Treatments

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.

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Balance Training For Seniors and Older Adults

Balance Training: A Better Way To Prevent Falls

A balance training guide for seniors, older adults, and their family members. Learn what conditions affect balance and coordination, ways to identify a fall risk, and how physical therapy can improve everything from stability to sensory orientation.

Improve Balance and Coordination At Physical Therapy

 

Balance and coordination tend to decline as a person ages. Luckily there are things you can do to improve balance, reduce fall risks, and improve the overall quality of life. Being physically active is always a great first step when it comes to improving your overall health. It can also be necessary to seek specialized care for a custom balance training program as health declines.

Balanced Physical Therapy helps senior and older adult patients improve balance, control and coordination. Patients are less likely to fall and suffer from injuries when they have

  • Increased Overall Independence
  • Reduce Fear of Falling
  • Improved Coordination
  • Faster reaction Time
  • Stronger Bones
  • Increase Walking Speed
  • Improved Muscular Function
  • Improved Cognitive Function

Seniors and older adults often experience a decline in motor and cognitive functions. Balance is strongly affected and daily activities such as cleaning, exercising, and getting dressed can become more difficult in a short time.

Knee Stability Exercise

What conditions affect balance in seniors and older adults?

 

The American Family Physician attributes gait and balance disorders to seven different types of medical conditions including:

Affective Disorder and Psychiatric Conditions

    • Depression
    • Fear of Falling
    • Sleep Disorders
    • Substance Abuse

Cardiovascular Disease

    • Orthostatic Hypotension
    • Coronary Artery Disease
    • Congestive Heart Failure
    • Arrhythmias

Infectious and Metabolic Diseases

    • Diabetes Mellitus 
    • Obesity
    • Hyper and Hypothyroidism
    • HIV-associated neuropathy
    • Vitamin B12 deficiency

Musculoskeletal Disorders

    • Gout
    • Lumbar Spinal Stenosis
    • Osteoarthritis
    • Osteoporosis
    • Muscle Weakness and Atrophy
    • Podiatric Conditions
    • Cervical Spondylosis

Neurological Disorders

    • Dementia
    • Parkinson Disease
    • Stroke
    • Vestibular Disorders
    • Multiple Sclerosis 
    • Myelopathy

Sensory Abnormalities

    • Hearing Impairment
    • Peripheral Neuropathy 
    • Visual Impairment

Other

    • Other Acute Medical Conditions
    • Recent Hospitalization
    • Recent Surgery

How To Know If Someone Is a Fall Risk

 

A person who is a fall risk can often show signs and symptoms before having an accident. The best way to keep track of age-related balance issues is to be consistent and active when going for yearly checkups. It is extremely important to always report falls and near falls to your physician. Your primary care physician can help monitor your overall health and identify fall risks as they present themselves.

In addition to seeing your primary care physician on a regularly, it can be useful to know and watch out for some common signs of a balance deficit among friends and family. These include

  • A person having a difficult time getting up from a chair. This can indicate a weakness in the glutes, quadriceps, hamstrings, or hips.
  • A person who has a difficult time walking. Someone who tends to reach out for support on furniture or walls.
  • Near falls or someone who would have fallen if they had not caught themselves.
  • Someone taking pain medication or sleep aids. Some medications can cause dizziness, drowsiness, and balance issues.
  • Dizziness when standing up from a sitting or laying position.
  • Foot, knee, or hip pain that leads to an abnormal or shuffling type of walk.

Why Balance Training Is Important

 

People that fall once, have double the chance to fall again. Studies show that one out of five falls causes seniors injuries such as broken bones or head injuries. These falls can lead to long periods of pain, lower quality of life, disability, or even death. 

Balance training under the supervision of a physical therapist is a way to promote better overall health in a safe environment. A physical therapist can help improve balance and decrease your risk of falling by implementing a training program specific to your needs.
Patients can reverse the effects of physical inactivity and overcome the fear of falling. Patients can also benefit from additional education as well as emotional support from a healthcare professional.

Physical Therapy Program for Balance and Coordination

 

Patients who are unsure if they require specialized balance training should consult with their primary care physician. Your doctor can prescribe physical therapy to help improve balance and coordination. 

Once prescribed, your physical therapy program will always begin with an evaluation. A physical therapist will conduct a fall-risk assessment to better understand risk factors such as vision, mobility, transfers, daily activities, environment, and nutrition. Patients can also ask questions, discuss their goals, and express any concerns during the assessment.

Based on your current health your therapist will create a balance training program that is fit for your needs. Our therapists are experienced in modifying most therapy techniques to best suit your condition and to properly challenge you on a day-to-day basis.

