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Jennifer Lane

Chronic Ankle Instability: Why does my ankle constantly give out on me?

Chronic Ankle Instability: Why does my ankle constantly give out on me? 635 405 Jennifer Lane

Ankle sprains are the most common musculoskeletal injury in physically active people. Chronic ankle instability can arise from repeated acute lateral ankle sprains. Lateral ankle sprains are incurred when your ankle rolls outward. The ligaments are strained or torn causing pain and instability. Research shows that individuals who sustain an ankle injury are more susceptible to re-injury which can result in a string of long-term issues. Chronic Ankle Instability, or CAI, is a term used to describe patients who have experienced prolonged functional deficits and report subjectively that their ankle is unstable. Over time, these people are less physically active, which can lead to decreased health-related quality of life and increased risk of developing ankle osteoarthritis as compared to healthy individuals.

What is the cause of this long-term ankle instability? Studies have shown that when given functional performance tests, individuals with a history of CAI tested as well as people without ankle pathology. But when asked how their ankle felt, the subjects who had CAI reported feelings of instability while performing the tests. So, what is the root of the issue? I would suggest that after suffering an ankle injury, proprioception is affected. Proprioception is the ability to know where your body or limbs are in space without consciously controlling it or looking at it. Proprioception helps you make minor adjustments in joints to stay balanced (piicture, standing on a moving train without falling). If you can’t sense properly where your ankle is, it is more likely that you will roll it again. For more info, read “Assessing Outcomes in People with Chronic Ankle Instability” in Journal of Orthopaedic & Sports Physical Therapy.

What should you do if you have rolled your ankle once or multiple times? See a PT who can prescribe appropriate balance and stability exercise, use Kinesiotape and who can check for proper ankle mobility, strength and flexibility.

What is Painful Bladder Syndrome (or Interstitial Cystitis)?

What is Painful Bladder Syndrome (or Interstitial Cystitis)? 520 250 Jennifer Lane

Also called Interstitial Cystitis, Painful Bladder Syndrome is a condition of chronic pain in bladder, pelvic floor, lower abdomen and low back that has persisted > 6 weeks with no infection present.  Urinary frequency and urgency are 2 additional symptoms. The average person urinates 7 times per day or every 2-4 hours. With Painful Bladder Syndrome, a person may go to the bathroom every 30-60 minutes. Urinating tends to be painful and incomplete. There is also an increased sense of urgency to get to the bathroom. While there is usually not any incontinence, there is an uncomfortable sense of urinary urgency. Women are 2-3 times more likely to suffer from this syndrome and there are many variables that may contribute to the pain syndrome including irritating foods and drinks, stress and dehydration.

Physical Therapy can help! If someone has been diagnosed with Painful Bladder Syndrome or Interstitial Cystitis, an evaluation by a specially trained PT should be performed. In this exam the PT is assessing for pelvic floor dysfunction including weak and/or tight muscles of the pelvic floor, reports of urinary frequency and urgency, reports of constipation or painful bowel movements, reported pain with intercourse and unexplained pain in pelvic region, bladder and lower back. Tightness, spasming and trigger points may be found in the 3 layers of pelvic floor muscles. These trigger points may refer pain to the bladder, low back or lower abdomen. Through soft tissue mobilization, the muscles can be restored to a normal state and Painful Bladder Syndrome symptoms can be reduced.

The treatment for painful pelvic dysfunctions differs from urinary incontinence issues. Treating a painful pelvic floor involves relaxing and lengthening the muscles of the pelvic floor whereas incontinence issues are treated with strength training. For someone experiencing a lot of pain from tight muscles, strengthening becomes part of the problem, not the solution.

