to seniors, we can get you moving!

Study hard! Physical therapists have up to 7 years of school before they can become a licensed therapist. After finishing a bachelor’s degree, many students today are entering a doctoral level program (typically 3 years) after which, they must take a national exam to practice in the field. Visit www.fsbpt.org for more information on licensing of physical therapists in your state! 199 colleges and universities nationwide support 212 accredited physical therapy education programs.

Inpatient, outpatient, home health… Physical therapists practice in a variety of settings including inpatient rehabilitation facilities, outpatient clinics, skilled nursing facilities, extended care, homes, education & research centers, schools, hospices, industrial/workplace settings, fitness centers, hospitals & sports training facilities. SSI is considered an outpatient facility that treats orthopedic and neurological disorders.

Conditions treated at SSI Physical Therapy include arthritis, back pain, balance problems, burns, carpal tunnel syndrome, developmental delays, COPD, dislocations, post-fractures, hand injuries, headaches, incontinence, lymphedema, osteoporosis, pelvic pain, sports injuries, stroke & TBI….. just to name a few!

APTA (American Physical Therapy Association) is the national association for physical therapists. This organization represents more than 77,000 PTs, PTAs and physical therapy students and has been around since 1921. To learn more about APTA, please visit www.apta.org.    All of SSI’s Physical Therapists are active members of APTA and the SC Chapter.

Love our jobs! A survey conducted in 2007 revealed that > 75% of physical therapists polled were “very satisfied” with their occupations. PTs were second only to clergy and were the only health care professionals in the top 5!

 Treatment of Plantar Fasciitis is a common ailment treated by SSI Physical Therapists. Chronic foot and heel pain can make everyday activities, even getting out of the bed, miserable. 

Healthy Living!!  After SSI’s Physical Therapists get you moving and relieve your pain we want to keep you moving.  SSI has organized fitness programs at both locations to keep you active. In addition, SSI’s Greer location house a state of the art Health Club and

Exercise! One of the most popular components to any physical therapist’s treatment plan is EXERCISE! SSI Physical Therapists are trained in using and developing ways to strengthen & stretch your muscles and joints to improve function and correct muscle imbalances. In most cases, patients will have a home exercise program to complete outside of therapy and also to continue once they have finished with physical therapy.

Return to work & play! SSI Physical Therapists receive additional training to become certified in administering functional capacity evaluations (FCE) and/or other functional assessments. These tests can help a physician determine when a patient is ready to return to work and also what the patient is capable of doing functionally. FCE’s are typically a 2-3 hour test that includes lifting, pushing, pulling, aerobic capacity, range of motion and strength assessments. Other functional assessments may include return to sport testing and balance testing.

Assistants: Physical therapy assistants are licensed professionals that work with patients while they are in therapy. PTAs can help patients in many ways including helping with their exercises and applying ice, heat and other modalities. A PTA must work under the supervision of a licensed physical therapist.

DPT: Doctor of Physical Therapy (DPT) degree. 96% of all accredited programs now offer the DPT and the remaining 4% plan to convert to the DPT in the future. A Master’s of Physical Therapy degree (MPT) was the highest degree offered for physical therapy students until recently and according to APTA’s Vision 2020, “By 2020, physical therapy will be provided by physical therapists who are doctors of physical therapy, recognized by consumers and other health care professionals as the practitioners of choice to whom consumers have direct access for the diagnosis of, interventions for, and prevention of impairments, functional limitations, and disabilities related to movement, function, and health.”  Over 90% of SSI’s Physical Therapists have their Doctorate or Advance Certifications.

LYmphedema is a condition that is treated by SSI Physical Therapists. According to the A.D.A.M. Medical Encyclopedia, lymphatic obstruction is a blockage of the lymph vessels that drain fluid from tissues throughout the body and allow immune cells to travel where they are needed. Lymphatic obstruction may cause lymphedema which means swelling due to a blockage of the lymph passages, usually occurring in either an arm or leg. The most common cause of lymphedema is the removal or enlargement of lymph nodes and can occur following surgery, particularly mastectomy. Following mastectomy, 10-15% of patients will develop lymphedema. Although lymphedema is a chronic condition and does not have a cure, it can be managed successfully. Physical therapy plays an important role in lymphedema management with light exercise, compression bandaging, patient education and manual techniques that help the body to drain lymph fluid from the arm or leg.

