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We'll be at SAYREVILLE DAY this Saturday 9/15!

We'll be at SAYREVILLE DAY this Saturday 9/15!

Hello Mana Physical Therapy followers. We will be at Sayreville Day this Saturday at Kennedy Park from 12-4pm. There will be lots of food, entertainment, and rides for the kids!

 Posted From Sayreville Recreation on Facebook

Posted From Sayreville Recreation on Facebook

Come to see us at our table and grab some swag! We will have t-shirts, water bottles, and more that you can WIN with a spin on the prize wheel.

We hope to see you on Saturday!

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Throwing Athletes & The Risk of Injury

Throwing Athletes & The Risk of Injury

A pilot study was recently published in Orthopedic Physical Therapy Practice which looked at balance deficits in throwing athletes (specifically baseball players) and whether or not it could determine injury risk.  The study was a small sample size of just baseball pitchers but it did highlight some interesting points. The results showed that approximately 30% of the participants increased their injury risk after throwing an average of 30 pitches.  Further, the study highlighted a significant decline in performance on the Y-balance test following pitching.  

With any athlete, the concern is always keeping the individual healthy.  For baseball pitcher specifically we worry about shoulder, elbow, hip, and back issues that can start to develop as a result of poor transfer of energy during a pitch.  As such, there parameters put in place to avoid injury such as age-related restrictions on pitch count.  This article highlights that injury prevention tactics should also involve a thorough evaluation of the athlete including dynamic balance.  

At Mana Physical Therapy we provide each of our athletes with the dedicated time necessary to assess fully for range of motion, strength, and balance issues. Each evaluation is tailored specifically to that athlete’s sport in order to enhance outcomes following therapy and ensure a quick return to sport or an injury-free season.  Call 732-390-8100 today to schedule. 

 Shoulder Rehabilitation Physical Therapy Degeneration 

Study Reference: 

Schroeder, Stacia and Gorman, Sharon L. “Decrease Balance and Injury Risk in Adolescent Baseball Pitchers”.  Orthopedic Physical Therapy Practice.Volume 30, number 3 (2018): 156-9. 

What is MANUAL THERAPY?

What is MANUAL THERAPY?

At Mana Physical Therapy, we pride ourselves on being advanced orthopedic practitioners with refined manual therapy skills, but what does that mean for you?  

What is Manual Therapy?

Manual therapy is the use of hands-on techniques to reduce pain and/or restore mobility.  These techniques include mobilizing and manipulating soft-tissues, such as muscles, and bone/joints in order to increase circulation, reduce adhesions, relax muscles or improve range of motion.  All of the above will ultimately help to reduce pain.  

Three Manual Therapy Techniques Commonly Used

Joint mobilizations: This technique involves a physical therapist using his/her hands to help loosen up a joint and improve its range of motion.  Joint movement is not something a patient can achieve on their own and is often effective in helping to alleviate pain related to muscle spasms.  Muscles tend to spasm because a joint has become restricted and until the normal joint motion is restored, the muscles around that area will usually continue to spasm.

Soft Tissue Mobilization/Myofascial Release:  Once joint motion improves, the soft tissues may continue to have tension.  This is when a physical therapist will implement soft tissue mobilization techniques.  These involve movement of the tissue to improve fluid dynamics, decrease myofascial adhesions (scar tissue) and decrease pain/tension in the area. Specifically techniques such as instrument assisted soft tissue mobilization, kneading and dynamic cupping are effective in achieving the above outcomes.  

High velocity-low amplitude thrust techniques:  These techniques involve taking a restricted joint to the end of its available range and thrusting (about ⅛ of an inch) to the end of the joint’s range of motion.  The technique is an aggressive joint mobilization technique but only moves the joint within its normal anatomical limit. It is very effective for stiff joints, when indicates and does not increase pain or damage the joint.   

 manual therapy physical therapy rehab sciatica low back pain rehabilitation

Is It Painful? 

Manual therapy is not meant to hurt, but there may be some discomfort felt because your physical therapist will be working on a painful or restricted area.  However, manual therapy is designed to help improve the patient’s symptoms; this is why actively communicating with your physical therapist is crucial to success with manual interventions.  A full assessment of your condition is alway completed before starting any hands-on technique and the techniques are then individualized to fit your specific needs and tolerance.  

How Is This Different Than a Massage? 

Some aspects of manual therapy are very similar to massage, however, manual therapy addresses very specific restrictions in soft tissues and joints. It is a therapeutic treatment performed by a licensed physical therapist who has extensive knowledge of anatomy.  

Can I just Stretch and Exercise?

While both of these are important, exercise and stretching alone cannot target specific areas like manual therapy can.  Exercise is of course a valuable part of physical therapy and research shows that manual therapy combined with exercise is the more effective treatment than either performed in isolation.  