To learn more about what PT can do for you, here is a helpful information from the Interstitial Cystitis Association. Read on…

Avoiding Upper Body Injuries

Avoiding Upper Body Injuries 612 408 Jennifer Lane

Playing sports is great fun and an excellent way to stay healthy and in shape, no matter what the age.  But what are the best ways to avoid injury while playing them? It’s important to train your muscles in the way you will use them during competition. Running every week at a 10-minute mile will not prepare you for sprinting up and down a soccer field on the weekend. The same muscles are being utilized but in a much different way. Throwing a ball in the backyard is not the same as pitching multiple innings in a baseball game. Whether you are playing in a rec league, a competitive league or professionally, there are steps you can take to protect your body from injury.  Here are just a few ways you can stay healthy and safe while having fun:

  1. Wear proper head gear: mouthguards, helmets, eye protection help prevent concussions and trauma to face and teeth. Football, lacrosse, ice hockey are contact sports that require proper head protection.
  2. Learn proper techniques: many injuries are sustained from over-use. If proper techniques are utilized while throwing a ball, hitting a puck or kicking a ball you can stay safe to play another day. Also, knowing how to check properly or tackle can help prevent you injuring someone else.
  3. Maintain a strong core: power is transferred from a strong core through the shoulders and hips. The spine stays protected from checks, hits, rapid deceleration and acceleration when you have a strong core. In contact sports, padding in addition to strong abdominal muscles can help protect the organs from any blunt force trauma.
  4. Treat an injury immediately: if you sustain an injury, R.I.C.E. immediately. Rest, Ice, Compression and Elevate. Continue with this protocol for first 72 hours until swelling resolves or until you can see a healthcare provider. If you hit your head, check for a concussion. Most coaches are now trained in screening for concussions. And don’t return to sports before you are ready. Returning to sports before you have healed properly just leads to re-injury and possibly more damage. Take the proper amount of time to recover and seek out a physical therapist to help you rehab correctly from your injury.

Read on for more information about Upper Body Injuries sustained in Ice Hockey. Need more? ProStock Hockey for all your hockey needs.

 

What is the Core?

What is the Core? 451 256 Jennifer Lane

Core strengthening or stabilization has become the buzz phrase in a lot of gyms and fitness classes. But what is it and what is it’s job? Think of the core as a canister. The top of the canister is the diaphragm. Yes, the diaphragm is a muscle and it is an important one! Not only does it help us breathe but it also is very important in having a strong core. The bottom of the canister is the pelvic floor muscles. There are three layers of muscles and their primary job is to keep us continent and to support our internal organs. The walls of the canister are made up of transverse abdominus, internal obliques, multifidus, gluteus medius/minimus and deep hip muscles. The main foll of all of these muscles are to provide a stable base from which to move. To be able to walk, reach for an object, get dressed or participate in any sporting activity, your core muscles activate to hold you stable and balanced. Weakness and instability in the core muscles leads to injury to joints and soft tissue. Weakness in core muscles can lead you to lose your balance and fall, strain your back or your neck. Peaple with weak core muscles tend to have chronic issues with their spine including neck pain and headaches, poor posture and low back pain.

How do you train these muscles to work properly? It is important to work with someone who can cue you correctly. We are great at compensating with stronger muscles whose primary job is not stabilization and this leads to injuries. A qualified physical therapist, pilates instructor or personal trainer can help you learn how to activate the muscles properly. But here are three tips to start you off.

Tip #1: With your hands on your lower ribs, take a deep breath in feeling the ribs expanding laterally into your hands. As you exhale feel your hands come back together. Practicing this and improving on rib excursion during deep breathing activates the diaphragm, one of the most important muscles in the core.

Tip #2: Stand up with good posture. Don’t force it by sticking your chest out or arching your low back. Stand naturally and then pull your belly button in towards your spine as if you were tightening your belt. Try not to move your rib cage or your pelvis while you do that. This is a subtle move and if you were doing this in a crowd of people, they wouldn’t even notice you doing it.

Tip #3: This may be the easiest. Squeeze your buttocks. In standing, sitting or lying down, tighten up those cheeks. This activates the gluts which are part of your core muscles. When contracting them, neighboring muscles also activate helping you have a more stable core.

For more info or help getting a stronger core, contact Jenn Lane at jennlane@holisticpt.net.

What is Pelvic PT?

