ARE YOU AT RISK FOR AN ACL INJURY?

At one time, it seemed that the majority of injuries or tears to the Anterior Cruciate Ligament (ACL) happened to professional athletes. In recent studies, however, it is estimated that there are nearly 200,000 ACL-related injuries annually in the United States (1). Unfortunately, females (particularly athletes) are up to 9.7 times more likely to have ACL injuries than males. The increased rate of ACL injuries in central New York athletes was so dramatic by 2007 that Syracuse-area orthopedic surgeons held a meeting with all New York State Division III High School Athletic Directors to address the need for ACL injury prevention programs for the spring of 2008.

There are a variety of non-contact ways to tear your ACL including (but not exclusive to):

• Trying to slow down while running
• Jumping and landing off balance
• Leaping and landing on one foot
• Quick change of direction
• Jumping and landing with stiff legs/knees

Why do non-contact ACL injuries to occur?

Poor functional movement is the main cause for non-contact ACL injuries. Muscles of the hips and legs that are tight, weak and lack coordination produce abnormal stress on the joints they surround. During activity, joints can be limited in normal motion by stressed muscles and produce abnormal stress on the ligaments that hold the joint together. The ligaments are then unable to handle the stress load on the joint and tear.

Why is the ACL injury rate so high among young females?

Young women have a higher rate of ACL injuries for two main reasons:

1. During adolescence, young women are begin to develop wider hips, producing greater biomechanical stresses in the knee joints
2. Young women are less likely to have the muscle mass developed around the hips and legs to adequately control stress on the knee

Can ACL injuries be prevented?

There is no guaranteed way to prevent ACL injuries, however, the risk of an ACL injury can be reduced through physical assessment and functional screening. Physical assessment of joint and muscle function occurs during an anatomical screen where each joint range of motion, muscle group flexibility, and muscle group strength are assessed throughout the trunk, pelvis and legs. In comparison, a functional assessment looks at how well the muscles and joints work together during specific movements, keeping proper body alignment and minimizing stress on the body. If you would like to determine your own potential risk for ACL injury, here are 2 functional tests you can try at home:

• SQUAT TEST:Stand in front of a mirror, hands on hips, feet shoulder width apart and toes pointing straight forward. Squat down slowly and try to get your thighs parallel to the floor. You could be at risk for ACL injury if: (1) your heels rise off the floor, (2) your knees go inward, (3) your hips shift to left or right, (4) you lose balance and step out of squat position.
  

• SINGLE LEG STANCE BALANCE TEST: Stand and lift your right foot from the floor, bringing your right knee forward and up to about waist height. Try to balance on your left foot for 20 seconds. Try the same test on your right foot for 20 seconds. You could be at risk for ACL injury if: (1) you are unable to maintain balance for 20 seconds, (2) your arms, non stance leg or upper body wave around during test

If you have difficulty with any of these tests, you may want to find a ACL Injury Prevention program or Sports Performance program to evaluate what you have to work on to avoid injury. Mary Lou Corcoran Physical and Aquatic Therapy offers an Athletic screening program and ACL Injury prevention program. These programs are administered by physical therapists who evaluate an individual's risk for injury based on medical history, anatomical screen, functional screen, running analysis and sport position played (if appropriate). After the screen, problem areas are identified and an exercise program can be designed to address these areas. This program can not only reduce the risk of ACL or other injury, but can improve sports performance.

If you have any questions regarding ACL injury prevention or Athletic screening please call 315-637-4747 or send an email inquiry to ptinfo@mlcpt.com.

Reference

(1) Gammons M, Schwartz E. January 5, 2010 Anterior Cruciate Ligament Injury. Retrieved from Medscape website: http://emedicine.medscape.com/article/89442-overview

Posted by TROY ANDREWS PT, CES

MLCPT- Racing For the Cure...and For Local Children

On May 15th, MLCPT joined over 8,000 other central New Yorkers at the NYS Fairgrounds to raise money and increase awareness for breast cancer research at the Susan G Komen "Race for the Cure". The day was colder and windier than expected, but the weather could do nothing to dampen the spirits of those around us. Whether we were speaking with survivors and their families or groups of local youths/volunteers who were there to help in any way that they could, the collective energy at the fairgrounds filled us with a positivity that is difficult to put into words.



To show our solidarity as a team, MLCPT wore our Breast Cancer Rehab shirts that read "We Make BooBoos Feel Better", the Friday before the race and the day of the event. The shirts were designed specifically with the Komen Race in mind, but they were very warmly received in the clinic and there were many people who expressed an interest in acquiring one. So many patients, (both from our exclusive Breast Cancer Rehab program and orthopedic patients) requested shirts, we needed to place a second order of shirts. If you have any interest in a shirt for yourself (or someone else you may know), please do not hesitate to stop in or call for details.


