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Thu, 25 Jun 2020

The Importance of ACL Injury Prevention

The ACL, anterior cruciate ligament, is a band in the knee that connects the femur to the tibia. It helps keep the joint stable as you walk, run, jump and make other leg movements. It is also one of the most commonly torn ligaments in the body. ACL injuries often require surgery and rehabilitation, which can be damaging for students’ and professional athletes’ careers, and this is the reason why it is so important to focus on injury prevention.

The ACL can be injured in several ways such as:

  • Suddenly stopping and changing direction quickly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision

A torn ACL is one of the most frequently reported sports-related injuries orthopedic surgeons see. Some of the sports where ACL injuries can often occur are soccer, football, tennis, basketball, volleyball and gymnastics. When an ACL injury happens, you might hear a “popping” noise that’s followed by pain and swelling. After this happens, the knee can be unstable and movement can cause wear and tear on the cushioning cartilage (meniscus) of your knee.

ACL injuries often require some sort of surgical repair and a minimum of six months to a year of rehabilitation. Having a focus on ACL injury prevention is crucial. Many ACL injuries can be prevented by strengthening the muscles around the knees, along with exercises to help increase balance, flexibility, core strength and stability. Having proper technique and form during sports and physical activities are key.

Here are a few tips to keep in mind for helping with ACL injury prevention:

  • Stretch and warm-up prior to the activity
  • Practice proper landing after jumps with your knees directly over your feet
  • Crouch and bend at your knees and hips when you pivot
  • Focus on strengthening your hamstrings, quadriceps, hips and thighs

Working with physical therapy specialists, like Joshua Bintz, PT, DPT, and Amanda Askey, PTA, is a good place to start for assessing how you can best modify movements to prevent ACL injuries. Therapists and clinicians can identify and target weak muscles and provide ways to improve strength and assist in preventing injuries.

Contact Miller Ortho for more information or to schedule your appointment.

Fri, 01 May 2020

Return of the Athlete

Athletes and Injuries: Returning to Sports After COVID-19

Whether you’re a coach, parent of an athlete, or an athlete yourself, life without sports is tough. Sports fill so many roles in our lives. Beyond just filling up our schedules, sports are often a primary social source for people, an outlet for stress and energy, a source of self-esteem and accomplishment. In the past several weeks, many of those roles have been taken away from us; and while it’s all for very good reasons, it doesn’t make it any easier. But for most athletes, sports will resume. Kids will go back to their clubs, high schools will turn the lights on the field, weekend warriors will step onto the court once more. Many of us are looking forward to that day, but how are we preparing, especially those involved in highly organized and competitive sports at the AAU, high school, collegiate, and professional levels?

Many athletes, whether recreational or competitive, are attempting to stay in shape somehow: home workouts from coaches, streaming videos to the living room, or just getting creative with what you have available are all good options. But what if it’s not enough? What are the risks of returning to whatever field, court, or pitch on which you find yourself after not having practiced in your typical routine or intensity for several weeks? In a recent article on SI.com, Brian Burnsed discussed what we’ve seen in the past from situations that can be compared to our current experience with restrictions related to COVID-19:

“… athletes’ muscles and ligaments will need adequate time to recalibrate to their sports’ demands. After the 2011 NFL lockout that kept players away from team medical personnel and strength and conditioning coaches for four months, Achilles tendon tears leapt from an average of eight per season to 12 in training camp and the preseason alone, according to a study done that year. Similarly, a 2012 report found that NBA injury rates jumped after the league’s 2011 lockout, including a rash of ACL tears among stars like Derrick Rose, Ricky Rubio and Baron Davis. Nine players tore ACLs in the two years after the lockout, a figure that dropped to an average of a little more than two per year in subsequent seasons.” 1

ACL and Achilles injuries nearly always require a surgical repair and then a minimum of six months of rehabilitation, often closer to one-year. Any increase in risk to an injury like this should prompt many athletes to re-evaluate their training regimen and coaches to reconsider their practice and workout schedules for the first few weeks of practice with these athletes. Between limited offseason training, shortened pre-season practices, and potential alterations to competition schedules, few athletes will return to their respective sports under normal circumstances.

So, what can we do to minimize this risk of injury associated with extended time off?

