News & Events

Shin Splits, How to Reduce Your Risk – 3 Strategies

I have two words for you.  Two words which give runners everywhere nightmares.  “Shin splints”. Most people are familiar with this diagnosis; and if you have had them before, you know that they are highly irritating!

In this blog, I want to talk about three strategies you can use to help reduce your risk of developing shin splints symptoms. 

1st: Buy a Good Pair of Running Shoes

Just like anything else shoes break down and need to be replaced. How often they need to be replaced depends on how far you are running in a week.

As a general rule of thumb, running shoes should be replaced every 300 to 500 miles, which means you can’t simply replace them once a year (if you are averaging 50 miles a week).

2nd: Slowly Ramp up Your Running Distance

Have a plan for building up your running distance. If you want to run a half-marathon this summer, but have not been putting in any miles during the winter, you should not start off running 30 miles a week.  You should instead begin by building up your walking tolerance, move to walk/run intervals, then build your running distance from there.

Going from spending most of your time sitting on the couch and binge-watching Netflix straight into hardcore run training is a sure fire way to end up with a case of shin splints.

3rd: Stretch Your Calf Muscles 

Finally, make sure you stretch out your calf muscles before and after your run. When stretching out your calves, it is important to ensure you stretch out both of the major muscles which reside there, your gastrocnemius and soleus muscles.

The gastrocnemius is stretched when your toes are pulled toward your head with your knee straight as this muscle spans across the knee. In order to stretch the soleus, you must have your knee bent as this muscle stops short of the knee.

soleus stretch

gastrocnemius stretch

 

Each of these three strategies can play an important roll in helping you to avoid shin splints and helping runners everywhere to get a better night’s sleep!

 

 

If you or someone you know is already dealing with this condition, then set up an appointment today to be seen by one of our physical therapists.  There are many strategies to help speed up recovery!

Written By: Josiah Parker, PT, DPT

How to Pick the Right Physical Therapist

Today’s blog post comes at the request of my father.  My answer to him was to simply call his son! Unfortunately this strategy will not work for most of you reading this post, and the decision may seem daunting. 

It seems over the last 10 years a physical therapy clinic has popped up on every corner in Omaha and the surrounding communities, which gives you a plethora of options. Going with the closest clinic may sound convenient but also may not deliver the results you are looking for. Today, I want to share my thoughts on how to narrow down your search!

IMG_9199_smallerjpg

First and foremost,

I would talk to former patients and see what their stories are along with asking several questions.

  1. Did they return to their desired activities?
  2. How long did it take?
  3. Did they get along well with their therapist?
  4. Did the therapist make adjustments if the initial plan was not quite meeting the patient’s needs?

Each of these questions can reveal important information about your potential therapist and what better person to ask than someone who has already worked with that person.

Next, see if you can get along with that potential therapist!

Therapy at times can be a long process. If you are recovering from a serious surgery you may work with your therapist for 6 months or longer. 

Stopping at the clinic and spending five minutes talking to your potential therapist can help you see if your personality meshes well with that person and if you can see yourself putting up with that person for the long haul.

Finally, set up an initial evaluation. 

During that evaluation the therapist should:

  • do a thorough history of your injury
  • take the needed measurements to show deficits and track progress
  • develop a plan of care

At some point during your first appointment the therapist should explain the “why” behind their plan of care.  If they don’t volunteer this information then feel free to ask them.

If the therapist cannot satisfactorily answer this question then I personally would find someone else to treat me. If you don’t understand why you are completing your exercises then it will be very difficult for you to buy in and give 100 percent effort.

Once a therapist has passed all these tests you should feel comfortable that you have a good person on your team to guide your road to recovery!

If you are reading this to start your selection process then I encourage you to give us a try! Stop in with any questions or use our website contact form to send an email.

Written By: Josiah Parker, PT

The Football Helmet vs. Concussions

Who is excited for the Super Bowl this weekend? I know I am as football is definitely my favorite sport to enjoy as a spectator. Along with my role as a spectator though, I am also a provider who may treat those players who may sustain a concussion from participation in this sport. It is this role which led me to find research on the efficacy of helmets protecting against concussions.

Let’s dive into one of the questions that I receive pretty frequently. Do football helmets protect against concussions?

The head can sustain many types of trauma in the midst of a football game. This trauma can mostly be categorized into two different kinds of force, linear and rotational. Helmets do a great job of protecting against linear forces, or those which lead to skull fractures and focal bruising.

