Common Hand Injuries: Text Thumb; Little League Pitchers: Do’s & Don’ts; Importance of Sleep for Optimal Recovery

Episode 17.35 Rerun

Segment One (01:10): Dr. Nik Verma sitting in this week for Dr. Cole joins Steve andImage result for thumb overuse Nicole Kauppila from Athletico Physical Therapy to discuss Tech Thumb injury.

Each year as we approach the holidays, smartphones are listed as a top gift.  With use of smart phones – tech-related injuries called “tech-thumb” resulting from unnatural movements like constant texting are on the rise.

New smartphones often means even more time straining thumbs, in fact young adults spend a staggering one-third of their waking hours on smart phones. Nicole describes causes, symptoms, prevention and treatment for overuse injuries of the hand.

 Segment Two (11:46): Dr. Nik Verma, Head Team Physician for the Chicago White Sox talks with Steve about how to avoid overuse throwing injuries in young athletes; avoid training in one sport all year long, high pitch velocity and pitch counts that can cause damage from repetitive load on the growth plates of young athletes.

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Segment Three (20:14): Todd Sayer, PT from ATI Physical Therapy talks about the importance of sleep for optimal recovery; the correct supportive neutral sleep position; avoiding compressed shoulder joint in side sleepers.

How you sleep dictates how you perform, so whether you are falling short on logging enough sleep each night or poor sleep posture is inhibiting a solid day’s performance, making a few simple changes can help to enable a good night’s rest and support your body’s ability to adapt and adjust.

Todd Sayer  is a Senior Regional Director with ATI. He has 18 years of clinical experience specializing in treatment outpatient orthopedic and sports medicine injuries as well as chronic pain and post-operative care.

Overcoming Sleep Challenges and Discomfort

Get Your Mind to a New Place This Summer

Clinical counselor and dance movement therapist Erica Hornthal gives us tips on how to get your mind to a new place this summer.


Rachel was a typical college athlete: focused, intense, and determined. When a knee injury threatened her ability to complete in her final soccer season, she simply played through the pain.

It wasn’t long before Rachel discovered she could no longer “grin and bear” her meniscus injury. She had to have the injured tissue replaced with an allograft – sidelining her for months from any physical activity.

“It was a difficult decision,” recalls Rachel. “But movement is everything to me. I knew I had to have the procedure.”

Today, Rachel went back to competition. In fact, she completed the Hawaii Ironman 70.3 Triathlon in May 2009, something she only dreamed of prior to her allograft meniscus replacement.

Inspired by her experience, Rachel chose orthopedics as her field of specialty in medical school as an MD candidate at Rush University Medical Center.

Snow Skiing as a Natural Anti-Aging Remedy

By Brian Rog for ATI Physical Therapy

Snow Skiing as a Natural Anti-Aging Remedy

Contributions by: Peter Braun MS, LAT, ATC, ITAT

The effects of time on one’s body are unavoidable and often substantial. Many of us in the field of medicine are in an endless search to find the perfect sport, activity or exercise that will unlock our physical potential, well into our years. Scientific research has found that there are certain factors that contribute to longevity and sustainability. Bone density, lower extremity strength, balance and cardiovascular endurance all play critical roles in maintaining a physically active lifestyle. With this, physicians make an effort to integrate these factors into exercise plans for much of our elderly population. But what if there was a simpler answer? What if we could prescribe involvement in a recreational activity that naturally addresses all these areas? As we unravel the details, we challenge the question; “Is there such a thing as an anti-aging activity?”

Snow Skiing and bone integrity

As we dive into the leading factors that affect our ability to remain physically active, it is important to begin by discussing the foundation of our musculoskeletal system: our bones. Proper bone integrity allows our joints and muscles to function at peak levels. As more research is released clarifying the comorbid factors associated with aging, we are realizing how important bone density truly is. As we get older, it is natural to lead a more sedentary lifestyle. This reduces the forces exerted on our bones and leads to less deposition and remodeling. Consequently, bones become weaker and more fragile.

There is also a threshold where forces may be too much for a bone to adequately tolerate. Therefore, we don’t see many 60 or 70-year-olds participating in heavy plyometric type activity that requires sprinting, jumping, or heavy lifting. What makes skiing so unique is that the peak force exhibited on the bone is achieved over a longer period of time compared to other activities. If someone is running, the peak force at heel strike happens instantaneously and stress is quickly translated through the bones. In skiing, this process is lengthened due to the natural mechanics of a turn. As we begin to turn while skiing, ground reaction force increases and it doesn’t achieve maximum force until the dynamic center of the turn, and gradually reduces as we bring the skis back underneath the body. There is no sharp or sudden spike in pressure or force. This allows for a healthy and acceptable loading of our joints and bones, which optimizes remodeling.

