SFMA Multi-segmental Rotation

Selective Functional Movement Assessment (SFMA)

SFMA Is An Evaluation Technique

Selective Functional Movement Assessments (SFMA) is a system used by healthcare professionals, including physical therapists, to evaluate and treat musculoskeletal pain and dysfunction. This system is based on the concept that the body’s movement patterns are interconnected and that movement dysfunction in one area can lead to pain or dysfunction in another.

The SFMA evaluation is a comprehensive assessment that consists of seven basic movement patterns. These include the cervical spine, shoulder mobility, multi-segmental flexion, multi-segmental extension, rotary stability, single-leg stance, and overhead deep squat. These movements are evaluated by a trained healthcare professional who assesses the quality and efficiency of the movement patterns.

Selective Functional Movement Assessment (SFMA) For Upper Body Injury

Selective Functional Movement Assessment (SFMA) For Lower Body Injury

The SFMA system helps identify and treat underlying issues causing pain or dysfunction. It provides healthcare professionals with a holistic view of the body, allowing them to understand how movement patterns in one area of the body may affect other areas.

SFMA Is Beneficial For Many Types Of Injuries and Conditions

The SFMA system is not a one-size-fits-all approach but a customized evaluation tailored to the patient’s unique needs. When developing a treatment plan, the healthcare professional considers factors such as the patient’s age, health history, and lifestyle.

The SFMA evaluation also identifies compensations, restrictions, or pain in the body’s movement patterns. The healthcare professional will observe and analyze the patient’s movements for these issues. Once identified, the healthcare professional can develop a treatment plan that addresses the root cause of the problem.

One of the benefits of the SFMA system is that it can identify movement dysfunction in individuals who are not experiencing pain or discomfort. This can be useful for identifying potential issues before they become more severe. It is a valuable tool for evaluating and treating musculoskeletal pain and dysfunction in individuals of all ages and activity levels.

In addition to identifying movement dysfunction, the SFMA system can also be used to evaluate the effectiveness of treatment. By re-evaluating the patient’s movement patterns after treatment, healthcare professionals can determine whether the treatment plan is working and make adjustments as needed.

SFMA As A Physical Therapy Tool

Physical therapy is one area where the SFMA system is commonly used. Physical therapists use the SFMA evaluation to assess the quality and efficiency of movement patterns in patients with musculoskeletal pain or dysfunction. Based on the findings of the evaluation, the physical therapist can develop a customized treatment plan that addresses the patient’s unique needs.

Physical therapy treatments for musculoskeletal pain and dysfunction may include exercise, manual therapy, and modalities such as heat, ice, and electrical stimulation. Physical therapy aims to restore function, mobility, and quality of life to the patient.

Physical Therapy Evaluation

Summarizing A Selective Functional Movement Assessment

In conclusion, the Selective Functional Movement Assessment (SFMA) system is a comprehensive tool healthcare professionals use to evaluate and treat musculoskeletal pain and dysfunction. 

  • The SFMA evaluation provides critical information about the quality and efficiency of movement patterns, allowing healthcare professionals to develop customized treatment plans that address the root cause of the problem. 
  • This system is not a one-size-fits-all approach but rather tailored to the patient’s unique needs. 
  • The SFMA system can be used by various healthcare professionals, including physical therapists, to evaluate and treat musculoskeletal pain and dysfunction in individuals of all ages and activity levels. 
  • Physical therapy treatments for musculoskeletal pain and dysfunction may include exercise, manual therapy, and modalities such as heat, ice, and electrical stimulation. 
  • Physical therapy aims to restore function, mobility, and quality of life to the patient.

Contact Balanced Physical Therapy

Get an accurate diagnosis and the best treatment by scheduling an appointment with Dr. Robert Litzenburg, PT, DPT, or Dr. Tori Gasperoni, PT, DPT, ATC, BRM. We work individually with all of our patients to ensure you and your family the safest and most professional care in Macomb Country, Michigan.

Joint Pain: Causes, Relief, and Treatments

Joint Pain: Causes, Relief, and Treatment

Joint Pain & PT

Joint pain can be a debilitating condition that affects people of all ages and backgrounds. It can make moving, walking, or even carrying out simple tasks difficult. In this blog, we will explore some common causes of joint pain, the role of physical therapy in treating joint pain, and some of the most effective joint pain relief strategies.

Causes of Joint Pain

There are many possible causes of joint pain. Some of the most common causes include arthritis, injury, overuse, and infection. Arthritis is a condition that causes inflammation in the joints. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. 

Joint Pain From Osteoarthritis

Osteoarthritis is caused by wear and tear on the joints over time. It is more common in older adults and can affect any joint in the body.

Osteoarthritis is a degenerative joint disease that affects millions of people worldwide. The condition is characterized by the gradual breakdown of joint cartilage, which can cause pain, stiffness, and reduced range of motion. The physiology behind osteoarthritis and joint pain is complex and involves several factors.

The joint comprises several components, including bones, cartilage, synovial fluid, ligaments, and tendons. The articular cartilage, the smooth, shiny surface covering the bones’ ends, helps reduce friction and absorb shock during movement.

In osteoarthritis, the articular cartilage begins to break down, which can cause the bone to rub against the bone. This can lead to the formation of bone spurs, which can further exacerbate joint pain and inflammation.

Joint pain in the knee from osteoarthritis

Several different factors can contribute to the development of osteoarthritis and joint pain. Some of the most common factors include the following:

  1. Aging: As we age, the cartilage in our joints may begin to break down, which can increase the risk of osteoarthritis.
  2. Genetics: Some people may be more susceptible to developing osteoarthritis due to genetic factors.
  3. Obesity: Being overweight or obese can put extra stress on the joints, which can increase the risk of osteoarthritis.
  4. Injuries: Joint injuries, such as a torn ligament or a broken bone, can increase the risk of developing osteoarthritis.
  5. Repetitive stress: Repetitive stress on a joint, such as overuse or engaging in certain sports or activities, can increase the risk of osteoarthritis.

In addition to these factors, several physiological processes can contribute to developing osteoarthritis and joint pain. These include:

  1. Inflammation: Inflammation plays a key role in the development of osteoarthritis. When the articular cartilage begins to break down, the body’s immune system may respond by releasing inflammatory chemicals, which can cause pain and swelling in the affected joint.
  2. Mechanical stress: Mechanical stress on the joint can also contribute to the development of osteoarthritis. When the joint is subjected to repetitive stress, the cells within the articular cartilage may become damaged, leading to cartilage breakdown and osteoarthritis.
  3. Altered biomechanics: Altered biomechanics, such as abnormal joint alignment or muscle imbalances, can also contribute to the development of osteoarthritis. These factors can put extra stress on the joint, which can accelerate the breakdown of the articular cartilage.

Joint Pain From Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that affects the joints and causes joint pain, stiffness, and swelling. It can affect people of any age and often affects the small joints in the hands and feet.