The following weekend, MLCPT rallied together to participate in the 5k walk/run to benefit Charity for Children. For those who may not be familiar with the group, Charity for Children is:

"...a registered 501(c)(3) non-profit charitable organization dedicated to providing financial and educational services to needy families in Onondaga, Madison, Cayuga and Oswego counties with children who suffer from disabilities, diseases and disorders."

As one of the leading pediatric outpatient physical therapy offices in the Syracuse area, the staff at MLCPT witnesses first-hand the financial and emotional burden that many families experience in their efforts to do everything that they can for the health and wellness of their children. It was with those personal experiences in mind that we gathered at Green Lakes State Park to walk/run for yet another worthy cause. For the second weekend in a row, the sun chose not to shine, but it didn't prevent the event from being a tremendous success: a total of $10,000 raised for the charity.


The MLCPT team is proud to have spent the last 2 weekends working together to benefit the the CNY community. With a staff that is comprised of 3 cancer survivors and 2 parents of children with special needs, these 2 events in particular held a special place in our hearts and we are happy that we are able to contribute in some way. And although the race events themselves have concluded, the organizations that they benefit continue to provide a valuable service to the community all year long and would be grateful for any contributions that you can afford to give. Should you wish to make a donation please click the links below.

Physical Therapy Lobby Day

On May 18th, Mary Lou Corcoran, joined over 400 other physical therapists state-wide in traveling to Albany to speak with local representatives in both the senate and assembly regarding the passage of S.4321 (Breslin) / A.8171 (Cahill), bills designed to unburden the physical therapy patient of unfairly high co-pays.

Physical Therapists throughout New York State have been lobbying for the passage of these bills for over one year, hoping to lessen the financial impact that physical therapy has on those who need to attend physical therapy. Currently, the bill being proposed would limit a co-pay to be no greater than 20% of the total physical therapy bill, mandating that the insurance company pays their fair-share. In many cases, the passage of this bill would lead to a 75% reduction in the amount of money billed to a patient who needs physical therapy services.

Brandon Roth of NBC Channel 3 in Syracuse, covered the problems facing patients with high co-pays prior to lobby day:


With your help, New Yorkers can work to take back control of their insurance plans and cease this unfair business practice of managed care companies. We implore all New York residents to take action. If you would like to make your own voice heard you can:

1. Call, email, and write your state legislators and tell them you want LOWER physical therapy co-pays; ask for fair-co-pays and ask them to support of two bills in the State Legislature, S.4321 (Breslin) / A.8171 (Cahill), which will prevent managed care companies from requiring patients to pay these excessively high co-payments for PT.
2. Sign the NYAPTA's Online Petition here
3. Tell your employer and health plan you oppose these high co-pays for your physical therapy.
4. Write a letter to your local newspaper.
5. Call your local media and invite them to tour your practice and discuss these high co-pays.
6. Pass this information along to your coworkers, friends, and family.

Susan G Komen Race For The Cure

MLCPT has 16 participants this year in the Susan G Komen Race For The Cure. The event is Saturday, May 15th at the New York State Fairgrounds.

According to the National Cancer Institute, if trends continue, 1 in 8 females born today are likely to be diagnosed in the their lifetimes with breast cancer. The chances are simply too great that someone you know will be afflicted with this disease, if they haven't been already. The trends need to be reversed. Better treatment and a cure must be found.

It is not too late to sign up, if you would like to participate.

If you would like to help us reach our goal of $1500, we would be appreciative for any support that you and/or your friends or family members would be willing to provide. Should you be so inclined, you can click on this link to be redirected to our Komen Page. Once you are at our page, you can simply make a donation by clicking on the "Make a gift!" link as pictured to the right.

Thank you in advance for your support!

Posture: More Than Just Sitting Up Straight

You have probably heard it over and over, or you may have even said it yourself: "You need to sit up straight." Everyone knows they should have good posture. Beauty pageant contestants practice with books on their heads to stand straight. People spend money on special chairs and sit on giant exercise balls to improve their sitting posture. But despite hours of practice or hundreds of dollars spent on the next great thing, when people are asked about their posture, they usually say, "it is hard to hold good posture."

If posture is just sitting up straight, why can it be so hard to maintain?