As stated in John Lloyd and Francis Conidi article entitled, “Comparison of Common Football Helmets in Preventing Concussion, Hemorrhage And Skull Fracture Using A Modified Drop Test” their study showed that skull fracture was reduced by 60-70 percent and focal bruising by 70-80 percent compared to not wearing a helmet.

On the other side of the spectrum there are traumatic brain injuries, which concussions are a mild form of. These injuries are often caused by rotational forces and are more diffused due to the bio-mechanics of the injury.

Their study also found that helmets, on average, only reduced the risk of concussion by 20 percent compared to not wearing a helmet.

At the end of the day, all sports involve some sort of risk but the more we know the better we can mitigate those risks.  Research continues to work towards finding a helmet that more effectively protects against brain injury.

In the meantime, safe tackling techniques and immediate removal from play should an injury occur are our best lines of defense.

The next line of defense is treatment starting after 2-3 days of rest.  If you find yourself or someone you know injured, find treatment as soon as possible from an athletic trainer or a physician trained in concussion management and if symptoms linger more than 2-3 weeks then contact us for further evaluation.

Source:

John Lloyd, Francis Conidi. “Comparison of Common Football Helmets in Preventing Concussion, Hemorrhage And Skull Fracture Using A Modified Drop Test. ” neurology.comNeurology April 8, 2014 vol. 82 no. 10 Supplement P5.320

 

What can a physical therapist do for a concussion?

What to learn more on the basics of concussion symptoms and how your physical therapists can help relieve these prolonging concussion symptoms? Then check out Josiah Parker’s blog, 3 Unexpected Treatments for Concussions – That Work! 

3 Unexpected Treatments for Concussions – That Work!

Written By: Josiah Parker, PT, DPT

Josiah Parker – My “Why”

I became a physical therapist really out of a desire to own my own business some day. My dad pushed me to find exactly what kind of business I would like to own and he saw that I am not the type of person who would be happy simply sitting behind a desk without people interaction all day long.

He brought up the occupation of physical therapy which I was familiar with due to all too many injuries through my sports career.

I initially was hesitant to the idea, but the idea caught on during my senior year of high school. I then got a scholarship which guaranteed me a spot at UNMC if I kept my grades during my undergraduate work. I haven’t looked back since receiving that scholarship!

My favorite part of my job at Athletes’ Training Center is seeing the difference that improved function makes in peoples lives. I love getting to know people and forging lifetime friendships.

Outside of work I am an assistant coach for grade school select basketball.

I coach an 8th grade basketball team called Elkhorn Attack. It was my first time coaching for a full season and I had a great time getting to know the kids on the team and helping them to improve their skills in the game that I have come to love.

Understanding Exertion Therapy

Concussion Treatment #1

The treatment of concussions has been widely debated over the past few years. What was previously known and proven with research about concussion treatment suggested that the patient must rest, both mentally and physically. This is indeed true for initial treatment of concussions. There has now been a shift with concussion treatment that suggests moderate amounts of exertion may be used to help treat those who suffer from lingering concussion symptoms.

If you read my earlier blog 3 Unexpected Treatments for Concussionsit may have stuck out to you that I used the term “exertion therapy.” You may have even thought to yourself, “is this guy insane?” People with concussions need rest. They don’t need to exert themselves!”  If this is what you thought, then you definitely aren’t alone.

As we all know, not all concussion injuries are the same. Sometimes people have symptoms months or years after sustaining an injury, this is called Post Concussion Syndrome (PCS). I will share a case study that comes to mind; he was a colleague of mine who played football and whom experienced long-term concussion symptoms.

football-official-standing

Case Study

He was a running back and had played football since he was eight years old. Throughout his career he suffered his fair share of hits and injuries and received two concussions before playing in college. On his last football game of his career he sustained his 3rd concussion, what a way to wrap up your collegiate career right?

This concussion was different than his previous injuries. He lost consciousness and had severe migraines for weeks, months and even years to follow. He had tried everything to relieve the pain. He had visited neurologists and multiple chiropractors. He had gotten mixed results and he never got rid of his migraines and overall neck stiffness. I reconnected with him years later and had heard his struggle. That was when I told him to come and get it checked out by a physical therapist. He was diagnosed with Post Concussion Syndrome.