In RA, the body’s immune system mistakenly attacks the synovium, which is the tissue that lines the joints. This attack leads to inflammation and thickening of the synovium, causing it to produce more synovial fluid than normal. As a result, the joint swells and becomes stiff, leading to joint pain and reduced mobility.

Joint pain in knee from rheumatoid arthritis

In addition to inflammation, RA can also cause damage to the cartilage, bones, and other tissues within the joint. This damage occurs due to persistent inflammation, which can wear away at the cartilage and erode the bones.

Injury is another common cause of joint pain. This can include acute injuries, such as sprains or fractures, and chronic injuries, such as repetitive strain injuries. Overuse can also cause joint pain, especially in people who engage in repetitive activities or sports.

Physical Therapy for Joint Pain

Physical therapy can be a highly effective way to manage joint pain. Physical therapists are trained to evaluate and treat musculoskeletal conditions, including joint pain. They can work with patients to develop a personalized treatment plan that includes exercises and other interventions to help reduce pain and improve function.

Physical therapy can be very helpful for patients with joint pain, as it can address the underlying causes of the pain and help improve joint mobility and function. Some ways physical therapy can help patients with joint pain include:

  1. Pain management: Physical therapists can use various techniques such as heat/cold therapy, manual therapy, and electrical stimulation to reduce pain and inflammation in the affected joint.
  2. Strengthening exercises: Physical therapists can prescribe specific exercises to help strengthen the muscles surrounding the affected joint. Stronger muscles can help support the joint and reduce stress, which can help reduce pain.
  3. Range of motion exercises: Joint pain can sometimes cause stiffness, making it difficult to move the joint. Physical therapists can help patients improve their range of motion with exercises designed to increase flexibility and decrease stiffness.
  4. Education: Physical therapists can educate patients on reducing stress on the affected joint in their daily activities. For example, they can teach patients proper body mechanics, posture, lifting, bending, and carrying techniques.
  5. Assistive devices: Physical therapists can recommend using assistive devices such as braces, splints, or crutches to help support the affected joint and reduce pain.

Overall, physical therapy can be a very effective treatment option for patients with joint pain. By addressing the underlying causes of the pain and improving joint function, patients can often experience significant pain relief and improved quality of life.

Joint Pain Relief Strategies

Many other strategies can also be used to help relieve joint pain. Some of the most effective strategies include:

  1. Exercise: As mentioned earlier, exercise can be an effective way to manage joint pain. Working with a physical therapist or primary healthcare provider is important to develop an exercise program that is appropriate for your specific condition and needs.
  2. Weight management: Being overweight can put extra stress on the joints, which can lead to pain and inflammation. Losing weight can help to reduce this stress and improve joint function.
  3. Heat and ice: Applying heat or ice to the affected joint can help to reduce pain and inflammation. Heat can help to increase blood flow to the joint, while ice can help to reduce swelling.
  4. Massage: Massage can help to reduce muscle tension and improve circulation, which can help to reduce pain and inflammation in the affected joint.
  5. Medications: Over-the-counter pain medications, such as acetaminophen or ibuprofen, can effectively manage mild to moderate joint pain. Prescription medications, such as corticosteroids or disease-modifying antirheumatic drugs (DMARDs), may be needed for more severe cases.
Types of back and neck pain

7 Types Of Pain In The Back and Neck

Pain and Physical Therapy

Physical Therapy is considered one of the best ways to treat multiple types of pain because it focuses so much on treating the root cause and not just the symptoms. Combining hands-on treatments like orthopedic manual therapy with proven pain management techniques like dry needling while progressing through therapeutic exercises brings patients better long-term relief.

The International Association for the Study of Pain (IASP) describes pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described  in terms of such damage.” When we are presented with something that causes pain, if capable, we rapidly or reflexively pull out. The tactile sensation of pain is called nociception.  

Pain is an awkward inclination that lets you know something might be wrong. It may be consistent, pounding, wounding, throbbing, squeezing, or depicted in many other ways. Now and again, it’s simply an annoyance, like a migraine. At different times it tends to be debilitating  

According to John Hopkins, medical pain can bring about other physical symptoms, like nausea,  dizziness, weakness, or drowsiness. It can generate emotional consequences like anger,  depression, mood swings, or irritability. In certain cases, pain could completely change your way of life and affect your job, relationships and independence. 

There are two categories to classifying pain 

  1. Acute Pain 
  2. Chronic Pain  

Types Of Pain

Acute Pain

It usually happens rapidly and disappears. Acute pain generally comes on abruptly and is brought about by something explicit. It is sharp in quality. For the most part, intense agony doesn’t endure longer than a half year. It disappears when there could be, at this point, not a basic reason for the aggravation. Acute pain ordinarily begins unexpectedly after a physical injury, a cut, wound, or muscle injury. Acute pain can likewise be brought about by fever, inflammation, and menstrual cramps. Acute pain is regularly treated by educating the patient, medication, exercise-based recuperation/physical therapy, chiropractic massage, or dynamic development programs.  

Chronic Pain

Chronic pain is continuous and, as a rule, endures longer than a half year. This pain can continue even after the injury or disease that caused it has recuperated or disappeared.  Certain individuals experience chronic pain in any event when there is no previous injury or issues. According to Cleveland Clinic, Chronic pain is linked to conditions that include:  

  • Headache
  • Arthritis
  • Cancer
  • Back pain 

Chronic pain is normal; it influences 1 of every 5 grown-ups and is the number one cause of disability globally. Chronic Pain is a quiet pestilence that diminishes personal satisfaction, adversely impacts connections and occupations, and causes depression. (Sessle, 2012).  

Types of Back Pain

According to the Health Policy institute, back issues are patients’ most regular complaints to their primary care physicians. Almost 65 million Americans report a new episode of back pain. Approximately 16 million grown-ups – 8% of all grown-ups – experience industrious or constant back pain, which has restricted them from carrying out certain activities in their everyday life.  Back pain is the 6th most exorbitant condition in the United States.  

There are three types of back pain; Axial Pain, Referred Pain, and Radicular Pain. 

Axial Pain:

Also known as mechanical pain. Axial pain is usually restricted to one specific spot or region in the lower back area. Axial pain is patients’ most common type of lower back pain. 

Axial Back Pain

Referred pain

This is a type of pain that is not restricted to one specific region it tends to move around, and the intensity of the pain often varies. Referred pain is the type of pain that a patient faces in one part of the body which is influenced by an injury or discomfort in another part of the body.  

Radicular Pain

According to spine health, radicular pain can be described as electric shock-like or burning; radicular pain follows the way of the spinal nerve as it leaves the spinal canal. This sort of aggravation is brought about by pressure as well as irritation to a spinal nerve root. In the lower back (lumbar spine), radicular pain might go into the leg. Different expressions for radicular pain are sciatica or radiculopathy (when joined by shortcoming or potentially deadness). It very well may be brought about by conditions, for example, a herniated plate,  spinal stenosis, or spondylolisthesis.