As an orthopedic physical therapist at Mary Lou Corcoran Physical and Aquatic Therapy, every assessment I perform starts with posture. Whether a patient comes in with a knee issue, a foot problem, back pain or even an elbow issue, I start with a postural assessment. Bad postural alignment influences every joint and every muscle in the body. If the postural alignment problem is severe enough, it can even effect internal organs.

When I assess posture, I am looking at more than just sitting or standing straight. That accounts for only one plane the body can move in, the sagittal plane (forward and backward). There are two other planes the body moves in, the frontal plane (side to side, or laterally) and the transverse plane (rotation). The frontal and transverse planes can be hard to see during static posture.

In assessing the human body, one plane of movement directly influences other planes of movement. For example, if a hip joint is posturally positioned into rotation, it limits movement of the hip into forward and backward movement. Also, if a hip is posturally positioned into rotation, it may prevent another area of the body (like the lumbar spine) from moving into forward and backward movement. In turn, if the lumbar spine cannot move forward and backward, it will influence the next area of the body, the ribs and thoracic spine. This process may continue to the top of the head and tips of the fingers. So asking your body to correct posture by moving one part of the body into one plane of movement without addressing the other areas and planes will actually inhibit your body 's ability to achieve "good" posture.

All of this can be complicated. That is where physical therapy becomes important. Throughout the course of a thorough examination, it is the role of the physical therapist to look at a patient's body to determine what might be too tight, too weak, too strong or too loose. Developing an understanding of each individual's posture guides the physical therapist to what needs to be corrected to take the negative influences off the posture of the body. For instance, neck pain may be relieved by stretching hip muscles to help correct the posture at the low back which directly places an undue stress on the neck.

Once neutral postural alignment is restored, it becomes easier to maintain a more upright posture. Unfortunately, the problem does not end there. Why do these postural imbalances occur? Everyone has habits and activities they do every day that create asymmetries, preventing them from maintaining good posture. Discovering what activities are having a negative impact and trying to find a good balance is necessary. One of the most important jobs of the physical therapist is to help the patient learn what can be done throughout their day to minimize the negative impact of their daily activities and work with the patient to develop a plan that helps patients attain (and keep) the balance their body needs to feel good.

With a keen eye and years of clinical experience, the physical therapists at Mary Lou Corcoran Physical and Aquatic Therapy can help you attain good postural alignment and balance across all planes and areas of the body, helping with problems that arise throughout the body and helping you "sit up straight".

Posted by Robert Wolfe, PT, CSCS

WIXT-9, The Real Deal On High Physical Therapy Copays

The following news segment recently aired on WIXT-9 and helps shed some light on the issue of high physical therapy copays in New York and the impact they are having on patient care.



Christine Casciano: In an effort to keep premiums down, many employers are choosing health insurance plans that have much higher copays.

Dan Cummings: It is a double edged sword for many people, especially those who need physical therapy, because in many cases, they are being forced to choose between what (they) can afford and what (their) doctor prescribes.

Christine Casciano: And Consumer Investigator Jennifer Lewke has the Real Deal now on how physical therapists say that it is only hurting everyone involved.

Jennifer Lewke: Sue Skabinski owns 3 physical therapy offices in Central New York. Over the past few years, copays for her patients have gotten out of control.

Sue Skibinski: Thirty, forty, fifty and in some cases sixty dollars [copays] depending on the plan.

Jennifer Lewke: And keep in mind, most people require two or three visits per week. Who can afford that?

Sue Skibinski: We have seen a significant number of patients who, before, would require a month's worth of PT. Now they are telling me, "Look, I can only afford to come in three times. Can you just do whatever you can do in 3 visits?"

Jennifer Lewke: Which Sue says may be pushing people into unnecessary medications and surgery. One of her patients, Theresa Piering, is beyond frustrated.

Theresa Piering: ...fifty dollar copay, so I had to pay the full shot. I had both knees (meniscus rips) repaired.

Jennifer Lewke: Eventually it just got too expensive.

Theresa Piering: I was coming in (at the beginning) three times, then it went down to two...

Jennifer Lewke: Part of the problem is that physical therapy is technically considered a specialty, so you've got to pay the more expensive "specialist" copay.

Sue Skibinksi: If you go to a cardiologist, and the office visit fee is $400...the insurance company is paying $360 of it, and you have to pay a $40 copay, you have spent 10%. You have paid 10% of the cost of service. I don't think that anybody thinks that is unreasonable.

Jennifer Lewke: But a PT visit is no where near that amount. Sue and some of her colleagues around Central New York have these cards for patients with high copays to fill out. They plan on bringing them to Albany in May. They want to be given a copay designation of their own or at least be moved to primary care. Most everyone here at Westside Physical Therapy agrees that a change is needed.

