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How to Improve Joint Range of Motion When Stretching Isn’t Enough

How to Improve Joint Range of Motion When Stretching Isn’t Enough

One of the toughest parts of having an injury or an operation is when you struggle to get the motion back into your joint. Often times, surgeries require you to be immobilized for a certain period of time such as in an ACL tear or a Rotator Cuff tear. This is needed to allow the repairs to heal. Sometimes your joint may get stiff because there was significant trauma and swelling creating scar tissue in the joint such as after an ankle sprain or a total knee replacement. Limited motion in our joints can cause us to compensate in our walking or in our ability to do our every day activities. Limited motion in the joint will also decrease the strength of the muscles surrounding the joint. Stretching and mobility exercises can help but are more effective on muscle and tendons. To stretch the capsule of the joint which is what is causing the stiffness, the most effective method is through Low Load, Prolonged Duration(LLPD) stretching. LLPD is sometimes called TERT which means Total End Range Time. The concept is that you are applying a low load or stretch for a long period of time at the end of the joints current range of motion.

Shoulder Pain As It Relates to Baseball

Shoulder Pain As It Relates to Baseball

Overhead activities such as throwing a baseball, is one of the most strenuous motions you can perform at your shoulder and elbow. No other exercise or activity can quite reproduce the stress on the joint and ligaments quite like throwing a ball. Baseball players are at risk for several injuries due to the high repetitions of throws they have to perform in games and practices. One typical injury we see is having pain in the anterior or front portion of the shoulder while throwing. This is called anterior instability and can be tested by performing an apprehension test which Dr. Chuck Bachi describes in this video. By placing the arm in the cocked position it causes the head of the humerus bone to slide forward and stress the front of the shoulder. When he pushes down on the head of the humerus to “ relocate” it, the pain is gone. This is a positive test for anterior Instability. So how do we treat it?

Top Exercises To Prevent Dance Injuries

Top Exercises To Prevent Dance Injuries

Core Strength

Dancers are notorious for having strong bodies and core. Many dancers practice for several hours a day on top of other activities such as school and work. Due to the high demands and the high level of endurance needed to dance all day, dancers need a stronger core than the average person. Many dance positions call for elongation of the spine. It is important to strengthen the muscles the way they would function in dance rather than static positions or typical flexion based core strengthening such as a crunch. When we refer to the core we are not just talking about your abdomen but rather a combination of muscles that form a cylinder at your trunk and consist of your abdomen, back, pelvic floor and diaphragm. Proper function and breathing is required for optimization of movement. Check out these videos on Dance Specific Core Strength!

Physical Therapy Perspective on Ankle Dislocations in Athletes

Physical Therapy Perspective on Ankle Dislocations in Athletes

Within the last week, the Eagles’ number one corner, Ronald Darby, and the Phillies’ outfielder, Pedro Florimón, both suffered an ankle dislocation. The most obvious concern of a die-hard sports fan is how long these players will be out of action, and from a physical therapy prospective, the answer, of course, is “it depends”.

An ankle dislocation is a rare traumatic injury with only 1% of reported dislocations involving the ankle joint. As such, there is limited evidence on prognosis and clinical management for ankle dislocations. This injury is most common in falls, motor vehicle accidents, and, sports. It usually involves a fracture to the bony structures of the joint, as well as ligamentous, neurovascular (nerves/vessels) and skin involvement. Medial displacement of the foot (foot rolling inward) is most common with this type of injury, as is the case of both Darby and Florimón.

What is Active Release Technique?

What is Active Release Technique?

Active Release Technique (ART) is a movement based massage technique which has shown to have great effect in conditions involving strains/ sprains and overuse conditions such as tendinopathy. ART is performed by professionals who have undergone extensive training and have superior knowledge of anatomy. ART is unique from other types of massage in that it has an active component.

The Top 5 Tips for Better Posture

The Top 5 Tips for Better Posture

  1. Embrace your curves!
    1. Spine has normal curvatures that help to maximize your muscles ability to stabilize and position your spine in the least shearing or compressive positions. Using something like a Lumbar Pillow can help maintain your normal Lordotic curve at your low back.

Copyright: http://i162.photobucket.com/albums/t271/Mom2nat_2007/SpineCurves.jpg

The 5 secrets To Sitting Without Pain

The 5 secrets To Sitting Without Pain

People are sitting now more than ever. Study after study are showing that prolonged sitting and desk work are causing multiple health problems. There is increased pressure on the spine, overuse injuries causing carpal tunnel, sciatica, pinched nerves, headaches and low back pain to name a few. Short of switching careers there are some measures you can take to prevent these injuries.

Pelvic Floor Physical Therapy

Pelvic Floor Physical Therapy

What is Pelvic Floor Physical Therapy?

Physical therapists are trained to utilize their vast understanding of the musculoskeletal system to diagnose and manage movement dysfunction. Just as the muscles of the rotator cuff in the shoulder can become dysfunctional and lead to shoulder pain, the muscles of the pelvic floor can become dysfunctional and lead to a laundry list of problems. Enter, Pelvic PT!