Sciatica Back Pain

Click here to read more about Sciatica


Types of Neck Pain

Neck pain is torment in or around the spine underneath your head, known as the cervical spine.  Neck pain is a typical side effect of previous injuries. According to the Cleveland Clinic, Neck pain is extremely normal. It happens in around one out of three individuals no less than one time each year. It is more normal in ladies than in men, and the possibility of developing neck pain increases with age.  

According to UpToDate Patient education: Neck pain (Beyond the Basics), The most common  causes of neck pain are Cervical strain, Cervical spondylosis, Cervical discogenic pain, Cervical  facet syndrome,  

Cervical Strain

A cervical strain is one of the most common issues that is being faced today. This usually occurs the neck muscles suffer an unusual injury. Cervical strains are usually caused due to sports-related injuries with heavy impact and physical/mental stress in everyday life, including poor nutrition and poor posture. Cervical strains last up to 4-6 weeks; neck muscles’ most common cervical strain symptoms are stiffness and tightness.  

Cervical Spondylosis

Cervical Spondylosis is a condition brought about by unusual cervical spine tears (degenerative changes). The most common symptoms of cervical spondylosis are neck pain, headaches, numbness, and little to no neck mobility. 

Cervical Neck Pain

Cervical Discogenic Pain

This type of neck pain might be the most widely recognized reason for neck pain. It is brought about by degenerative changes in the structure of at least one of the discs in the middle of the cervical vertebrae. The most common symptoms are pain in the neck while turning or shifting your head.  

Cervical Facet Syndrome

The facet joints are situated on the sides of the vertebrae, and arthritis in this space can cause pain in the center or side of the neck; certain individuals additionally notice pain in the shoulders, around the shoulder blades, at the foundation of the head, into the ear and jaw, or in one arm. A typical reason for cervical facet syndrome incorporates a task requiring an individual to expand the neck repeatedly in their daily life. 

Diagnose and Treating Your Pain

There are endless possibilities to modify a physical therapy treatment program in order to relieve your specific back or neck pain. At Balanced Physical Therapy, our Doctors are licensed and certified to diagnose the exact cause of your pain symptoms. We take a unique 1-on-1 approach to each treatment session to ensure that all our patients receive our undivided attention and are properly progressing throughout all phases of the rehabilitation. Visit our contact page to schedule an evaluation or to find out more about our doctors, treatments, and network of insurances.

Orthopedic Physical Therapy

5 Important Questions To Ask Your Physical Therapist Before Starting Treatment

Physical Therapy Questions To Ask Before Starting Treatment

If you are starting physical therapy for the first time or someone returning for another round of treatment but trying a different clinic, ask these five crucial questions before you begin treatment. These questions will help you make more educated decisions about your health while avoiding setbacks, wasting time, and insurance benefits. Ask these questions over the phone before your first appointment or during the initial evaluation to ensure your treatment plan is clear and in line with your goals and expectations.


Best Physical Therapy

Question 1: What specialized training do you have to treat my particular condition?

Each physical therapy practice specializes in different types of rehabilitation, and each therapist that works at the practice also has their own specific education and certifications. Make sure to ask your therapist if they treat your condition or symptoms regularly and what credentials they have that will benefit you during recovery. 

The American Board of Physical Therapy Specialties list ten specialties, which is always great to identify to start:

  • Orthopedics
  • Cardiovascular and Pulmonary
  • Clinical Electrophysiology
  • Geriatrics
  • Neurology
  • Oncology
  • Pediatrics
  • Sports
  • Women’s Health
  • Wound Management

On top of that, there are individual certifications and continued education for therapists, such as:

  • DPT– Doctor of Physical Therapy
  • OCS- Orthopedic Certified Specialist
  • MLD- Manual Therapy Certified
  • ATC- Athletic Trainer Certified
  • PAS- Postural Alignment Specialist
  • COMT- Certified Orthopedic Manual Therapist
  • BRM- Barbell Rehab Method
  • BFR- Blood Flow Restriction Training
  • IASTM– Instrument Assisted Soft Tissue Manipulation

And many more.

Question 2: Who will I be working with for each visit? Will it be the same person each time?

Many people run into this problem in as little as a couple of appointments. They have an initial evaluation with a Doctor of Physical Therapy (DPT) and return to their second appointment to find out they will be working with a physical therapy assistant or a physical therapy technician.

Technically, this is ok as long as a licensed DPT is present in the clinic area, but it could lead to some problems with the quality of treatment moving forward. A PTA or PT Tech does not attend the same amount of schooling or have the same experience as a DPT.

If you or someone from your family is a fall risk, has new questions at each appointment, or requires special attention, it may be best to find who you will be working with each time. 

At Balanced Physical Therapy, all of our patients get treated by a licensed and certified Doctor of Physical Therapy. We believe this is the best way to provide the safest, most effective care for everyone. Patients experience different symptoms and feel better or worse daily. With Dr. Robert Litzenburg and Dr. Tori Gasperoni working individually with each patient for all appointments, they can adjust treatments quickly, provide timely and accurate education, and notify primary care doctors when necessary.

Mt. Clemens Physical Therapy

Question 3: How much time will I get with my physical therapist? How much time will I spend with an assistant, tech, or aid?

A great follow-up question to question number two is to find out the specific details of how much time you spend with each person. Confirm exactly what your treatment will look like if you are getting treatment from a physical therapy clinic that splits up your treatment time between a doctor, the assistant, and/or aid.

Sometimes certain therapy places will have the DPT or PTA perform manual skills at the beginning or end of treatment and exercises under the supervision of a tech/aid/or assistant.

Question 4: How long will each physical therapy appointment be? And how long will I be attending physical therapy?

These two questions for your physical therapist will give you a better idea of how long your recovery process will take. While an exact time may be difficult for any healthcare professional to provide for new patients, you can still gain valuable insight, even if it’s a general estimate.

Appointment times vary from clinic to clinic and typically range from 30 minutes to 45 minutes, up to an hour. At Balanced Physical Therapy, we always say time is valuable and something to consider seriously (which is why we treat every patient for 1 hour). From the surface, patients can flat out get more done in an hour than they can in 30 minutes, allowing them to progress better and/or more quickly. Other patients recover a little slower and can’t rush through an entire treatment program like others, which is another reason more time should be allowed.

Question 5: What will I do at each appointment with my therapist?

Each patient is different and requires specific treatments more than others. Knowing what you will be doing at a physical therapy session for the first week, month, and months after is crucial.

Pain management, strength, flexibility, mobility, biomechanics, and sports-specific exercises are a few possible things to work on during an appointment. Ask this question to make sure what you are doing is safe, will contribute to better outcomes, and help you achieve your long-term goals.