Theresa Pierling: It's become ridiculous, you know? It's like, "Why even have insurance?"

Jennifer Lewke: The word "co"-pay is a bit misleading too. In order to be in-network, physical therapists have to agree to accept a certain amount, per visit, from an insurer. Sue has an agreement with MVP, for example, that she'll accept $42 per visit. Most of her MVP patients are paying a $40 copay. So, the insurer is really only paying $2. Makes you wonder if it is even worth the stamp and paperwork to bill the insurance company. Of course, they have to but you get the ridiculousness of all of this. That is the real deal...

Dan Cummings: Now because of the how the copay rules are written, there is really nothing that can be done about this until there is a change in the law. That's why those providers are petitioning the local politicians.

Take Action: Help Bring An End To High Physical Therapy Copays

Imagine you are a single mother of 4 who goes to the store to purchase milk for you and your family. The last time you went shopping, a gallon of milk was $2.39. Today you walk into the store to discover that there is a new pricing plan in place. Strangely, if you buy only one gallon of milk, the store is only going to charge you $2.39, but if you purchase more than one gallon of milk, the price is going to double to $4.78 per gallon. How could this be? How would that be equitable? Isn't the store just making that much more money at your expense, and on a product they KNOW that you need for the health of your family?

Unfortunately, for subscribers of insurance plans in New York State (including Blue Cross Blue Shield, Pomco, and others) this is what is happening in regards to their physical therapy coverage. In an effort to cut costs, many of New York State's managed care companies have decided that because most patients have to attend physical therapy two to three times weekly, they are going to charge the patients more for services rendered at physical therapy offices than they will at other medical offices. Many insurance plans now charge their subscribers nearly 110% more for copays to physical therapy clinics than to their general practitioners. It is not uncommon for a patient to go to visit their physician's office for blood work, a diagnostic workup and evaluation for $20 and then be charged $50 for their copay when they attend their first physical therapy visit.

Mary Lou Corcoran Physical and Aquatic Therapy, in support of legislation endorsed by the New York American Physical Therapy Association (NYAPTA), is asking for your help in ending this unfair and inequitable practice of deferring cost from the insurance companies to the patient when it comes to receiving the care that they so desperately need. The NYAPTA President states:

"Physical therapy provides cost effective care that gets people back to work sooner, reduces pain and suffering and gives people the opportunity to live happy and productive lives by maximizing their potential for movement. Insurance companies have decided to place a barrier between physical therapy and their patients for purely financial reasons. Patients who need physical therapy are having a hard time keeping up with these high co-pays which are keeping them from finishing their care and reaching their goals. Managed care health insurers have designated physical therapists as specialists for co-payment purposes, allowing health plans to charge patients more per visit while maintaining reimbursement levels to physical therapists, thus shifting more of the cost burden onto the backs of consumers. These specialty co-payments add up for New Yorkers, since physical therapy frequently requires multiple visits over an extended period of time as the practice of physical therapy works in conjunction with the healing process."

As a worst-case scenario, the situation has gotten so bad that physical therapy clinics state-wide are actually being forced to accept co-pays from patients that are greater than the negotiated rate with that insurance company. The physical therapy clinics are left powerless, placing themselves at risk of being charged with insurance fraud if they accept co-pays that are less than their contractually obligated amount. Even worse, because of the resultant lack of affordability, the patient attends therapy less frequently per week than recommended by the therapist/physician and minimizing the positive impact that therapy could have on the patient's pain and difficulties with daily activities.

With your help, New Yorkers can work to take back control of their insurance plans and cease this unfair business practice of managed care companies. We implore all New York residents to take action. The NYAPTA encourages residents to:

1. Call, email, and write your state legislators and tell them you want LOWER physical therapy co-pays; ask for fair-co-pays and ask them to support of two bills in the State Legislature, S.4321 (Breslin) / A.8171 (Cahill), which will prevent managed care companies from requiring patients to pay these excessively high co-payments for PT.
2. Sign the NYAPTA's Online Petition here
3. Tell your employer and health plan you oppose these high co-pays for your physical therapy.
4. Write a letter to your local newspaper.
5. Call your local media and invite them to tour your practice and discuss these high co-pays.
6. Pass this information along to your coworkers, friends, and family.

Albany needs to act. They need to act now. Every day, week and month that goes by without legislation is another opportunity lost for a patient who desperately wants to get better, can't return to work or is in excruciating pain but can't get better fast enough; a direct result the insurance industries compulsive need to redirect the cost burden to the patient to maximize their own profits.