Growth of employment for physical therapists is expected to be 30% between 2008 and 2018 according to Bureau of Labor Statistics. As the population ages and is living longer, physical therapy is important to keep people active and enjoying their lives.

E-stim/TENS, ultrasound, iontophoresis, anodyne, heat & ice are all examples of modalities that SSI Physical Therapists might use to treat a patient. Modalities help decrease pain and inflammation.

Teach! SSI Physical Therapists are great teachers about posture, lifting mechanics, anatomy, precautions to follow after surgery and injury prevention. We love to talk to groups, so let us know if there is a group or topic you want to learn more about.

Specialization. Physical therapists can choose to become certified in one or more of eight specialty areas of practice. These include cardiovascular & pulmonary, clinical electrophysiology, geriatrics, neurology, orthopedics, pediatric, sports & women’s health. Certification involves a minimum number of hours working in the specialty area and applicants must pass a national exam. Certified specialists can be found at www.abpts.org

 Your game!  Physical Therapy can help you improve YOUR game whether you are a runner, cyclist, golfer, tennis player or love to play pick-up games of basketball.  SSI’s PTs can show you sports specific strengthening and stretching programs to help improve your performance!

Orthotics. SSI has physical therapists that are specially trained to fit patients for and make custom orthotics. Orthotics are not only prescribed for patients with foot and ankle problems, but can also be helpful for patients with leg, hip or lower back pain.

Underwater: Although patients aren’t under the water completely, aquatic therapy is sometimes helpful for physical therapy patients. Being in a pool helps to unweight the joints making exercise easier and allowing patients who may not be able to exercise on land to get moving! Aquatic therapy is used for patients with low back pain, post-surgical weight bearing restrictions, arthritis, multiple sclerosis, lymphedema and hip/leg pain. Aquatic Therapy is offered at both of SSI’s locations.

 Measuring is important to track progress in physical therapy. SSI Physical Therapists use goniometers to measure angles of joints, tape measures to document swelling and their hands to measure strength by applying resistance. On your first visit to a physical therapist, we will take lots of measurements so that we can track your progress throughout your treatment and can set measurable goals for your care.

One third of adults 65 years old and older fall each year in the United States according to the CDC. Of those that fall, 20-30% of them suffer moderate to severe injuries. Not only can SSI Physical Therapists help treat these patients after they fall, we can also teach fall prevention. Strengthening, stretching and balance training can help older adults remain functionally independent and mobile and help prevent falls. Education also plays a role in fall prevention. Knowing potential fall hazards and utilizing the correct assistive devices (cane, walker, etc.) can help stop a fall before it happens.

Vestibular rehab is another service provided by SSI’s Physical Therapists to treat dizziness and vertigo. According to the Vestibular Disorders Association, Vestibular therapy can help with a variety of vestibular problems, including benign paroxysmal positional vertigo (BPPV) and the unilateral or bilateral vestibular hypofunction (reduced inner ear function on one or both sides) associated with Ménière’s disease, labyrinthitis, and vestibular neuritis. Even individuals with long-term unresolved inner ear disorders who have undergone a period of medical management with little or no success may benefit. Vestibular therapy can also help people with an acute or abrupt loss of vestibular function following surgery for vestibular problems. Visit www.vestibular.org for more information on vestibular function and vestibular rehabilitation.

DIrect access means that patients can see a SSI Physical Therapist without a doctor’s order. 46 states, including South Carolina have direct access laws in place and most insurance carriers will cover PT services under direct access. Currently, Medicare does not cover physical therapy services provided under direct access and these patients still need a doctor’s order to seek physical therapy.