Exercises For Balance Training

 

Physical Therapy exercises can be targeted to a specific physiological system or combine multiple systems to better simulate real-life activities. Certain parts of the balance training program will be geared towards motor function while other parts will focus more on cognitive improvements. Examples of these include

  • Increase stability limits
  • Improve anticipatory postural adjustments
  • Improve postural responses
  • Improve sensory orientation
  • Improve stability in gait

Yoga Ball Balance Exercise

Therapy sessions normally last about an hour and begin with a warm-up such as riding a bike, marching in place, or stretching. After warming up patients often train using therapy balls, uneven surfaces, body weight, and resistance training. A therapy session will conclude with stretching, massage, and a cool-down period. Not every appointment will be the same, in fact, they often differ to properly progress while keeping things interesting and fun.

At Balanced Physical Therapy, we pride ourselves on providing every patient with the expertise they deserve. Each patient is treated by a DPT for their entire session, avoiding any issues that may arise when working with assistants or techs. Your therapist will always be by your side and we encourage all our patients to ask questions and issue any concerns whenever at any point of your appointment.

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Improve Post-Op Recovery with Prehabilitation

What is Prehabilitation?

Prehabilitation, or “Pre-hab”, is a proactive measure for patients scheduled for orthopedic surgeries. A surgeon or primary care physician will often prescribe patients “prehab” to help prepare them for physical and lifestyle changes associated with surgeries.

Studies show that patients who move better, feel better, and feel stronger tend to do better. This article can be useful for patients considering or expecting orthopedic surgery. You can also find some specific tips at the end of each section about some common spine, knee, shoulder, and foot surgeries.

 

What are the benefits of prehabilitation?

‍Patients who attend physical therapy before surgery can improve physiological, mental, nutritional, and lifestyle health. Orthopedic surgery can be thought of as a marathon, meaning the preparation put before actually running the race will ultimately help your overall performance during and after it.

Physical Therapy Before Surgery

Tip #1: Timing, Type, Setting, and Costs

When considering a prehab program prior to surgery, important things to consider are timing, type, setting, and costs.  

The U.S Department of Health and Human Services published a study related to patient outcomes of major joint replacement surgeries (Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA). The evidence showed that when your rehabilitation occurs (timing), what the training consists of (type), where your rehab occurs (setting), and out-of-pocket or insurance costs are the most important things to consider for patients, surgeons, and therapists.

Physiological benefits of prehabilitation

If your surgeon has prescribed physical therapy prior to surgery, you can improve the function, strength, and conditioning of your body many weeks ahead.  A physical therapist can evaluate you and come up with a treatment plan that includes aerobic exercise, strengthening, and stretching, and pain management.

Improve Recovery After Knee Replacement

Studies show aerobic exercises such as low-impact cycling or walking as an effective nonpharmacological option for patients undergoing total joint replacements. Patients can often expect a decrease in pain symptoms, joint tenderness, and better overall function for daily activities.

Tip #2: Getting Prehab

The best way to get started with prehab is to work individually with a physical therapist.

If you are dealing with insurance issues and the number of appointments available, we recommend talking with your doctor, surgeon, or local physical therapy clinic. They may be able to direct you to some free prehab education classes or come up with a treatment plan that can be done at home.

Mental benefits of prehabilitation

‍Mental health is one of the most important and often overlooked aspects of orthopedic surgery. It is natural for patients to feel stressed and anxious before surgery. Attending physical therapy can be extremely useful to help get you prepared mentally and feel confident.

Tip #3: Make use of downtime

It is common for patients to wait multiple weeks before entering the operating room, this time can be used to get acquainted with your physical therapy clinic, your therapist, and surgical procedure. Learning how to modify daily activities, transferring positions, and using crutches or walkers can help reduce your hospital stay and home care costs.

Nutritional support from prehabilitation

Nutrition plays an important role when recovering from orthopedic surgery. Physical Therapists can assist you with fine-tuning your diet to improve blood circulation, manage glucose uptake and insulin resistance while reducing oxidative damage to blood vessels.

Daily Nutrition For Orthopedic Surgery

Tip #4: Avoid high-fat meals

Adults expecting an orthopedic surgery of any kind diets should limit fat intake to less than 35% of their daily calory intake. A high-fat meal close to surgery can increase the risk of blood clots and inflammation at the surgical site.

 

Lifestyle support from prehabilitation

Physical therapy can help patients adjust to various lifestyle changes associated with surgery recovery. Helping you prevent fall-related injuries, work from home tasks, and things like sleeping or showering.

Tip #5: Home Preparation For Knee and Hip Surgery

Move things you use frequently above waist level, prepare food ahead of time, and make sure your bed, armchair, car, and toilet seat are at safe levels before you leaving the hospital.

Question about Prehabilitation?

Balanced Physical Therapy is dedicated to providing everyone an equal opportunity for a full recovery. Contact us with any questions you have about insurance, treatments, and the rehabilitation process.