Back Pain: Causes, Treatments, and Costs

Back Pain: Causes, Treatments, and Costs

A review of some common acute and chronic back pain conditions. We cover ways to manage minor back injuries at home, finding medical professionals to diagnose and treat back pain, and physical therapy treatments available to help you recover.

Back Pain Review

Back pain encompasses many different experiences and levels of debility for people who suffer from it. The basic term can encompass acute pain or chronic issues that get in the way of enjoying life or working. The one constant for people who suffer from painful back problems is that they wanted to stop as soon as possible. Once you understand the different types of back pain and have your specific problem diagnosed, there are multiple ways to manage it so you can go back to your regular, positive lifestyle.

Back Pain: Causes, Treatments, and Costs


Types of Back Pain

Categorizing back pain can be done in multiple ways. Is the pain temporary or permanent? Where does the pain come from? How much does it hurt, and does it impede physical functionality in any way? Answering these and other questions are important parts of identifying the cause of your back pain and potential treatment options.


Acute Back Pain Caused by Minor Injury

Injuries cause the most specific and short-lived types of back pain. These include bruises due to an impact of some kind in most cases. Like with any other minor injury, rest, ice or heat, and time will help you recover. Of course, more serious accidents can lead to chronic problems. When your back is involved, always seek medical diagnosis and treatment as soon as possible.

When most people talk about back pain, they mean chronic discomfort that gets in the way of their ordinary activities and enjoyment of life. This is caused by a variety of problems.


Muscle Strains and Soreness

The most common types of back pain reported by Medical News Today include general soreness and ache from pulled muscles, tension, damaged ligaments, and other strains(Back Pain: Causes, Symptoms, and Treatments). These can create everything from an unpleasant ache at the end of a hard day to constant discomfort that leaves you lying on the couch and reaching for over-the-counter pain relievers more often than not.

This type of muscular pain issue may come from one instance of slipping and falling, lifting a heavy object improperly, or otherwise experiencing abrupt trauma. A lot of back pain comes from repetitive stress injuries, however. Regular heavy lifting, bending and stretching, poor posture, long periods of driving, and even poor sleep habits can cause ongoing discomfort.


Spinal Structural Problems

Back pain’s other main cause comes from physiological problems related to the spinal column. These include bone- and nerve-related issues. In most cases, wear and tear over time and age-related conditions make up the bulk of these problems. (NIDH: Low Back Pain Fact Sheet) They include:

  • Bulging, herniated, or ruptured disks
  • Arthritis including osteoarthritis and spondylosis
  • Spinal stenosis – narrowing of space for nerves
  • Osteoporosis or other vertebrae fractures
  • Sciatica – Pressure specifically on the sciatic nerve

Issues with the kidneys, uterus and other internal organs can also cause lower back pain. In some cases, things like tumors or blood clots are also at fault.

Managing Back Pain

Eliminating and managing back pain involves either fixing the problem that caused it or finding a way to minimize discomfort going forward.

Lifestyle Changes

Eliminating the causes of muscle and ligament strain is the first step in recovering comfort. Minimize picking up heavy objects, minimize sitting or driving time, and reduce strenuous physical activity that puts tension on your spinal column and back muscles. Also, get a better mattress and use foam wedges or pillows to align your spine more positively.

Ice Packs and Hot Compresses

Both hot and cold treatment options can reduce pain temporarily. This is the same type of treatment you would use if you sprained your wrist, twisted her ankle, or strained any other large muscle in your body.

OTC Medication and Prescription Drugs

For temporary pain, simple over-the-counter pills and topical creams or ointments can help you feel better. Anti-inflammatory medications are specifically designed to target the type of pain that frequently occurs with muscle strains. Your physician may prescribe more serious anti-pain drugs or muscle relaxants for acute injuries, surgery recovery, and chronic problems.

Moving, Stretching, and Strength

Although it may seem contraindicated, certain types of careful exercise actually help with back pain. This includes everything from gentle stretches to help align the spine and work out tense muscles to core strength building for longer-term back support. Make sure your physician or care team approves any type of physical activity or therapeutic movement before you begin.

Back Stretch

Types of Doctors for Back Pain

The type of physician you use for back pain depends entirely on its cause and ongoing management options(Very Well Health: 10 Types of Back Pain Specialists). Receiving an accurate diagnosis is essential for continuing with an effective treatment plan. This matters for both acute, short-term discomfort and chronic pain.

General Practitioners

Due to the structure of the healthcare industry and access, most patients who experience back pain go to a general practitioner, primary care physician, or family doctor first. This is the person who can usually identify the cause of back pain and refer you to a specialist who treats the specific issue. If your pain stems from repetitive stress or an accident, they will undoubtedly handle your treatment directly.

Orthopedic Doctors

More serious issues with the spinal structure get handed over to orthopedists. These surgeons specialize in musculoskeletal problems like scoliosis, ruptured discs, vertebrae fractures, and similar problems. In some cases, surgery is the final option for alleviating pain and minimizing the risk of further issues after you and your care team exhaust other treatment options.


These specialists deal with the nervous system, which obviously involves the spinal column. In the process of alleviating back pain, these positions will diagnose chronic, nerve-related pain. Their primary roles include diagnosis, prescribing medication, and referrals to neurosurgeons or other specialists.


If arthritis or osteoarthritis is the main cause of your back pain, a rheumatologist will help solve the problem. For extremely serious problems that affect the spinal nerves or bones, you will probably get a referral to another type of doctor.


Physical Therapy: Effective for a Variety of Back Pain

Broken vertebrae need mending, arthritis may need anti-inflammatory medication, and all types of back pain can benefit from a proper mattress, good posture, and more careful bending and lifting practices. If surgery or other serious treatment options are not good options for you, physical therapy can alleviate a lot of back pain for many sufferers.

What Can a Physical Therapist Do?

For chronic back pain, therapists present a variety of options. They can help with simple treatments, help release muscle tension, and teach you ways to position yourself and move to reduce discomfort. This may include flexibility and strength training, help with posture and sleeping positions, and proper lifting or work techniques to minimize the risk of making back pain worse.

Back Pain Treatment Options


Physical Therapy is Cost-Effective

When exploring options of any type of medical treatment or ongoing therapy, the cost depends a lot on your personal insurance plan. While the actual monetary numbers differ, the value of a physical therapist when it comes to acute or chronic back pain cannot be understated. Taking medication or using special creams costs a lot with no end in sight. Surgery not only costs a lot upfront but also carries the risk of additional problems in the future. Also, you have a much greater risk of missing more work if you go that route from the start.

Physical therapy provides ongoing help in an affordable way that usually does not impact your ability to do your job and maintain your income. Insurance reimbursement is common with a referral, but even out-of-pocket expenses become manageable when you regain a pain-free or reduced-pain lifestyle you can enjoy.

Stress Awareness and Management

Stress Awareness and Management: 3 Natural Ways To Start Feeling Better

A special guest blog post from The Kee Institute in West Bloomfield focusing on mental health, stress awareness, and management.