Bottom Line: 

Manual therapy involves hands-on techniques which are tailored to your condition. Manual therapy can address all areas of the body and is extremely effective when combined with therapeutic exercise.  At Mana Physical Therapy we take the time to assess your specific needs and developed an intervention program right for you. If you are experiencing any aches, pains or just have some general questions on how we can help you, give us a call! 

Resources:

Abbott, J.H. et al. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness.  Osteoarthritis and Cartilage.  2013; 21, 4: 525-34.  

Bang M, Deyle G. Comparison of Supervised Exercise with and without Manual Physical Therapy for Patients with Shoulder Impingement Syndrome. Journal of Orthopaedic & Sports Physical Therapy 2000; 30: 126-137.

Niemisto L, Lahtinen-Suopanki T, Rissanen P, Lindgren K, Sarna S, Hurri H. A Randomized Trial of Combined Manipulation, Stabilizing Exercises, and Physician Consultation Compared to Physician Consultation Alone for Chronic Low Back Pain. Spine 2003; 28: 2185-91.

KNEE ARTHROSCOPY: A Case Study

KNEE ARTHROSCOPY: A Case Study

Recently I had a patient come to me complaining of right knee pain which started several months ago; 

The patient is a female in her mid-fifties and recounted no trauma to her knee, but has been avoiding using her right leg in such activities as walking up/down stairs or getting in/out of a chair.  She also reported of difficulty with bending/straightening her knee occasionally and a feeling of “weakness” in her knee with prolonged walking.  The patient at this point in time did not have a consult with her primary care physician or orthopedic at this time, but was scheduled for an appoint in about 2 weeks. Objective findings included pain with active movement of right knee, especially toward end range knee flexion and extension, decreased strength in her right knee and hip without increase in pain levels, and decreased balance/proprioception as measured by single limb stance time and compared to the left leg.  

The patient was started on a range of motion and strengthening program for right hip and knee within patient’s tolerance.  The second visit the patient reported of decreased pain in her knee while trying to move the covers in bed with her leg.  Fast forward a few weeks: the patient has had her X-ray/MRI and saw an orthopedic doctor.  The imaging revealed a tear in her medial meniscus and degenerative changes in the right knee.  Per the patient, the orthopedic doctor told her she needed to have surgery in order to have less pain in her knee.  At this point, I have a long discussion with my patient regarding arthroscopic knee surgery outcomes and the research which does not support meniscectomy is appropriate for all patients with tears on MRI and further still the strong recommendation against arthroscopic surgery in degenerative knees.  

Ultimately, the patient opted for the surgery because her orthopedic told her she needed it. I thought for some time about this particular situation.  It is not the first patient I have seen who has had a positive finding on imaging for meniscal involvement who’s doctor recommended or insisted on surgery.  Up until this point in time there had only been 1 other patient of mine who opted for surgery rather than a course of conservative care or physical therapy.  I began to think, “what am I doing wrong in trying to educate my patients?”  “what am I missing?”  Then I thought, “why are there orthopedic doctors out there recommending a surgery that is not supported in the evidence?”  So for this blog post I wanted to provide some educational information regarding evidence and knee surgeries.  Please do not mistake me, there are definite indications for knee surgeries and knee surgery can be successful, but surgery is not indicated for ALL meniscus injuries or degenerative knee conditions.   

 knee joint pain tendinitis lumbar relief acupuncture arthroscopy avoid surgery

knee joint pain tendinitis lumbar relief acupuncture arthroscopy avoid surgery

Below is a link to a great podcast through ClinicalAthlete where an orthopedic surgeon discusses why he has changed his practice mentality and is trying to educate the public and doctors alike regarding evidence-based practice.  The other is a link to a clinical practice guideline regarding recent recommendations for knee surgery.     

http://www.clinicalathlete.com/clinical-athlete-podcast/2018/7/8/episode-11-ineffectiveness-of-knee-scopes-when-sounding-good-isnt-good-enough

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5426368/

Quick Tips for Cycling From A Physical Therapist

Quick Tips for Cycling From A Physical Therapist

Quick Tips for Cycling

Summer is practically here and cycling is a great way to get outdoors and exercise during these warm months.  But how can you do it safely and avoid any aches and pains?  Here are a couple key things to keep in mind. 

Make sure you have the proper bike fit

Knee pain is often related to saddle and/or cleat positioning in over 85% of cases.  Because cycling involves the repetitive pedaling, small adjustments in positioning can make a dramatic impact on knees.  Your seat height should allow for slight knee bend at the bottom of the pedaling motion and keep your hips from rocking back and forth on the saddle. 

Mobility/Flexibility and Strength

Cycling is not just about the knees.  Because the knee is a simple hinge joint, the position and control of the knee occurs at the hip, ankle and even low back.  Similarly, 65% of the total work to propel your bike comes from hip extensors, your gluteals (butt muscles) and hamstrings along with your quadricep.  Decreased mobility and strength deficits in these areas can result in compensatory patterns which can lead to improper pedaling technique and pain.