Eighty percent of people who suffer a concussion are symptom free within 2-3 weeks of their injury. However, this means that 1 in 5 people make it past this 3-week time frame and continue to have symptoms.

 

Post Concussion Syndrome (PCS) Symptoms

  1. Elevated heart rate – Tends to be high even at rest for those with PCS.
  2. Depression – Many people with PCS begin to feel some level of depression due to their decreased tolerance to activity. This can be especially true in an athlete who is used to a regular high level of activity.

Thinking back to the case study that I shared above, there are a few techniques that can be used to help address symptoms of PCS that can speed up recovery time.

Exercise is a great start, and that’s the basis of exertion therapy. Of course I am not suggesting that three weeks after a concussion you should go out for a 10 mile run and then that evening suffer from a throbbing headache.What I am suggesting is that your daily exercise routines should be monitored by a professional.

This is crucial so that your exercise does not negatively affect your concussion recovery. Sometimes it is hard to know if your workout negatively affects you without having someone monitor you, so let me help clarify what I can do for PCS patients.

PCS patients who are seeing me are taken through a graded exercise test, which helps me to find how high they can get their heart rate prior to their symptoms getting worse. I then use this information to help them develop a program they can use to get moving again.

If this situation describes you or someone you know then contact us today to get a more comprehensive evaluation!

Written by, Josiah Parker – PT, DPT

Question: Do you have any questions about exertion therapy treatment for physical therapy?

3 Unexpected Treatments for Concussions – That Work!

I often get asked about what I do for a living and when I respond that I am a physical therapist many people ask me what kind of injuries I see. My response usually begins with the orthopedic injuries, which everyone kind of already expects, but one area in particular that almost always catches people off guard is when I tell them that I treat concussions.

What can a physical therapist do for a concussion?

That is a great question! Let me share with you the basics on what a concussion actually is.

Concussions: A mild form of traumatic brain injury, which is caused by a bump, blow, or jolt to the head. These injuries may be classified as mild but the symptoms they cause can be devastating to the people who are experiencing them.

Symptoms: Dizziness, headaches, poor balance, trouble concentrating, depression from lack of participation ability. Surprisingly, the symptom most correlated with a lengthened recovery is dizziness. For more information on the basics of concussions visit www.concussionfocus.org.

Now that you understand the basics of a concussion, I promised that I would begin to reveal the three unexpected concussion treatments…and here they are!

  1. Exertion therapy is used to help get the body back to regulating its normal functions like heart rate, and also returning the patient back to sport or work.
  2. Finally, the musculoskeletal piece is used to help with neck or back pain, which often goes hand in hand with a concussion.
  3. Vestibular therapy is used to help address dizziness, headaches, and lack of balance.


In order to avoid getting too long winded, I will be breaking down each one of these three main areas in future blog posts. For now I know this is a very general overview so if you have any further questions feel free to contact me!

Written by, Josiah Parker – PT, DPT

Question:  What do you want to know about concussion therapy?

Football Concussion Crisis: How to Respond

 – Advice from a Physical Therapist to a Concerned Mother

I absolutely love this time of year – temperatures are not quite so warm, the trees will soon start changing colors, and most importantly football is back! But my love for this sport has lead to many, serious conversations about football injuries. There is a common theme among these conversations, concern.

As you probably guessed, concussions are the prevailing topic of concern. The frequency of these conversations has led to writing this blog post. What should you do if your child sustains a concussion?at

As a parent your first line of defense is an athletic trainer, if the team has access to this person.  Athletic trainers are extremely adept at dealing with these injuries and will likely take point in your child receiving any medical attention that is needed.  But what if you don’t have access to an athletic trainer? My goal is to educate those of you who don’t have access to an athletic trainer on what to look for and what to do.

Concussions can be difficult to diagnose due to the subjective nature of the symptoms. Your child may be suffering from a concussion if they report:

– a persistent or worsening headache
– feeling dizzy/nauseous
– mental fogginess
– or a range of other similar symptoms

If these symptoms are reported after a blow to the head, medical attention should be sought out as soon as possible through the child’s pediatrician or an emergency room.

The initial goal is to rule out more serious, life threatening conditions such as a brain bleed or skull fracture which can be identified through imaging (unlike a concussion.) Once those are ruled out the initial recommendations will be rest from physical and mental activity.

“80 – 90% percent of concussions resolve within three weeks – but for those that don’t, further medical attention may be needed.”