Back Pain Review

Stress Levels Are At Record Highs

If you’re currently feeling stressed, know that it’s normal and you are not alone. Stress and worry during the Coronavirus have increased in most adults by 30%, and there is still so much uncertainty in the world. When will things ever feel normal again? Will I have to go back into an office? When will it be safe to fly? The more unanswered questions we have, the more stressed we become. So what is stress anyway? 

What Is Stress? 

When we were hunter-gatherers, stress was our brain’s natural defense mechanism in response to danger. It would flood the body with hormones that prepare us to flee or fight whatever the threat might be. Today, while we’re less likely to run into a bear, a job interview, multiple work deadlines, or even driving in traffic can still trigger our brain with a fight or flight response. 

What Are The Symptoms of Stress? 

It can be challenging to manage stress as it doesn’t always manifest itself in the most obvious ways. Here are some of the more commonly associated behaviors and physical effects of stress: 

Common Symptoms 

● Difficulty sleeping or sleeping too much 

● Jaw clenching 

● Trouble staying on task 

● Lack of motivation 

Tension and muscle pain 

● Restlessness 

● Moodiness and irritability 

● Low energy 

● Aches, pains, and headaches 

Symptoms of Stress

Impulsive Stress Behaviors 

● Binge eating or skipping meals 

● Compulsive online shopping 

● Excessive drinking 

● Shutting yourself off from friends and family 

● A decline in self-care and personal hygiene 

You might spend every Monday feeling exhausted and moody, thinking that it’s just a “classic case of the Mondays,” without even realizing that you’re feeling stressed. A new week can be overwhelming, and Monday mornings will often greet us with a not-so-pleasant inbox. Your brain can perceive Monday as a threat because of how you’ve felt on Mondays in the past. So much so that you might start feeling anxious and restless on Sunday night. 

How You Can Manage Your Stress: 

While it’s nearly impossible to prevent altogether, there are some simple methods you can try next time you’re feeling stressed. 

Schedule Time For Yourself 

Life can be chaotic sometimes, and stress management isn’t always top of mind. We often forget to schedule a time to check in with ourselves with so much on our daily calendar. Put some relaxing “me time” on your calendar once a day. Whether that’s listening to a podcast, reading a book, taking a bath, a quick walk, or cooking yourself a nice meal, try to spend 15-30 minutes each day enjoying something that makes you happy and put the to-do lists out of mind. Make time for yourself and fit it into your schedule so, at the end of the day, you took that time to relax and breathe. 

Move Your Body 

One of the most effective ways to calm your mind is to move your body. If you’re mindlessly scrolling through your phone or struggling to get out of bed, your mind has plenty of time to run through your mental checklist of to-dos and other life triggers. When you exercise, your mind must focus on the movement, mainly so you don’t trip over your own feet. It’s difficult for your mind to wander when following a workout video, listening to a podcast on a walk, or playing a sport with friends.

Not only is exercise a great distraction, but it can increase the production of the brain’s feel-good chemical called endorphins, which can naturally improve your mood. You don’t need to go wild and take up CrossFit to feel the benefits. A simple 15-minute walk with a friend can make a world of difference. 

How to manage stress

Be Kind To Yourself 

Be kind to yourself. It might feel like it’s easier said than done but try your best to listen to your inner cheerleader and ignore your inner critic. The time you spend telling yourself that you can’t complete your tasks in time, that you won’t answer the interview questions right, that there’s no way you’ll make your flight will never positively impact the outcome. While stress is normal, you’ll have difficulty remembering a situation when worrying about something repeatedly made the outcome any different. 

It’s important to note that your feelings are valid no matter what is stressing you out. You, along with your fellow humans, have just endured one of the most challenging years in the last century. Identifying stress is the first step to effective management. While these tips are helpful, it is always beneficial to seek professional help before your stress levels get out of control.

Dry Needling Treatments

Dry Needling: Therapy for Pain and Movement Impairments

Balanced PT offers dry needling treatment to help with neuromusculoskeletal pain and movement impairment. Learn more about the dry needling process and some specific conditions that benefit from this treatment.

What is Dry Needling?

Dry needling is a safe and minimally invasive treatment used to help patients with neuromusculoskeletal pain and movement impairments(Mayo Clinic). Some benefits include decreased muscular pain, easing trigger points, and improved range of motion.

It is administered by certified and trained healthcare professionals such as physical therapists, medical doctors, and some chiropractors. Some other common names for dry needling therapy include trigger point dry needling (TDN) and Functional Dry Needling (FDN).

Difference Between Dry Needling and Acupuncture?

While dry needling stems from traditional Chinese medicine like acupuncture, dry needling is a treatment that has evolved into a modern western medicine treatment. Inserting needles into the skin is something both dry needling therapy and acupuncture share, but after that, the treatments are undoubtedly different (Denver Physical Medicine and Rehab).

Acupuncture treatments are more of traditional eastern medicine based on restoring the proper energy flow throughout the body by inserting needles along meridian lines. 

Dry needling therapy has been developing since the 1980s and focuses on relieving chronic and acute pain by inserting needles into trigger points to restore normal function.

Will Dry Needling Therapy Work For Me?

Patients that are experiencing chronic pain are typically great candidates to receive dry needling therapy. Patients can expect to see the most significant benefits when this dry needling is incorporated with exercise, manual therapy, stretching, and education. It is a low cost, low-risk treatment that can help with conditions such as (Virginia Sports Medicine Institute):

  • Acute and Chronic Tendonitis/ Tendinosis
  • Athletic Overuse Injuries
  • Carpal Tunnel Syndrome
  • Frozen Shoulder
  • Muscle Spasms
  • Whiplash from auto accidents
  • Ehlers Danlos Syndrome
  • Fibromyalgia
  • IT Band Syndrome
  • Sciatic pain
  • Tennis and Golfer’s Elbow
  • Neck and lower back pain

Whiplash from auto accident

While dry needling can be beneficial to various conditions, it is also essential to know when dry needling is not appropriate. Dry needling is not suitable and potentially harmful (Cleveland Clinic) for the following reasons:

  • A patient with a needle phobia
  • Pregnancy (first trimester)
  • Patient with an allergy to metals
  • Patients that have an infection present
  • Needling over cosmetic implants
  • Patients with a heart valve replacement (endocarditis)
  • Patients with epilepsy (or other seizure disorders)

Suppose you are looking for natural pain management treatment options, and dry needling is not an option. In that case, we always recommend scheduling an appointment with your primary care physician, orthopedic surgeon, or physical therapist. They will be able to diagnose your pain and provide you with a list of safe treatments available near you.

How Does Dry Needling Work?

Multiple clinical studies show that dry needling works by restoring muscles to a normal resting state. We know that patients suffering from chronic pain, a traumatic injury, or overused muscles often develop trigger points (also known as knots) that cause pain and discomfort. 