Trunk Stability

While your power may come from your hips and knees, endurance and stability comes from a strong core.  Poor deep abdominal strength and endurance can lead to loss of proper form and increased low back pain.  Further, as the posture at the trunk decreases, weight is shifted onto the arm which can lead to increased shoulder and neck pain. 

Consult a Physical Therapist at Mana Physical Therapy! They can provide you a comprehensive evaluation of mobility/flexibility, strength and stability which may be causing pain or increasing your risk for injury in the future. They can also help to discuss proper training techniques and refer to a bike fit professional in order to keep your riding through the beautiful summer months!

Set up your consultation today by calling 732-390-8100.

 Cycling Biking Injury Injuries Knee Pain Back Lumbago Cervicalgia Joint Bone rehab

Running season is finally here! Don't Let runner's knee hold you back!

Running season is finally here! Don't Let runner's knee hold you back!

Runner’s Knee

One of the most common injuries with running is knee pain and often times it presents itself as patellofemoral pain syndrome or Runner’s Knee.  

What is patellofemoral pain syndrome?

PFPS occurs due to improper tracking of the kneecap between the condyles of the femur (thigh bone).  As you bend and straighten your knee the kneecap should move down and up respectively. When the above does not occur it can create friction, inflammation and pain in the area.  

Why does this occur?  

Most often the kneecap does not move properly  due to muscular imbalances between the quadriceps (front of the thigh); hamstrings (back of the thigh) and gluteals (buttock).  This can be a result of increased tension in the iliotibial (IT) band, stiffness at the ankle joint, hip or back, or improper running technique.  

What can we do?

At Mana Physical Therapy we can do a thorough evaluation of your movement patterns to identify strength and flexibility deficits.  Through video analysis, we can assess your running technique and develop a plan of care tailored to your specific needs.

Call Mana Physical Therapy today to address your runners' knee or other running injuries, at (732) 390-8100.

 

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Dear RockTape, THANK YOU for managing my chronic back pain.

Dear RockTape, THANK YOU for managing my chronic back pain.

by Olivia Barton on the RockTape blog:
https://www.rocktape.com/dear-rocktape-thank-managing-chronic-back-pain/

 Chronic back pain relief with RockTape

I just want to say that I am SOOO glad I discovered RockTape. I am 23 years-old and I suffer from a small central disc protrusion with associated annular tear and central canal and neural foramina on my L5-S1… paired with some mild scoliosis…crazy right? I have been dealing with this issue since was about 14. I have been through a lot of trial and error trying to relieve the pain. From physical therapy twice, acupuncture and cortisone shots… Physical therapy didn’t work for me and acupuncture worked but it wouldn’t last long enough and getting an appointment on a military base (shout to our veterans and military spouses!) is about near impossible. Last year my back pain became SO severe that I couldn’t do any leg related workouts because It would feel like my back was being physically crushed; it really took a toll on my mental state and physical state. Then the best thing ever happened…. I stumbled upon RockTape. As an individual who has been through some serious pain and suffering – to the point of not being able to walk for days at a time, I’m always down to try things that might take even 20% of my pain away. So I bought some.

I first tested RockTape on my five-hour plane ride – plane rides are the worst because I usually can’t even go more than ten minutes without feeling SO uncomfortable with having to adjust my seating position or get up and walk around. I used to directions on how to apply for the lower back, two pieces vertical and one piece horizontal. IT. WAS. INSTANT. RELIEF. It was like a cortisone shot. I felt such relief in my first minutes of having RockTape on that I cried; I was pain free again – all my tightness and tension from my lower back, down to my hamstrings was gone! As for my plane ride? Awesome! I did wiggle around once, but I didn’t have to get up AT ALL and I even fell asleep because I was so comfortable. UGH it was such an awesome plane ride haha.

My next test was trying RockTape in the gym… you bet your butt it was AMAZING!! I was able to do TWENTY box jumps in a row without stopping because my back wasn’t a bother (before I could barely do six in a row without having to stop) I was also able to do my squat cleans and presses without pain (and able to go into a deeper squat). I was feeling so great, I did a banded glue workout (this usually kills my back) and was able to work through it with, you guessed it, no pain! RockTape has forever changed my life. I cannot thank the people RockTape enough for creating such an amazing product that allows sport-loving, weight lifting people like me to be able to do the things we love to do. I wish I could thank each and every one of you personally and you could see the happy tears that roll down my face. Thank you, thank you, thank you! 2017 was a horrible year and it kicked my butt. I vowed to make 2018 my year and I’m off to amazing start thanks to RockTape!!! STAY AWESOME!!!!!!!!

Sending so much love your way!!