What is Pelvic PT? 1000 667 Jennifer Lane

Pelvic Physical Therapy is a specialized form of PT that focuses on, to name a few, pelvic pain, urinary incontinence, sexual dysfunction and muscular dysfunction of the pelvic floor muscles. It also addresses issues like diastasis recti, the splitting of the abdominal wall usually after pregnancy. Pelvic Physical Therapists assess the musculoskeletal system of the pelvic region, abdominal region, lumbo-sacral spine and hips. PT’s examine how musculoskeletal issues can adversely impact people’s daily lives, and treatment is designed to help restore normal function. Pelvic dysfunction, like urinary incontinence can have profound impact on someone’s daily activities. It can keep someone from going out with friends, running errands or participating in community activities due to fear of urinary leakage. With specific muscular work and prescribed exercises, a patient can expect reduced incontinence and return to normal activity participation.

There are three functions of pelvic floor muscles. The first is to provide sexual pleasure, second is to keep you continent and the third is to support the organs of the abdomen. Pelvic floor muscles are part of our core and help to provide some stability through our trunk while performing activities.

Here is a great 3D video of the female reproductive system. Do you or someone you know suffer from pelvic floor dysfunction? Get help! Don’t suffer in silence! There are skilled practitioners ready to help you on your road to recovery. Contact Jenn Lane, PT at Holistic PT to set up an appointment today!

What is Vertigo?

What is Vertigo? 1440 431 Jennifer Lane

Vertigo is often described as a feeling a spinning, dizziness, light-headedness, nausea or loss of balance. What causes it? It can be caused from inflammation to the vestibular nerve, inner ear dysfunction or another neurological problem. Some of the symptoms are blurred vision, sensation of the person spinning or the environment spinning, ringing in the ears, nausea and loss of balance. These symptoms have a profound effect on quality of life and can be very disabling to a person suffering from this.

Vertigo is a catch-all phrase for many kinds of dysfunctions. It is therefore important to get the correct diagnosis. Your physical therapist in conjunction with an Ear Nose and Throat doctor will be able to run tests to determine what is causing your symptoms. Benign Paroxysmal Positional Vertigo (BPPV) causes severe sensation of spinning. According to its name, symptoms only occur in very specific head positions. It is caused by the otoconia, or crystals in inner ear becoming dislodged from the utricle and get stuck in a semi-circular canal. There are sensors in the semi-circular canals that get stimulated by the floating crystals and give the sensation of spinning to the brain. It can be diagnosed by a specially trained PT and is treated with a simple maneuver to move the crystals out of the canals and back into the utricle.

There are other diagnoses associated with inner ear dysfunction including Meniere’s, vestibulitis and labrynthitis. A specially trained practitioner should be able to differentially diagnose between the different causes of vertigo. Vestibular Rehabilitation Therapy (VRT) is a specialized form of therapy to treat both the primary and secondary problems caused by vestibular issues. Therapy will work on habituation exercises, gaze stabilization and balance training. Our ability to balance is governed by 3 separate systems in the body. The vestibular system (inner ear), visual system and proprioception are a redundant system so that if one is not working we are still able to balance and function. For instance, in a dark room, most people can keep their balance. Walking on sand or a soft surface doesn’t cause most people to lose their balance either. When one system is not working properly, the other 2 systems can be up-trained to pick up the slack. This is a key concept in VRT.

If you suffer from loss of balance, dizziness, ringing in the ears or spinning sensation, find a PT trained specifically in Vestibular Rehab. You don’t have to live with these debilitating symptoms.

For more information, keep reading!

Understanding Vestibular Disorders

What is BPPV?

 

 

Risk of Falling in Elderly Patients

Risk of Falling in Elderly Patients 466 800 Jennifer Lane

Risk Factors for Falling in Elderly Patients

Statistics show that at least 1/3 of people over age 65 fall at least once per year. This frequency increases as people get older too. Falls can lead to fractures, most commonly wrist and hip. Mortality rates increase to greater than 75% after a hip fracture is sustained. When a patient falls, they lose confidence in their physical capabilities and therefore reduce their activity levels and community participation. The cost to the healthcare system is also great as the population ages and medical attention is needed following a fall.