If further medical attention is required, start with a doctor who has had further training on how to deal with concussions.  There is a list of suggestions available on www.concussionfocus.org.  This physician may suggest modifications to activity, medication, or rehabilitation to help return to normal function.

Concussions can be a scary ordeal, both for the affected individual and their family, but with the proper treatment most kids are able to get back to football, and other desired activities.  If you are in need of rehabilitation, or need help figuring out where to start, contact us today!  You can also visit the Concussion Focus website listed above for more details on concussions and for resources on how to treat them.

Written By: Josiah Parker, PT, DPT

Question: What questions do you have for a physical therapist about concussions?

3 Simple Things You Can Do To Make Running Easier

I have been thinking a lot about running related injuries recently. If you remember a while back I described the importance of your hip muscles. Today, I want to show some common running deviations and an easy way to fix these issues.

The first deviation is excess bounce

Bounce is the amount of up and down movement present during each stride of the gait cycle. Research has shown that this should be limited to 6-10 centimeters. If excess bounce is present the runner is at risk for many running related injuries including stress fractures, anterior knee pain, plantar fasciitis, etc.

Next up is over-striding

Over-striding can be difficult to see with the naked eye due to the speed of the gait cycle, but over-striding is landing with your heel too far in front of your center of mass. When this happens, the amount of force going through your body per step is increased and can lead to break down more quickly. This deviation can lead to all the same injuries as I mentioned above.

Increased compliance of the knee rounds out our list of gait deviations.

This is what I described in my last running blog The Hips Don’t Lie as knee valgus or the knee excessively tracking medial (inside) to your big toe. As I previously stated this can be helped with hip strengthening but can also sometimes be improved by a simple change in gait. This deviation can lead to low back, hip,knee, or foot pain.

Now you may be asking, I think I have one or more of the above issues but how do I fix them?! Glad you asked! One potential fix for each of the above issues is changing the number of steps you take per minute. I am certainly not saying that everyone will benefit from this but it is an easy thing to experiment with and often leads to powerful results. All you need to do is run the same pace but take a few more steps per minute to achieve that pace!  A change as small as a 5 percent increase is often all that is needed.

Written By: Josiah Parker, PT, DPT

If you would like a more thorough assessment of your gait or would like help implementing the above strategy then call and set up an appointment today!

Your Hips Don’t Lie

2 Reasons Hip Muscles are Vital For Runners

The sun is finally shinning and the temperature is rising, which means many of us are moving our workouts outdoors!  Some people are year-round runners, but if you’re anything like me then you only run on a beautiful day and as a last resort for a quick workout.

Athlete runner feet running in nature, closeup on shoe. Woman fitness jogging, active lifestyle concept

It never fails this time of year I see an uptick in the number of runners coming in with overuse injuries.  Many of these injuries could be minimized, or even prevented completely, with some proper maintenance of hip strength.

A runner’s hip muscles are important for many reasons.  Today I am going to focus on two reasons:

      1. The first is controlling knee position during the stance phase of running. Stance phase is defined as the time from when your foot initially contacts the ground until you push off for your next step. A runner’s knee should generally stay in line with their second toe while in stance phase and deviation inside of this point is called knee valgus. Excessive knee valgus consistently during the stance phase can lead to break down in a runner’s knee or foot.  The good news is the hip muscles can easily control this knee valgus.
      2. The second reason hip muscles are important for a runner is for pelvis control.  hipsphotoEvery time a runner is standing on one foot their hips should stay relatively level (see photo on the left).  If they drop while standing (photo on the right) on one foot then either the hip muscles are weak or are not being properly activated while running.

In my opinion the best way to avoid either of these problems is to make lower extremity strength training a part of your weekly training regimen at least 2 times a week. Your strength plan should consistently contain single leg strengthening exercises such as: single leg squats, lunge variations, and step up or down variations. While completing these exercises make sure and focus on your knee staying in line with your second toe and keeping your hip level each time.

If you have questions about completing these exercises for current issues with pain or just for injury prevention then contact us today! We will get you connected with the right person for your needs.

Written By: Josiah Parker, PT, DPT

Question: Do you have any questions about the strength of your hips and the exercises you should be implementing into your workout routine?

Jennie A., Collegiate Track & Field Athlete

Athletes’ Training Center has worked to specialize workouts to fit my athletic needs. The strength coaches have a one on one personal connection to fix minor details that have had a major impact on my athletic performance.