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Sciatica Symptom

Sciatica: Symptoms, Causes, and Treatments To Know

A simple guide to a common problem. We cover the sciatic nerve anatomy, elated pain, and physical therapy treatments proven to relieve sciatica.

Sciatica is a term used to describe pain along the sciatic nerve. The Sciatic nerve is made up of five nerve roots; two at the lumbar spine (lower back) and three at the sacrum (lowermost part of the spine). These nerve groups combine to make up the left and right sciatic nerve.

What does Sciatica feel like?

‍Pain is normally one of the first symptoms a person suffering from sciatica experiences. This pain can either be constant or intermittent down one leg( although both legs can experience this pain). The most common symptom of sciatica is a sharp, burning feeling. Other sciatica symptoms include:
  • Electric shock-like, shooting pain
  • Numbness and tingling feeling at the back of the leg
  • Throbbing or pulsating pain
  • Dull aching feeling
  • Discomfort that comes or goes
  • Weakness at the lower back, leg, or foot

What causes Sciatica?

‍Some of the most common reasons for the onset of sciatica include:
  • Herniated or Slipped Disk that puts pressure onto the nerve roots. The Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/12792-sciatica) estimates that about 1% to 5% of people will experience a slipped disk at some point in their lives. When too much pressure is applied to the vertebrae of the spine, it can “push” out a disk causing it to bulge( herniate). A herniated disk along the lower portion of the spine can put pressure on the sciatic nerve.
  • Degeneration (https://www.spine-health.com/conditions/sciatica/sciatica-causes) of the tissues along the lumbar spine, facet joints, and the actual vertebral bone can all cause pressure to the sciatic nerve through compression and inflammation.
  • Spinal Stenosis is the actual narrowing of the spinal canal (the passageway where your sciatic nerve runs through). Spinal Stenosis is most common for people over the age of 60, resulting in pinching of the sciatic nerve.
  • Spondylolisthesis occurs when one vertebra slips out of line with the vertebrae above it. A good example of this is when the L5 vertebra slips forward over the S1 vertebra, causing sciatic nerve compression. Spondylolisthesis is most common with young adults and can result in pain along the right and left sciatic nerves.
  • Osteoarthritis and the bone spurs (jagged edges of bone) that develop with age can also compress the sciatic nerve.

What are the treatment options for sciatica?

‍Most often, patients experiencing acute or chronic sciatica will receive nonsurgical treatments by their primary care physician or spine doctor. Nonsurgical treatments for sciatica often include rest, physical therapy, medications, or therapeutic injections. Physical Therapy can be one of the most beneficial treatments for sciatic pain. Combining pain management techniques with flexibility and strengthening exercises can be a long term solution for patients to:
  • Restore pain-free functional movements
  • Relieve lower back, buttock, thigh, and leg pain
  • Reduce muscle spasms
  • Improve lower body mobility
  • Promote a better soft tissue healing environment for the lower back
  • Prevent future flare-ups
  • Restore function of the lumbar spine and sacroiliac joint

What should I expect when going to physical therapy for Sciatica?

‍If you have received a referral for physical therapy to treat your sciatica, the first step would be to undergo an initial evaluation with a licensed Doctor of Physical Therapy. This first appointment serves to provide your therapist with a baseline knowledge of your current condition. Your physical therapist will use this time to learn about your specific sciatic symptoms, past medical history, lab tests (MRI or X-rays), lifestyle habits, and short/long-term goals. Your therapist will also test specific functional movements such as range of motion, flexibility, posture, and reflexes. From there your therapist will craft a therapeutic program designed to reach your goals based on the results found from the initial evaluation. A typical sciatica treatment program will consist of passive and active techniques. Depending on the severity of symptoms, your physical therapist will progress these techniques as required. Passive techniques for sciatic nerve pain serve to help patients with promoting blood flow, reduce muscle spasms, and decrease pain. The passive portion of a sciatica treatment program can consist of modalities such as:
  • Hot/Cold packs
  • Traction
  • Manual Therapy
  • Transcutaneous Electric Nerve Stimulation (TENS unit)
  • Neuromuscular Electric Muscle Stimulation.
Active techniques for sciatica serve to improve leg mobility and range of motion, strengthen core muscles, stretch tight muscles such as the hamstrings, and encourage the flow of nutrients and fluids throughout the body. Active physical therapy techniques may include:
  • McKenzie Method
  • Abdominal and Back Exercises
  • Abdominal and Back Stabilization
  • Hip Mobilization
  • Functional stretching of the hamstrings, quadriceps, and deep lower back muscles
It is best to seek treatment for sciatica as early as possible. Pain symptoms often progress and flare-ups become more common as you age. To make an appointment with one of our physical therapists call (586) 741-5806 and one of our friendly staff will assist you with the process.

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