What can physical therapy do to help? There is strong support for the effectiveness of exercise, balance work and gait training in the prevention of falls in older people. Exercise helps strengthen key muscles like the quadriceps and calf muscles. Physical Therapists are experts in challenging patients in a safe and meaningful way to gain functional ability and reduce the likelihood of falling.

There is an interesting article from Australia that goes into more detail on the matter. See link below.

https://www.sciencedirect.com/science/article/pii/S1836955315000120

What Causes Low Back Pain and Sciatica in Older Adults?

What Causes Low Back Pain and Sciatica in Older Adults? 682 1023 Jennifer Lane

In patients 80 years and older, what causes low back pain and radiating pain into the leg? The incidence of lumbar disc herniation increases into adulthood but it then decreases significantly in people 80 years and older. So what is causing low back pain and sciatica symptoms? Spinal stenosis, the narrowing of the spinal column, foraminal stenosis, the narrowing of the opening through which nerves travel through or nerve root compression can all cause the classic radiating pain into the leg.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743527/

Why is this important? Because the treatment for a disc herniation versus stenosis can be very different. Treatment that can reduce radiating pain for a patient with a herniated disc could increase the pain for a patient with stenosis. A careful evaluation performed by a Physical Therapist can help determine what is causing the pain and then can develop the appropriate plan of care.

Concussions in the Youth Athlete

Concussions in the Youth Athlete 420 280 Jennifer Lane

There are over 300,000 high school athletes that suffer from concussions every year. A study conducted at Northwestern University showed that the number of diagnosed concussions doubled from 2005 to 2015, female athletes experienced greater rates of concussions than male athletes playing the same sports.

This rise in numbers is due in part to athletes coming forward with mild and moderate symptoms as well as more attention being brought to the issue by schools, media and parents. All sports are seeing a rise in reported concussions but many still go unreported. Young athletes still tend to put their team ahead of their own personal health. They don’t want to let down the team during an important game so they don’t come forward to report symptoms.

What are the symptoms of a concussion? Symptoms fall in these following categories: physical, cognitive, emotional symptoms as well as sleep disturbances. Throbbing head, light sensitivity, nausea, lack of appetite, difficulty concentrating, fatigue, loss of consciousness, dizziness, blurred vision, slurred speech, appearing dazed or confused, delayed response to questions, ringing in the ears are just a few signs that you might observe.

What is the role of PT in recovering from concussions? For many years, healthcare providers prescribed rest and removal of all stimulation from a patient recovering from a concussion. But now there is mounting evidence pointing to a more active approach to concussion rehab. Physical Therapists’ expertise in treating vestibular (inner ear), cervical (neck), ocular (vision) and post-traumatic migraines makes them key participants in the rehab process. For patients to have the best recovery takes an interdisciplinary approach that can involve PT’s, physicians, OT’s, ophthalmologists, neurologists, speech pathologists, to name a few.

There are great tools out there to help diagnose for concussions. If you are suspicious of having a concussion or your child having one, go see your PT, athletic trainer, coach or physician. They can help you get a proper diagnosis. There are other tools available too. Headcheckhealth.com app for concussion testing. You can run baseline, sideline and return-to-play concussion tests using mobile app.

The Risk of ACL injuries to the Female Athlete

The Risk of ACL injuries to the Female Athlete 735 490 Jennifer Lane

Female Athletes are 8 times more likely to injure their ACL’s than their male counterparts.

The ACL or Anterior Cruciate Ligament is a critical ligament in all sports involving cutting, sudden changes in directions and sudden stops and decelerations. Why are females more likely to injure this ligament? There are many different reasons including higher center of gravity, more laxity in ligaments, wider hips, slower reflex time, changes in estrogen levels and a greater quadricep to hamstring strength ratio. The good news is that the evidence shows that when female athletes follow a specific training and conditioning protocol, they can significantly reduce the likelihood of an ACL injury. The protocols include proper leg muscle strength training, proper balance and speed training, proper coaching on how to jump and land with bent knees and proper footwear and orthotics as needed. More specifically, plyometric and speed exercises showed to be most effective in reducing ACL injury. Here is a video of 7 excellent exercises for all young athletes to work on.

https://www.youtube.com/watch?v=xWBSf4BfKRk#action=share

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