Neuropathy is another condition that is treated by physical therapists. SSI physical therapists can determine an appropriate treatment plan for patients with peripheral neuropathy that may include strengthening, stretching, balance training and modalities such as anodyne which is an infrared light therapy that is indicated to increase circulation and reduce pain, stiffness, and muscle spasm.

Goals! When you are evaluated by a physical therapist at SSI, the two of you will develop goals for your treatment to get you back to doing what you need and want to do. These goals will guide your treatments and will help you and your PT know when it is time for you to graduate from physical therapy.

National Physical Therapy Month is October! Take some time to learn more about what physical therapy can do for you and spread the word!

Overuse injuries are another condition that physical therapists help to treat as well as prevent. SSI PTs go into work environments and evaluate work stations to determine if changes could be made to help prevent overuse injuries.

Wellness & injury prevention are important responsibilities for physical therapists. Educating patients and our communities about health and wellness is another way to keep everyone moving and enjoying life!

Football season is here and along with it is tailgating! In celebration and to limit calories in the game day feast, SSI Health Club director, Alison Howard has found low calorie rcipes for your tailgating feast. Check back with us each week for the latest recipes!

Did you miss the previous recipes? Week 1 – Chili Con Queso, Week 2 – Boneless Buffalo Wings,  Week 3 – Southwestern Layered Bean Dip

Week 4 – Barbecued Pork & Coleslaw Sandwiches

Two Southern favorites are combined here: pork in sweet barbecue sauce and crunchy coleslaw.  This is an interesting, healthy alternative to the traditional pulled-pork barbeque.

Ingredients
Coleslaw
     3 tablespoons cider vinegar
     4 teaspoons sugar
     2 teaspoons canola oil
     1 teaspoon Dijon mustard
     1/4 teaspoon celery seeds
     1/4 teaspoon mustard seeds
     1 cup shredded green cabbage
     1 cup shredded red cabbage
     1 carrot, shredded
     Salt & freshly ground pepper to taste
Barbecue Sauce
     1 teaspoon canola oil
     1 onion, chopped
     1 clove garlic, finely chopped
     1 cup ketchup
     1/4 cup cider vinegar
     1 tablespoon brown sugar
     1 teaspoon dry mustard
     1 teaspoon Worcestershire sauce
     1/4 teaspoon hot pepper sauce
     Salt to taste
Pork & Rolls
     2 12-ounce pork tenderloins, trimmed
     6 Kaiser or other large rolls, split

Preparation
1.  To make coleslaw:   Whisk together vinegar, sugar, oil, Dijon mustard, celery seeds and mustard seeds in a mixing bowl.   Add green and red cabbage and carrots; toss well.   Season with salt and pepper.
2.  To make barbecue sauce:   Heat oil in a saucepan over medium heat.   Add onions and garlic and sauté until golden brown, 4 to 5 minutes.   Add ketchup, vinegar, sugar, mustard, Worcestershire, hot pepper sauce and salt.   Cook, stirring, until the mixture boils, 1 to 2 minutes.   Remove from the heat and set aside.
3.  To cook pork and assemble sandwiches:   Preheat the broiler.   Place tenderloins on a broiler pan and season with salt and pepper.   Broil 4 inches from the heat until lightly browned, about 6 minutes.   Turn the tenderloins over and broil until the internal temperature registers 160°F, 6 to 7 minutes longer.   (The center should be juicy with just a trace of pink.)   Let the meat stand for 5 minutes before cutting into thin strips.   Add the meat to the barbecue sauce and toss well.
4.  To assemble the sandwiches:   Layer the coleslaw and the pork mixture inside rolls.

Serving Size:  1 sandwich, makes 6 servings.

NutritionPer serving:  413 calories;  9 g fat ( 2 g sat , 3 g mono );  74 mg cholesterol;  55 g carbohydrates;  32 g protein;  4 g fiber;  547 mg sodium;  713 mg potassium.