  • Athletes
    • Do everything you can to stay in shape. Listen to your coaches and trainers. Try to maintain a sleep schedule. Eat well: poor quality protein = poor quality muscle. Go online and see what professional athletes are doing to workout. Use whatever random things you can find to load your body and maximize intensity.
    • Understand what this will look like: you normally work out at least five days per week in a high intensity and structured program – now say you’re working out three days a week at your own discretion. Most studies show a notable drop off in strength after three weeks of detraining. Maybe you can extend that number out a bit longer because you are doing something a few days a week, but we can all likely agree you will have some loss after eight or more weeks of isolation. Not only will you have strength loss, but muscle memory loss as well. It sounds silly, but your muscles will forget how to coordinate to jump/cut/sprint efficiently. So now you show up to practice and you’re weaker and uncoordinated. You fatigue a bit earlier in practice than you normally would, you get into a situation that requires max effort but your form is sloppy and your power fades, you plant your foot in the ground… That’s when injuries are most common and we didn’t even talk about the effects of detraining on ligaments, bones, etc.
  • Parents
    • Help your kids and encourage them to do the things listed above. That may look different in each house, but do what you can.
    • Keep an eye on your athletes as they return to sports. If they’re showing signs of pain or injury, talk to them about it. The likelihood is greater that an athlete may try to hide an injury because they’re already behind or there’s less time to earn that starting spot.
    • Don’t get stressed or upset if your athlete gets subbed out of a game more frequently or for longer stretches. The coach may be taking precautions to not overuse/overwork them early in the season.
  • Coaches:
    • I have seen many posts on social media encouraging athletes to do all they can to keep up their fitness. Keep contacting and pushing your athletes with this. Especially encourage high speed and high intensity training in athletes whose sports demand cutting, acceleration/deceleration, and jumping. (soccer, basketball, football, volleyball). These sports already carry an increased risk of injuries like ACL tears and these movements must be performed frequently to maintain proper mechanics, endurance, and muscle memory.
    • Realize your athletes will not return at the point they left off. In some way, even if it’s small, athletes will be behind where they normally would be at the beginning of the season. Their nutrition, sleep, and workouts have all been affected during this time and may mean you have to ease them in a bit more than usual.
  • Fans
    • We all want sports back, but realize these athletes will need time to prepare the right way. Give them time. Once things start to trend back to whatever normal might look like in the future, sports will not and should not instantly resume. Otherwise, you might see your favorite player sidelined for the next year or possibly their career.

The time will come, sports will return, you’ll be able to go back to the gym, but no one should expect it to be business as usual. In the coming articles, we will look at other areas of fitness beyond sports including running, weight management, and more.

Sources Cited:

  • Burnsed, Brian. “What Does the Coronavirus Do to an Athlete’s Body?” Sports Illustrated, Maven, 6 Apr. 2020, www.si.com/more-sports/2020/04/06/effects-of-coronavirus-on-athletes-bodies.


Fri, 26 Apr 2019

How Physical Therapy Can Help You Recover From Injury

Physical Therapist assisting a patient

   By: Ashley Rodriguez

If you have experienced substantial injury or undergone surgery, you may have been surprised when your doctor suggested physical therapy programs to aid your recovery.

Going to physical therapy at a time when you are  tempted to relax and take it easy may seem like a burden, but it can actually help you recover faster. While you might think that a successful procedure is enough to get your body functioning the way it should, the rehabilitation process is just as crucial for a full recovery.

The Rehabilitation Process

Physical therapy can help your body regain its original capabilities. The process can involve almost anything – from relearning essential bodily functions to muscle-building and improving mobility.

The sessions are carefully-planned and specially designed to get your body out of its weakened state, and gradually increase your strength and freedom of motion so you can return to living a normal life as soon as possible. They may be composed of all or a combination of the following:

Stretching and Strength Exercises

After not having served their purpose for a while, your joint and muscles may become rigid. Stretching plays an important role in preserving the body’s range of motion and maintaining muscular flexibility. Strengthening exercises, on the other hand, focus on improving the strength and endurance of the different muscles in your body.

Core Strength and Stability

Consider your core as the foundation of your body. Build something on a weak foundation, and it will collapse – maybe not now, but eventually. These programs put an emphasis on building up the core muscles, especially that of the back and pelvis to better the chances and potentially hasten the progress of recovery.

Ice and Heat Application

Cooling the muscles can decrease swelling while heating them helps stimulate blood circulation. Done right and with proper timing, ice and heat application can be very beneficial to the therapeutic process.

Ultrasound and Electrical Stimulation

There are situations when using ultrasound may be necessary to stimulate the tissues within your body. On some instances, passing an electrical current through the affected area changes the nerve conduction in that specific region, which, in turn, increases blood flow and improves muscle contractility.

The Many Benefits of Physical Therapy

Physical therapy can be very troublesome, uncomfortable, and inconvenient, but in most cases, it does get the job done. Here are some of the many benefits of physical therapy to bear in mind:

Regain your mobility

Limited range of motion is a common scenario post-surgery or after an injury. Physical therapy helps your joints and muscles regain mobility and resume their normal functions.

Enhance the healing process

While it’s true that the body has the ability to heal itself, it can use a hand. Physical therapy can make the healing process go faster and smoother. The ultimate goal of physical therapy is to pave the way for a faster but safe recovery.