Physical therapists specializing in Pelvic PT are trained to assess and treat musculoskeletal and neuromuscular dysfunction as related to the pelvis. Pelvic floor dysfunction includes, but is not limited to, urinary incontinence, pelvic pain, pelvic organ prolapse, sexual dysfunction, and associated conditions.

Fultz injury

Fultz injury

How bad is the Fultz injury?

Markelle Fultz is the latest Sixers rookie to be injured before ever playing a game for the team. If anyone else was watching the summer league to see what the #1 overall pick looked like, you probably saw and gasped when he landed on another player's foot and his ankle rolled. Luckily the x-rays were negative for a fracture, but it was scary seeing him being helped off the court unable to put any weight through his leg. What does a grade 1 ankle sprain mean, and what will his rehab look like?

Tendinopathy

Tendinopathy

Tendinopathy is the broad term used to describe pain at or along the insertion of muscle into the bone. Tendons are what connect our muscles to the bone and often times we can strain or injure the tendons. When injury occurs to the tendon we call this a tendinitis with the suffix “itis” referring to inflammation in the tendon. Without proper care and healing this injury can turn into a more serious problem termed tendinopathy. When an injury to a tendon lasts longer than 4-6 weeks and starts drifting towards over 3 months this becomes a chronic issue and is harder to treat. This is where the research starts to lack sufficient evidence as to why pain and injury linger. It is theorized to result from mechanical overuse with inflammation during the acute stage and degeneration in the chronic stage1.

5 Tips For Arm Care In Spring Sports

5 Tips For Arm Care In Spring Sports

High school spring sports season means the return of baseball, softball, lacrosse, and track (and usually still snow on the ground). Also, it means the first time that some athletes are practicing their sports since last year. The Journal of Athletic training published an article looking at the incidents of shoulder injuries by month of the high school season.

This data tells us that injuries are happening most commonly during the first month of the season. This finding could be attributed to a couple of causes, including lack of preseason preparation or a deficit in regaining mobility after normal soreness when first returning to an exercise. Since the offseason preparation window has closed, let’s talk about how to manage soreness and tightness through stretches to avoid compensations that could lead to injury.

Ken, Disney and 3DPT

Ken, Disney and 3DPT

When I was 6 years old, my family took me to Disney World for the first time. I can still remember the sights, sounds, and smells from this trip. I still think of happy memories of the rides, fireworks, and meeting the characters with my grandparents, aunts, uncles, and cousins. I returned to Disney a number of times while I was growing up. My wife and I visited the parks during part of our honeymoon. More recently, I have been able to go with my two daughters as well as my parents and in-laws. Each and every time I go back to Disney, I am reminded of the same sights, sounds, and smells as that first time. Each vacation brings me back to being six and holding my grandparents’ hands while watching the fireworks over the castle.

My “Almost” Ironman Story

My “Almost” Ironman Story

I recently crossed off a BIG bucket list item when I completed my first Ironman triathlon (2.4 mile swim, 112 mile bike and 26+ mile run) in early October. I was convinced that this would be a “one and done” event – do the Ironman, finish it, and be done with it forever.

Mother Nature reared its ugly head, however, and due to unsafe conditions in the river, the swim part of the race was cancelled. Even though I completed the bike and the run and heard the words “Jeff Sallade – you are an Ironman!”, I came away feeling like I didn’t really finish the full race. That leaves me and my friends from the Medford Milers in search of another Ironman to do next year.

What is a Board Certified Physical Therapist?

What is a Board Certified Physical Therapist?

Board Certified Physical Therapists are:

  • Highly skilled
  • Have more accurate clinical diagnosis skills
  • Possess advanced manual therapy skills (especially Sports and Orthopedic specialists)
  • Have additional Postdoctoral Training and Education
For you, this means better care and better results in fewer treatment sessions.

A History of Physical Therapy in the U.S.

The Physical Therapy profession has been evolving and changing in America since “Reconstruction Aides” were tasked with helping wounded soldiers in the World War I. Since Physical Therapy in America was born as the result of war, it is not surprising that the first PT school was started at Walter Reed Army Hospital right after World War I began.

The field evolved from treating injured veterans. and by the 1920’s, was being utilized as a treatment for individuals suffering from Polio. In the 1940’s, Physical Therapy practice began to advance from instructing in exercises, massage, and traction to include joint mobilizations of the spine and extremities. By the 1950’s, Physical Therapists began moving out of the hospital setting and into outpatient clinics, schools, skilled nursing facilities, colleges/universities, and rehabilitation centers.

As the Physical Therapy profession grew and expanded, the need for specialization became evident. In 1974, the Orthopedic section of the American Physical Therapy Association (APTA) was created. The APTA now has 7 other specialized sections: Sports, Pediatrics, Geriatrics, Neurology, Women’s Health, and Clinical Electrophysiology.