Nutrition Bonus:   Selenium (48% daily value), Vitamin A (45% dv), Vitamin C (35% dv), Potassium (20% dv), Zinc (17% dv).

Carbohydrate Servings: 3 1/2

Exchanges: 2 starch, 1 other carbohydrate, 1 vegetable, 3 1/2 lean meat

- from EatingWell.com

Due to the age of the participants, a lot of the responsibility for injury prevention falls on the coach.   It is important for all coaches to be aware of the rules of the sport as well as the proper techniques used for lifting and flying in stunts.   Proper hand placement of the bases and spots is key to ensure ankle injuries are avoided in the girls who are flying.   Improper hand placement can also lead to wrist and shoulder injuries in the girls at the bottom of the stunt.

Although knee injuries are not among the most popular sites for injuries, they do occur and are more common in the female population.   Coaches should watch their athletes land from jumps, dismounts, and tumbling sequences.   The goal is to land all of these with the knees directly over the feet. If the athlete has increased weakness, she/he may land with the knees close together and inside the feet.   This type of landing can lead to knee injuries such as ACL/MCL sprains/tears.

Proper conditioning is a key component to preventing injuries.   Coaches should include time during each practice where the athletes participate in specific exercises to promote core, arm, and leg strengthening.   It is also important to incorporate endurance training to ensure the athletes are performing at their best – injuries are more likely to occur when they are tired and more careless with their form.

So coaches, cheer your way to a VICTORY by keeping your team educated on the proper techniques as well as keeping them strong and fit for the high physical demands that are needed for a perfect routine.

-Kendall Kineard, DPT

For more information, Contact Us!

Football season is here and along with it is tailgating!   In celebration and to limit calories in the game day feast, SSI Health Club director, Alison Howard has found low calorie rcipes for your tailgating feast.   Check back with us each week for the latest recipes!

Did you miss the previous recipes?  Week 1 – Chili Con Queso, Week 2 – Boneless Buffalo Wings

Week 3 – Southwestern Layered Bean Dip

Plenty of black beans, salsa and chopped fresh vegetables mean a healthy amount of dietary fiber in this Tex-Mex layered dip.   We use reduced-fat sour cream along with full-fat (and full-flavored) cheese to make the dip lighter without compromising great taste.   Be sure to have lots of baked tortilla chips on hand when you serve it.

Ingredients
1 16-ounce can nonfat refried beans, preferably “spicy”
1 15-ounce can black beans, rinsed
4 scallions, sliced
1/2 cup prepared salsa
1/2 teaspoon ground cumin
1/2 teaspoon chili powder
1/4 cup pickled jalapeño slices, chopped
1 cup shredded Monterey Jack, or Cheddar cheese
1/2 cup reduced-fat sour cream
1 1/2 cups chopped romaine lettuce
1 medium tomato, chopped
1 medium avocado, chopped
1/4 cup canned sliced black olives, (optional)

Preparation
1.  Combine refried beans, black beans, scallions, salsa, cumin, chili powder and jalapeños in a medium bowl. Transfer to a shallow 2-quart microwave-safe dish; sprinkle with cheese.
2.  Microwave on High until the cheese is melted and the beans are hot, 3 to 5 minutes.
3.  Spread sour cream evenly over the hot bean mixture, then scatter with lettuce, tomato, avocado and olives (if using).

Makes 12 servings, about 1/2 cup each.

Tips & Notes
Make Ahead Tip: Prepare through Step 1, cover and refrigerate for up to 1 day.   To serve, continue with Steps 2 & 3.
NutritionPer serving: 146 calories; 7 g fat ( 3 g sat , 3 g mono ); 12 mg cholesterol; 15 g carbohydrates; 7 g protein; 5 g fiber; 288 mg sodium; 164 mg potassium.

Nutrition Bonus:   Fiber (20% daily value), Vitamin A & Vitamin C (15% dv).

Carbohydrate Servings: 1/2

Exchanges: 1 starch, 1 very lean meat, 1 fat

Adapted from EatingWell.com