What Goes Up, Must Come Down

Due to the anatomy of the human ankle, when a person's foot hits the ground the resulting forces can be transferred up an individual's whole lower extremity in what are known as "obligatory motions/movements".  The shape of the ankle joint forces the tibia (main lower leg bone) to either rotate inwards or outwards depending on the motion that the foot undergoes.  The two main movements of the foot that are commonly focused on are "pronation" and "supination". 

 

Pronation of the foot can generally be thought of occurring when a person's weight is bore more on the inside of the foot, and supination more on the outside.  Due to the obligatory motions of the foot and ankle, pronation of the foot causes the tibia to turn inwards ("internal rotation"), while supination of the foot causes the tibia to turn outwards ("external rotation").  These coupled motions continue up the "kinetic chain," in this case the rest of the lower extremity.  If the foot pronates, then the knee flexes and also bends inward in what is known as a "valgus" direction (think knock-knees).  The femur (upper leg/thigh bone) also is forced to internally rotate at the hip joint.  With supination it is the opposite, the knee extends, the knee bows outward ("varus" direction) and the femur externally rotates just like the tibia. 

 

Because of this biomechanical connection between the foot, the hip and everything in-between, one should take into account what is occurring at the foot with any orthopedic problem that a person has involving the lower extremity.  The opposite also holds true, one should always consider the hip as a potential factor when dealing with a problem involving the rest of the lower extremity, all the way down to the foot.  Strength deficits of the hip muscles as well as structural abnormalities of the femur can both play a role in common orthopedic issues of the lower extremities such as plantar fascitis and knee pain. 

 

Fortunately a thorough examination performed by a skilled physical therapist can determine the appropriate treatment to address these types of orthopedic problems.  Whether it be therapeutic exercises, recommendation of appropriate footware, manual therapy and SASTM, electrophysical modalities (example: ultrasound), or a combination of different treatments, physical therapists are very capable of helping individuals return to their normal quality of life and function. 

                                                                                                                     ~Drew Nelson, PT, DPT

 

2013 Triathlon Training Program

Peak Performance
Triathlon Training Program

• 9 week program
• starts Feb 2nd, register by Jan 25th
• weekly spin classes
• swim analysis
• run clinic & strength training
• functional assessments by physical therapists

For more information email peakperformance1@verizon.net or click on

http://www.mlcpt.com/images/mlc_program.pdf

Check out our new program for Triathletes!

Peak Performance Triathlon Training Program

Designed for optimal performance & conditioning

• Functional screen by a physical therapist
  
• Swim analysis & conditioning
  
• Triathlon specific spin class
  
• Strength training

Click this link to view more information about Peak Performance!

Torticollis

Mary Lou Corcoran Physical & Aquatic Therapy’s Pediatric Team evaluates the infant/child’s range of motion, muscle tone, posture, developmental milestone and neuromotor status to identify areas of concern. A treatment plan is developed in conjunction with family/caregiver education. Without treatment, Torticollis patients’ fail to develop essential range of motion and eye convergence effecting the visual field, neglect of one upper extremity, jaw malalignment, scoliosis, muscle imbalances, poor balance, misshapen heads and extreme muscle tightness.

Therapeutic interventions include hands on techniques such as manual therapy, neuromotor re-education and modalities. Combination stretches into multiple planes of motion target the sternocleidomstoid muscle in supine, prone, sitting and side lying positions. One on one techniques utilize bilateral upper extremity task completion including fine motor skills and scapular stabilization.

Education of the parent(s)/caregiver(s) is provided through the use of interactive demonstrations along with illustrative handouts teaching proper hand positions, stretching techniques and positioning while emphasizing “tummy time” when the infant is awake and active.

MLCPT’s exclusive Pediatric Program was developed by two of our physical therapists with over 30 combined years of hands on pediatric clinical experience. Throughout the child's care at MLCPT, the Physician, parent(s)/caregiver(s), and therapist work together to help the child develop their maximum functional independence.

Persistent Wrist Pain Following Distal Radius Fracture

Have you broken your wrist and still have experience pain with gripping and twisting activities like pouring a drink or turning a door knob? Did you believe that you have a sprained wrist, as a result?

A common problem from a broken wrist (distal radius fracture) is pain after the fracture has healed. The distal radius is commonly broken because it bears 80% of the force when falling on an outstretched arm. This is why more people break this bone (radius) instead of the other bone in the forearm, the ulna. However, although the fracture occurs at the “thumb side” of the wrist, there is a ligament complex located on the opposite side of the wrist called the triangular fibro cartilage complex (TFCC) that can be injured. Additionally, the distal radius bone can heal shorter than it once was which will ultimately produce more force though the articular disc and TFCC creating more pain.

Studies indicate that 35-50% of all patients with wrist fractures present with problems in the TFCC region. As a result, an individual who has a recent wrist fracture may begin to feel discomfort at the ulnar/pinky side of your wrist after the bone heals and they start to regain motion. People will often complain of clicking, increased swelling, weakness, and lack of motion. They have difficulty with activities such as turning a door knob/key as well as difficulty ironing, scrubbing, performing a push up, Yoga and pouring a drink.