Physical Literacy for Kids

Physical Literacy for Kids

Thirty years ago, kids did not have video gaming consoles and cell phones to keep them entertained. Rather than sitting in front of a computer screen for hours on end, kids would venture outside for fun. They would climb trees, jump on trampolines, throw baseballs, kick soccer balls, and run at full speed while playing tag. Nowadays technology has found its way into every home in some way, shape, or form. A study conducted by the CDC in 2011 found that nearly one-third of high school students play video or computer games for 3 or more hours on an average school day.1 As of 2012, only 6 states (Illinois, Hawaii, Massachusetts, Mississippi, New York and Vermont) require physical education in every grade, K-12.2 In January of 2015, the World Health Organization published a report on physical activity which found that over 80% of the world’s adolescents did not meet the recommended activity guidelines of 60 minutes a day of moderate to vigorous intensity.3 Kids are not getting out and about and experiencing the same amount of physical activity than children in the past.

My MRI Showed...

My MRI Showed

Patients are often discouraged by the findings of an MRI. We often hear patients say something along the lines of “The MRI showed I have a herniated disc and the only way to fix it is surgery, but my doctor wanted me to try Physical Therapy first” or “my insurance company will not cover the surgery unless I do Physical Therapy first”. As Physical Therapist we love to hear that because that means we have the opportunity to change the way this person thinks about their condition and about Physical Therapy. There is nothing more satisfying then seeing that same person walk out the door pain free and fully functional without the need to have surgery.

Youth Pitch Counts

Youth Pitch Counts

Arm fatigue is the number one cause of shoulder and elbow injuries in youth baseball players. Many athletes play on multiple teams in the spring and summer, so it is even more important to know and understand the limitations on pitches per day and the recommended rest breaks in between pitching. These limits apply for ALL teams that an athlete plays for, so if an athlete pitches for their school team, they should follow the recommended rest before they pitch again for either the school or the travel team.

3 Keys to a Positive Outcome in Physical Therapy

3 Keys to Positive PT=

When it comes to optimizing the ability to have a positive outcome in physical therapy, 3 areas must be examined. These areas include attitude about an injury, therapeutic alliance, and compliance.

A patient’s attitude about their injury can greatly affect the results they have in physical therapy. Thoughts and beliefs about an injury will lead to one’s attitude which in turn translates to their motivation. For example, if someone believes that their injury is too severe and there is no hope that they will ever get better, they will be less likely to have the drive that is needed to complete the steps and exercises required to achieve their goals.

The Benefits of Instrument Assisted Soft Tissue Mobilization

Dry Needling

“Can I Scrape you?”
You might hear this phrase from your therapist at 3DPT during your visit, but before you become alarmed by what that means, let us explain. Instrumented assisted soft tissue mobilization (IASTM) can be associated with ancient Eastern healing technique known as Gua Sha which means, “to scrape”1. Gua Sha therapy uses flat edged surfaces such as Jade or coins to create local ischemia or bruising on skin surfaces to release toxins2. Recently, IASTM has gained notice as an adjunctive manual therapy method that involves specialized tools made of metal, plastic or ceramic. It has become widely noticed in the sport and athletic settings for the use on tight and restricted muscles. You may have heard about the Graston Technique which is a unique set of tools that are used with specific techniques developed by Graston3. Currently, there are a variety of tools on the market for therapeutic use but they all are designed to achieve the same outcomes.
Now, you may be thinking “Metal? Bruising? No thanks!” but before you dismiss this technique let’s look at some of the research that shows IASTM to have benefits for various injuries.

6 Points to Ponder when Picking your PT

Thinking Guy

When going to any medical appointment, you are trading your time and money (copay or deductible) in the belief that the interaction will help you to get better. Whether you have pain, an illness, or loss of function, the medical appointment should lead you down the right path towards recovery. This could be in the form of medication, a surgery, a diagnostic test, or an exercise session. I have had a number of patients tell me that they have “never seen Physical Therapy like this before” when they come to 3DPT, which made me ask about what their previous experiences were in Physical Therapy. Below are 6 key questions to ask when scheduling your first Physical Therapy visit and think about on each follow up visit to make sure that you are trading your time and your money for the best services to get you back to full function.

Kinesiotape: What is it and how can it help you?

You've seen athletes on TV with strips of colored tape on their bodies, from the Olympic Games to the NCAA tournament. First popularized in the 2010 Vancouver Olympics, this taping method was first developed by Dr. Kenzo Kase 30 years ago in Japan. The Method was designed to facilitate the body's natural healing process while allowing support and stability to muscles and joints without restricting the body's range of motion. Although the media has primarily associated Kinesio Taping with popular athletes, 85% of its applications are for non athletes. It is used to successfully treat a variety of orthopedic, neuromuscular, neurological and medical conditions. Kinesio Taping has become a very popular technique in the worlds of physical therapy and athletic training, but what is it, and what are the benefits?

The Meniscus Surgery Conumdrum

In the United States there are approximately 850,000 people undergoing meniscal surgeries every year. Are you—or somebody you know—on the fence and unsure of where to turn?

We at 3DPT are here to help you decide.





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"The team at 3DPT is made up of dedicated and caring Physical Therapists whose expertise and hands-on approach are what I seek for my patients. It is their fundamental philosophy that has made my professional experiences with them nothing short of exemplary."

     -      Dr. Kathryn Gollotto, DO - Orthopedic Reconstruction Specialists