Looking further into why this causes you pain, research shows that the trigger points form due to prolonged or abnormal muscle contraction where your muscle is not receiving enough blood supply. The lack of blood supply (filled with oxygen and nutrients required for healing) to an injured area will cause the surrounding tissue and nerves to become more sensitive.

By stimulating the trigger point with a sterile needle, dry needling therapy can help drive more blood to an injured area, release muscular tension, and help the brain release endorphins that promote healing.

Step By Step Dry Needling Procedure

Before administering dry needling therapy to any patient, your physical therapist will perform an examination that includes your past medical history to ensure the treatment is appropriate and safe. Part of the evaluation will also consist of your therapist using palpation skills to identify trigger points causing pain and limited motion.

Phsyical Therapist finding trigger points for dry needling treatmetn

Once you and your therapist agree that dry needling will benefit your recovery, the therapist will go over each part of the treatment in more detail (Verywell Health). Specific details that help patients understand dry needling can include:

  • How long does dry needling take? Typically a single treatment can take anywhere from 15-30 minutes, which is most commonly a part of a total of 30-60 physical therapy sessions.
  • What to wear for a dry needling appointment: We recommend our patients wear the usual, comfortable physical therapy attire. Clothing that allows easy access for your therapist to administer the treatment is always a good idea. 
  • Insurance information and expected costs: Some insurances do cover dry needling, while others do not. It helps to know upfront what co-pay and out-of-pocket costs to expect.

Once an evaluation is complete, some patients can start dry needling therapy that same day( others may need to wait until the second appointment, this varies from clinician to clinician.)

Your physical therapist will always begin the dry needling procedure by sterilizing the treatment area and preparing the needles in a private setting. After preparing the treatment area, the therapist will start inserting thin, dry needles (needles that do not contain medications or fluids ) into problem-causing trigger points. 

The dry needles are inserted directly into the skin at varying depths (depending on the dry needling technique). Oftentimes, patients will feel the physical therapist gently move the needle around to stimulate a local twitch response. A local twitch is a good thing, as it signifies that a muscle is reacting to the treatment.

After 15-30 minutes, your therapist will carefully remove the dry needles. They will inspect the treatment area for bleeding and skin reactions before leaving for home.

What To Expect After a Dry Needling Treatment

After a dry needling treatment session, patients often report a decrease in pain and an increase in range of motion. In more severe cases, a patient will require more than one treatment to reach the desired results.

Muscle soreness and light bruising is a common side effect of dry needling, for which your therapist may recommend rest, heat, or ice. These symptoms typically resolve themselves over a couple of days to a week.

If you are experiencing more severe side effects (these are considered rare), such as difficulty breathing or significant bleeding, we recommend contacting emergency medical services immediately.

Schedule Dry Needling Treatment Today

Balanced Physical Therapy offers safe, effective, and certified dry needling treatments. Our patients enjoy working in one-on-one therapy settings with board-certified physical therapists. To schedule an appointment, call us at (586) 741-5806 or visit our Appointments page to schedule an evaluation.




Knee Replacement Surgery

13 Week Recovery Timeline For Knee Replacement

Find out how long it will take to recover from a knee replacement surgery. This general, 13 week timeline is an overview of common things to expect during your hospital stay, at home, and outpatient physical therapy.

How Long Does Recovering From Knee Replacement Surgery Take?

When patients and their orthopedic surgeons agree that knee replacement surgery is a good option, one of the first questions or concerns usually is “how long will the recovery process take?” The simple answer would be about 13 weeks to recover. This timeline is dependant on a lot of factors such as type of procedure, limiting complications, and being consistent with their doctor and physical therapy visits.

Patients typically have a good understanding of the benefits of having a knee replaced, but they also appreciate knowing what is required to reach those benefits. A knee replacement, otherwise known as knee arthroplasty, is one of the most successful surgeries performed throughout the world. If you want to be a part of the 90% of people with a well-functioning knee, 15 years post-surgery, understanding each part of the recovery process can help you with that goal. 

Balanced Physical Therapy has combined real-world experience with proven clinical research from around the internet to help you better understand each part of the recovery process, specific timelines for recovery, and why each element is essential. 

Knee Replacement Recovery Timeline

Generally, someone who undergoes a knee arthroplasty takes about 12-14 weeks to recover fully. With the help of the Wisconsin School of Orthopedics and Rehabilitation and Healthline, we have broken down the recovery process into 5 phases:

Phase 1: Hospital Stay to Discharge

Phase 2: Weeks 1-2, 

Phase 3: Weeks 3-6, 

Phase 4: Weeks 7-12

Phase 5: Weeks 13 and Beyond

Knee Replacement Recovery Phase 1: Hospital Stay and Discharge

A typical hospital stay after a knee arthroplasty ranges anywhere from 1-3 days. Some patients even leave the same day, which depends on the type of procedure that is performed.

Hospital Stay After Knee Replacement

The reason knee replacement surgeries are so successful is because of their relatively low risk of complications. A majority of your hospital stay will include surgeons and hospital staff working hard to prevent complications such as infection, blood clots, pain, hardware issues, and neurovascular injuries. 

While your healthcare team continues to monitor and prevent complications, patients can expect to start rehabilitation soon after the surgery. Within 24 hours, patients will work with a physical therapist to begin standing and walking again. Lack of confidence is very common during this time, so crutches and walkers help provide that extra support many patients require. 

Another standard device used amongst the knee replacement population is a continuous passive motion (CPM) machine. This machine helps provide your knee with a constant motion to prevent scar tissue buildup and stiffness from being immobile. You can expect your surgeon or physical therapist to help educate you about this device and how to use it at home.

Knee Replacement Recovery Phase 2: Weeks 1-3

The first week after undergoing knee arthroplasty, patients can expect to be back in the comfort of their own homes. One of the first and most important things to know during this period is your follow-up appointment with your surgeon. Typically the follow-up is scheduled about two weeks after the knee replacement and is something every patient should markdown as “must-attend.”

Phase 2 of knee replacement rehabilitation also includes patients becoming more active with therapy. Some patients start treatment at home, while others can attend an outpatient clinic. One is not necessarily better than the other; it just depends on a person’s health status.

Some goals and priorities to be aware of include:

  • Reduce pain and stiffness
  • Being able to transfer from lying to sitting to standing safely with the help of assistive devices
  • Being able to “heel strike” while ambulating
  • Increase knee range of motion
  • Ability to extend leg without lag
  • Being consistent with the home exercise program provided
  • Understanding the pain scale and the difference between “hurt and harm.”