Reduce the Risk of Further Injury

Engaging your body in physical activities is a good way to heal, but they may also cause more harm than good without proper planning and guidance. Physical therapy programs are tailor-made so that your body is only subjected to the amount of stress it can handle.

If you’re recovering from a condition that brought about a drastic change in your daily life, physical therapy can help you avoid injuries as you adjust and acclimate yourself to the newness of it all. Without a doubt, the benefits far outweigh the risks.

Mon, 09 Apr 2018

Do You Have A Torn Rotator Cuff? Check These Symptoms!

Rotator Cuff Tear

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of the upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side.  A torn rotator cuff is a very common shoulder injury that can be caused from repeated movements while playing sports, performing a job function or doing common household chores such as yard work.  Other common causes of a torn rotator cuff include falling, lifting or pulling a heavy object, or in some cases bone spurs in the shoulder.

With repeated motion, the muscles and tendons that surround the shoulder socket can become torn. A torn rotator cuff can be both painful and inconvenient, which is why it is so important to get a diagnosis early if you think you may have this injury.

4 Common Symptoms of a Torn Rotator Cuff

Some of the symptoms of a torn rotator cuff include:

  1. Pain– Many people feel a dull ache in their shoulder joint in association with a torn rotator cuff. The pain is typically felt deep in the joint and can increase with movement of the shoulder.
  2. Limited range of motion– If you have a torn rotator cuff you may find it difficult to reach behind your back, lift your arm over your head, or lift your arm laterally.
  3. Disturbed sleep– Because of the pain in the shoulder, many people find it difficult to sleep, particularly on the side of the injured arm.
  4. Weakness– Muscle weakness in the arm on the injured side of the body is a common symptom of a torn rotator cuff.
  5. Crackling sensation – when moving the shoulder in certain directions.

An orthopedic doctor will diagnose a rotator cuff injury by palpating the area and doing a series of range of motion tests. In some cases scanning equipment is used to identify damage to the soft tissue in the shoulder joint.

Common treatments for a torn rotator cuff include rest, joint immobilization and physical therapy. Many people recover from rotator cuff injury with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint; however, in extreme cases, surgery may be recommended.

Shoulder injuries such as a torn rotator cuff should be treated immediately to prevent further damage and start the healing process as soon as possible.  See a physician right away if you have a sudden loss of motion after an injury — you could have a substantial rotator cuff tear.

If you have pain lasting longer than a few weeks or you’ve been formally diagnosed with a rotator cuff tear, you need to be seen by a shoulder specialist, because some of the surgical procedures are time sensitive. Please contact Miller Orthopedic Specialists today if you think you may have torn your rotator cuff!

Wed, 21 Jun 2017

Dry Needling Therapy

Dry Needling

Dry needling involves the insertion of a fine filament needle into neuromuscular junctions /motor points, stimulating the muscles, and bringing unbelievable pain relief and significantly improved function to athletes and patients who have been suffering for years.

There is no injectable solution and the needle which is used is very thin.  Most patients will not even feel the needle penetrate the skin, but once advanced into the muscle, the patient may have a sensation like a muscle cramp – which is often referred to as a “twitch response”.  The twitch response results in deactivating the trigger point, thereby reducing pain and restoring normal length and function to the involved muscle.

Typically positive results are apparent within 2-4 treatment sessions but may vary depending on cause and duration of the symptoms and overall health of the patient.    Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects.   This technique is unequaled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.

Dry needling may also be used for many acute, chronic and sports related injuries such as:

  • Muscular hematomas
  • Muscle strains/tears
  • Compartment syndrome
  • Medial tibial stress syndrome (shin splints)
  • Rotator cuff injuries
  • Impingement syndrome
  • Tennis/golfer’s elbow
  • Piriformis syndrome
  • Cervicogenic headaches
  • Sciatica
  • Hamstring issues
  • IT band syndrome
  • Patellar Femoral Syndrome
  • Patellar tendonitis
  • Achilles tendonopathies
  • Plantar fasciitis
  • Thoracic Outlet Syndrome
  • Carpal Tunnel Syndrome
  • Back pain: A common cause of nerve irritation and neuropathic pain is underlying spinal degeneration (i.e. spondylosis of the spine), which can be a result of trauma and/or normal wear and tear. Spondylosis irritates the nerve root and leads to neuropathy which can result in muscle shortening. This process leads to pain and dysfunction in many common acute and chronic conditions that practitioners see in their everyday patient population. The introduction of a dry needle into the active trigger sites of these muscles can provide enormous relief of symptoms.

Miller Orthopedic Specialists own physical therapist, Joshua Blintz, PT, DPT, is now providing Dry Needling Therapy as a treatment option.  Call 712-323-5333 to schedule an appointment for a consultation.


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