Rehabilitation following a distal radius fracture involves the use of modalities, range of motion and strengthening exercises. How well healed the fracture is (based on x-rays) and when an individual begins physical therapy determine what exercises they should be doing. These exercises may need to be modified by a physical therapist especially when persistent wrist pain is present. Functional recovery for stable fractures without complications can be six months and 1-2 years for complex fractures. Fortunately, the rehab process does not take that long. It is the therapist’s role to educate the patient and assist them in making maximizing their outcomes both in the clinic and home setting. The goal of physical therapy is introduce the patient to all of the available tools and exercises available to manage their symptoms until recovery is complete.

The wrist is very complex and requires careful evaluation to develop a good plan of treatment to achieve maximal functional recovery. If you are experiencing these symptoms and would like to schedule evaluation with our upper extremity team please call Marylou Corcoran Physical and Aquatic Therapy (315) 637-4747.

Operation Walk

Operation Walk is a non-profit organization that allows severely disabled arthritic patients in countries with underdeveloped health care systems to receive total-joint replacements at no cost. The recipients of care are afflicted with intense and unrelenting pain with mobility limitations that make the experience of a normal and productive life nearly impossible. The goal of Operation Walk is to enable people to return to their lives as productive members of society. To date, Operation Walk has conducted successful operations in Panama, Ecuador, Russia, Cuba, China, The Phillippines, Nicaragua, Peru, El Salvador, Vietnam, and the United States.

MLCPT is proud to announce that Julie Randall, PT, CSCS, LMT will be a member of an inter-disciplinary medical team that will be traveling to Kathmandu, Nepal in November 2011, the first journey for Operation Walk Syracuse. As a member of Operation Walk, Julie will be working closely with physicians (from St Joseph’s, SUNY Upstate and Crouse Hospitals), physical therapists, nurses and other health professionals; maximizing the post-operative outcomes of over 75 joint replacements to be performed in one week. While in Nepal, she will not only be responsible for the direct care of post-operative patients, but she will also serve as an educator, helping to instruct Nepalese health care workers in the latest techniques in rehabilitative science.

As you may imagine, the cost for such an endeavor can be staggering. In the United States, the charges for one hip or knee replacement can be in excess of $100,000, with the total cost being greater than $7,500,000. Fortunately, through the donations of more than 40 professionals, coupled with donations from implant and pharmaceuticals companies, the cost is reduced significantly. Contributions continue to be needed, however, to cover $200,000 in remaining expenses for team transportation, supply shipping, food, lodging, non-donated supplies and equipment repairs. If you have an interest in helping support Julie and Operation Walk, we would encourage you to visit the Operation Walk website to make a donation.

Don't Forget The Gluteals!

Do you have a stubborn running injury that won't go away? Do you ignore working your gluts in your training while focusing on your quadriceps and hamstrings? Most people fail to recognize that many common running injuries are often traced back to weak gluteals, namely the gluteus maximus and the gluteus minimus.

The gluteus maximus is the larger of the gluteals. Its primarily extends your leg/hip while you are walking. If you have a weak gluteus maximus, you may develop limited range of motion in your hip, poor running form, slower speeds and muscle imbalance that often leads to injury. The smaller of these muscles, your gluteus medius, has an even more important role. Located on the outer surface of your pelvis, it is responsible for stabilizing and balance your hips. when balanced on one leg, as is the case when walking and running. With exercise programs designed without emphasis on the the gluteals, many runners and athletes suffer from poor balance, and they do not even realize it.

How are they able to run with poor balance? They compensate by using other muscles that aren't intended to be used for balance. Over time, runners with poor balance will develop bad form and alignment issues in their hips leading to pain and injury. Common running injuries due to weak gluts include ITB syndrome, patellar tendinitis, hip flexor tendonitis, achilles tendinitis and even plantar fascitis.

How do you check your balance to see if this may be your problem? Practice standing on one leg with your knee slightly bent and time yourself. Repeat the same activity on your opposite leg. Pay attention to see if one leg easier to stand on than the other and assess if you have pain while standing on either leg.

Another, more challenging test (if the first is too easy) is to try a single leg squat. Try standing on one leg and while maintaining your balance, complete a squat. Are you able to maintain your balance? Does your knee bow inward or outward? Do you have pain and/ or difficulty completing the task? If so, you may need to work on strengthening your gluteals.

Most people who run will experience at least one or more injuries over the course of their running career. There are many simple ways to prevent these injuries without spending hours at the gym, using fancy equipment or lifting heavy weights to achieve good results. Effective exercises to strengthen the gluteals and improve your balance can be done with no equipment and with a minimal amount of time/effort.

If you are interested in prolonging your running career or improving your running form/overall health, a visit to a knowledgeable physical therapist can be a very helpful and beneficial way to achieve your goals. Although the gluteals are important, they are just one of many muscles groups involved in running and other athletic activities whose dysfunction and imbalance can lead to injury. Mary Lou Corcoran Physical and Aquatic Therapy has experienced clinicians who work with runners and athletes at varying stages of their lives, helping them relieve pain and return to a lifestyle that is important to them.

Many injuries, if caught early, can be healed much quicker and easier if stopped before they are serious. Don’t wait until the pain is severe before looking for help. If you are experiencing pain, consider calling us at (315) 637-4747 to schedule an appointment with one of our physical therapists for an evaluation and movement analysis screening; it may be the best decision you make in your efforts to maintain an active and healthy lifestyle.

Posted by Julie Randall, PT