Your physical therapist will design a rehab program to help you reach these goals without harming the new knee hardware or incision. Examples of exercises to expect for the weeks 1-3 after your surgery include:

  • Heel Slides
  • Quadriceps Sets
  • Straight Leg Raises
  • Sit To Stand Squats
  • Stationary bike with little to no resistance
  • Hamstring Curls

One of the best things about Phase 2 is that while you train your body to regain a proper gait and pain-free life, your therapist will also mix in modalities to help you progress more. Common knee replacement modalities include 

  • Electrical stimulation (E-stim) can help activate the quadriceps better
  • transcutaneous electrical stimulation (TENS) can be applied to help control pain symptoms
  • Soft tissue mobilization on elevated surfaces to help reduce edema (also known as swelling)

Note: These therapeutic modalities can and often are used throughout all phases of knee rehabilitation.

Knee Replacement Recovery Phase 3: Weeks 3-6

The third phase of recovering from a knee replacement is typically outside the home, in an outpatient physical therapy setting. A follow-up appointment around the six-week mark is also required, just like the one at the two-week mark. 

The main goals for patients that are 3-6 weeks post-surgery include:

  • Continue improving knee range of motion and quad strength
  • Progress strengthening towards bodyweight, functional ambulation
  • Normalization of gait (walking)
  • Reduce the need for assistive devices, such as walking with only one crutch a just using a cane
  • Walking short distances without using any assistive devices

During this part of the knee rehabilitation, patients are progressed with more moderate exercises such as:

  • Sit to stand squats
  • Leg Press
  • Stationary bike with resistance
  • Single leg balance
  • Gastrocnemius strengthening
  • Standing knee extension with therabands
  • Hip and core strengthening as needed
  • Neuromuscular reeducation
  • Pool therapy (must have authorization from a surgeon, never before four weeks, and must have a closed incision)

Knee Replacement Recovery Phase 4: Weeks 7-12

When recovering from knee arthroplasty, the fourth phase is when most patients see the most rapid improvement to mobility and range of motion. It is an exciting time where the hard work of attending physical 2-3 times a week and staying compliant with home exercise programs starts to pay off. 

Some common goals and milestones during this phase of rehab include:

  • No extensor lag (lack of full knee extension with full quadriceps contraction)
  • Normal gait without the use of an assistive device
  • Engaging in everyday activities such as driving, housekeeping, and shopping
  • Ability to ascend and descend 1-2 flight of stairs with a reciprocal gait

Knee Replacement Recovery Goals

Your physical therapist will continue to progress your rehab and increase difficulty in the 7-12 weeks following surgery. Patients can expect exercises such as:

  • Toe and heel raises while standing
  • Single leg balances
  • Step-ups in multiple directions
  • Continued lower extremity strengthening

Even if you do not see the best results, it is crucial to stay the course. Don’t give up, ask questions, and continue to follow the guidance of your healthcare team.

Knee Replacement Recovery Phase 5: Weeks 13 and Beyond

After 13 weeks since your surgery, most patients are happy to see the finish line. Some patients may still be attending physical therapy to reach the goals you set entirely, while others are safe for discharge. Both scenarios are expected, and it varies from person to person.

Providing you have not experienced any major setbacks or complications, pain should be almost nonexistent. It is a good idea to still check in with your healthcare team. If you have pain, swelling, stiffness, or unusual movement, it is always best to call your doctor immediately.

At Balanced Physical Therapy, we understand how important fully recovering from knee surgery is to our patients. From your first evaluation, we take the time to understand everything about you and your condition. Our treatments consist of one-on-one therapy with board-certified physical therapists who are always willing to help. Call us at (586) 741-5806 or visit our Appointments page to schedule an evaluation.

Uneven Hips and Abnormal Pelvic Tilt

5 Things To Know About Uneven Hips and Abnormal Pelvic Tilts

A guide for anyone who believes their hips are out of alignment. Learn about the signs and symptoms of misaligned hips. Find out how this condition relates to your pelvis, spine and posture. See the ways physical therapy can help you get realigned and get back to functional, pain free life

What Does It Mean When Your Hips Are Out Of Alignment?

When it comes to having uneven hips, it is essential to understand that your pelvis and spine are also affected. Having uneven hips is often associated with an anterior pelvic tilt. These two can drastically change a person’s back health, posture, and overall biomechanics. A slight misalignment can cause pain and discomfort in the hip and lower back regions. Over time this small problem can have compounding effects that reach up into the shoulders and neck. To help you avoid these type of complications, we will go over:
  1. How you can determine if your hips and pelvis are properly aligned
  2. Common symptoms and causes of uneven hips and abnormal pelvic tilts
  3. Physical Therapy Treatment for uneven hips and abnormal pelvic tilts

What Is A Normal Hip Alignment?

To determine whether or not you have proper hip and pelvis alignment, a physical therapist would need to observe and measure multiple factors around the hip, pelvis, and spine. As always, it is best to seek a professional opinion from your primary care physician, physical therapist, spine specialist, or chiropractor.  If you haven’t gone to see your doctor or physical therapist and would like to self-check your hip alignment, you should look out for three things:
  1. Your pelvis should be parallel to your shoulders and the ground
  2. Your hips should stay neutral and not be tilted forward or backward
  3. Your hips should be on the same level horizontally, not one higher and one lower
Uneven Hip and Pelvis Alignment
Hip and Pelvis Alignment Comparison via Runners World
An excellent way to check all three is to stand in front of a full-body mirror to observe your posture thoroughly.  First, take notice if your shoulders are even. A shoulder that sits higher than the other may present a lower, misaligned hip on the same side. A shoulder blade that sticks out can also help you determine the hip and pelvis’s misalignment on the same side.  Next, take a look at how your spine is aligned. A curved “C” or “S” shape of your spine can help you determine if the cause of your uneven hips is scoliosis-related.  It can also help to imagine a straight line from your nose to the belly button. If the line doesn’t touch, this would also indicate a spinal misalignment, possibly related to your hips or pelvis. Suppose you do not have access to a full-body mirror or have trouble visualizing the proper hip and pelvic alignment. In that case, it can help understand some common symptoms associated with misaligned hips and pelvis.

Signs And Symptoms Of Misaligned Hips or Pelvis

People with misaligned hips or abnormal pelvic tilts often experience symptoms that progress from minor and unnoticeable to significant and life-altering.  Minor symptoms that often go unnoticed for long periods include:
  • General low backache
  • Pain in the hip and buttocks area that increases during or after walking
  • Pain in the hip and low back after standing in place for long periods
  • Unbalanced walking or gait
  • Achy feeling in the lower back or hip while laying down
If these minor symptoms go untreated for too long, they can progress into more severe complications such as:
  • Pain that goes down into the thigh towards the knee
  • Pain in and around the groin
  • Inability to stand in place or walk
  • Poor spine alignment

What Causes Uneven Hips and Abnormal Pelvic Tilts?

To get back to a pain-free and active life, it is always best to understand why your hips and pelvis are misaligned. We recommend everyone see their primary care physician, spine doctor, or physical therapist as soon as symptoms begin to show. A medical professional can evaluate posture, gait, measure each leg’s length, prescribe an X-Ray or CT scan for the most accurate diagnosis.  Your health care professional can diagnose the cause of misaligned hips or abnormal pelvic tilts, which may include:
  1. A functional Leg Length Discrepancy: You can think of this as poor posture for prolonged amounts of time that result in muscular imbalance. When bad posture becomes a habit (in sitting or standing), the muscles surrounding the hip and can become tight and shorten, causing the hip to pull upwards. Also, on the other side of the body, muscles can become weaker and looser, causes the hip to sit lower.
  2. Structural Leg Length Discrepancy: You can think of this as one leg being shorter/longer than the other, outside the commonly accepted range. Most people have a slight difference in leg lengths, but significant differences (4cm or more) can cause hip and pelvic misalignment. These leg length discrepancies can be congenital (naturally from birth). Other causes include growth plate injuries (Salter-Harris fracture is common amongst children and adolescents), poor healing after bone breaks, joint conditions such as arthritis, or bone diseases such as neurofibromatosis.
  3. Scoliosis: This abnormal “S” or “C” curve in the spine is a prevalent cause of hip and pelvic misalignment. Scoliosis is more common amongst young females and can run in the family. 
Once a medical professional confirm a diagnosis, people with misaligned hips and pelvis can begin the recovery process. One of the best and most common ways to correct these issues is physical therapy.

Treating Uneven Hips and Misaligned Pelvis With Physical Therapy

Physical therapy is typically one of the best non-surgical treatment options for misaligned hips and abnormal pelvic tilts. Your physical therapist can help diagnose the cause of your pain and misalignment. They can also assist you with pain management, stretching, strengthening exercises, and biofeedback to prevent and eliminate symptoms. Some techniques and practices that are effective include:
  • Muscular release to tight hip flexors, quadriceps, hamstrings, and glutes.
  • Corrective exercises that address your specific diagnosis. Each type of pelvic tilt (Anterior, Posterior, and Lateral Pelvic Tilts) requires different treatment plans to realign.
  • Help fix bad habits related to posture when standing and sitting.
  • Assist and educate patients on the best way to sleep with as little pain as possible.
Early treatment can help speed up the recovery and prevent significant complications. If you believe your hips are misaligned, you have an abnormal pelvic tilt, or unsure about the cause of your back pain, please contact us at (586) 741-5806 today to make an appointment
Preventing Overtraining Syndrome

Prevent Overtraining Syndrome and Overuse Injuries in Youth Sports

Helping parents, coaches, and young athletes understand overtraining syndrome (OTS), the specific injuries associated with overuse, early signs of detection, and general guidelines for training.

Overtraining in Youth Sports

With over 30 million youth sports participants ages 6 to 18, it is important for parents and coaches to know about overtraining syndrome (OTS), the specific injuries associated with overuse, early signs of detection, and general guidelines for training.

Every year more children and adolescents are participating in organized and recreational sports. This is a great sign in the fight against childhood obesity as it builds lifelong physical activity habits, promotes healthy competition, and builds skills for future opportunities. Unfortunately one of the downsides with increased activity in youth sports is the increased risk of overtraining, overuse injuries, and burnout.

What is Overtraining Syndrome (OTS)?

Overtraining Syndrome (OTS) is more commonly referred to as “burnout”. OTS or “burnout” is caused by intensely working the body for long amounts of time without allowing the time for rest and recovery.

The American Academy of Pediatrics describes overtraining syndromes as a “series of psychological, physiologic, and hormonal changes that result in a decreased athletic performance. With so many options such as football, gymnastics, swimming, wrestling, and tennis at all levels; kids have naturally become more likely to suffer from injury.

What is an Overuse Injury?

Overtraining can directly cause an overuse injury. Overuse injuries often include damage to bone, muscle, and tendons. These injuries can be classified into 4 stages:

  1. Pain in the affected area after physical activity
  2. Pain during physical activity, but not restricting performance
  3. Pain during physical activity that also restricts performance
  4. Chronic, persistent pain, even at rest

Because young athletes’ bodies are still developing, they are more susceptible to overuse injuries. Their bones are still growing, therefore cannot handle as much stress as fully developed adults. Generally, the best way to prevent major overuse injuries is to understand and identify the young athlete who is at most at risk.

If your young athlete is showing signs of injury, it is always a good idea to get a professional assessment. A physical therapist can diagnose the injury and provide a treatment plan to safely return to competition.  Contact Balanced Physical Therapy to schedule a free injury screening or comprehensive evaluations here.

Common Overuse Injuries in Youth Sports

Some examples of overuse injuries and risks that may result from overtraining in youth sports include:

Little league and travel baseball players can be at risk for throwing injuries such as medial apophysitis or “little leaguer’s elbow”. Too much overhand throwing, especially with poor technique, can result in excess inflammation and irritation in the elbow. This can have long-lasting effects on the medial apophysis growth plate.

A child or adolescent gymnast can be at risk for developing spondylosis (pain in the spine due to deterioration) when doing repetitive hyperextension and rotation while participating.

Preventing Overtraining in Youth Athletes

Young swimmers are susceptible to shoulder injuries such a rotator cuff or bicep tendonitis, shoulder impingement, and neck pains.

Track and distance runners often develop shin splints and stress fractures as a result of overtraining.

These injuries are commonly caused over time, and not suddenly. This is good news, especially for parents and coaches who know the signs of overtraining and overuse.

Signs of Overtraining and Burnout

Parents and coaches concerned about the possibility of overtraining have multiple ways to tell when a young athlete needs more time to rest and recover. The Boston Children’s Hospital lists common signs of overtraining that include:

  • Slower times in distance sports
  • A decrease in athletic performance
  • Decreased ability to achieve training goals
  • Decreased motivation to practice
  • Young athlete getting tired easily
  • Irritability and unwillingness to work with teammates
  • Disturbance in sleep schedule
  • Weight loss or appetite changes

How To Prevent Overtraining Syndrome

General guidelines suggest that to promote fun, develop skills, and achieve individual goals; a young athlete requires good training and rest balance. Some ways to prevent overuse injuries and burnout include:

  • Encourage young athletes to take 1-2 rest days per week. This allows time to recover physically and psychologically between competition.
  • Advise young athletes that their weekly training time, repetitions, or total distance should not increase more than 10% per week.
  • Encourage athletes to take a seasonal rest from a single sport for 2-3 months a year. Taking breaks and developing other skills are essential for preventing injuries.
  • Focus on proper nutrition, hydration, and sleep.
  • Be mindful and cautious when entering multiple tournaments on consecutive weeks
  • Be consistent with yearly checkups with pediatricians and family physicians. 
  • Emphasize that the reason we participate in sports is to have fun, develop healthy lifestyle habits, and improve athletic skills.

Using these guidelines, parents, coaches, and healthcare professionals can help keep young athletes injury-free. Mixing in rest days and diversifying the activities kids participate in can help tremendously when developing skills and avoiding burnout.