Snow Skiing and lower extremity strength

Lower extremity strength has been promoted by many as a key to upholding a physically active lifestyle and essential to healthy aging. The biomechanics of a skiing turn activate all lower leg muscles in a complex and symmetrically balanced fashion. The intrinsic muscles in the foot are important to control edge initiation and release. These muscles are also essential to foot rotation, which affects the degree and engagement of an edge throughout the turn. The muscles of the lower leg are important for staying balanced and continuously adjusting to the changing pressure and contact with the snow.

Even during various parts of the turn, the hip flexors, quadriceps and hamstrings help create dynamics and proper leg lengthening necessary to carve and ride the edge of the ski. The core, hip flexors, hip rotators, hamstrings and glutes all work harmoniously to transition our body from the initiation of the turn through to its completion. These muscles are stressed, more or less, depending on the size and shape of the turn, slope of the hill, and conditions of the snow.

The combination of all these components create an exceptional foundation for strengthening. In addition, skiing requires a diversity in motor activation patterns, therefore resisting motor specificity and repetition. The movements of skiing are so complex that when coupled with the aid of gravity and slope as we ski downhill, chronic injuries are minimized when compared to many other recreational sports-activities.

Snow Skiing and the role of balance

Balance is another function that tends to decline with age. The rate of falls and severity of resulting injury are often fatal in the elderly population. There are many contributing factors to one’s overall capacity to stay balanced. It is important to recognize that even as we challenge this system there may be limiting factors, whether centrally or peripherally, that inhibit our skills as we age. But there are few other sports that challenge the body in such a dynamic and functional way as skiing. Proprioception is arguably one of the most important skills in skiing. Awareness of our limbs in space allow us to successfully stay standing as we move down the hill. Even in a static fashion, as we click into our skis there is an immediate and drastic reduction in friction under our feet. This makes even the most finite movements more substantial and challenges our joint awareness and control.

As we begin the move down the hill and turn our skis, this skill becomes exponentially more difficult. Our movements, pressure, center of balance, turn dynamics, turn radius, as well as the snow conditions all affect how we need to position our body over our skis. Furthermore, the skier often must be reactive to many of these factors. To put all this in perspective, it would be like executing a balance exercise in the clinic wherein the surface that we are balancing on is changing, while simultaneously shifting weight from side to side, alternating single leg stance, and also reacting to a stimulus (such as catching a ball). Tremendously complex, right? If there are any benefits of proprioceptive training to improve overall balance as we age, you will definitely see the results if skiing is incorporated into your lifestyle.

Get active, and stay active

Individuals in the physical therapy profession and others in the medical field are continually trying to encourage others to enroll in an active lifestyle. We can all agree, regular exercise is important, but leading a life that incorporates consistent and regular activity throughout the days is the main goal – and it shouldn’t stop at 10,000 steps. What we are doing during the time we are not accumulating steps is just as important. When we observe the scope of different activities we can perform to stay physically active, none are quite as sustainable as skiing. Most skiers set aside an entire day to enjoy time on the mountain. Even other sports that are notoriously lengthy such as golf, hiking, or long distance biking and running, don’t even remotely match an eight hour day.

Although activity isn’t continuous, a single run on the slopes, which typically takes only a few minutes, is just enough time to increase the heart rate and stress the musculoskeletal system before resting on the chairlift. This is a perfect combination of rest and exercise that can easily fill an entire day. The sustainability of skiing is what makes it stand apart from most other sports activities. If the overall goal is to create a physically active lifestyle, skiing may be one of the few solitary solutions that can achieve this goal.

We will never be certain as to what is the best thing to do to resist the effects of aging. Our genetics, our bodies, and our history all have a role that is too intricate for us to predict. However, if there’s one thing that is definitive, it’s the positive impact that exercise and activities like skiing brings to someone’s well-being.

Dealing with a lower body injury?

Recognizing and assessing an injury is the first step in ensuring a speedy and effective recovery. Most individuals are led to believe that surgery or opioids are their only lines of defense when dealing with an injury. Instead, consider physical therapy as a first course of action, even if it’s only a screening, which are complimentary at all ATI locations. Recent research suggest that people who underwent physical therapy enjoyed faster recovery and less pain than those who chose alternative routes such as surgery and opioids. Give PT a try!

Competitive Ice Hockey Player Kicks Foot Injury

From Midwest Orthopaedics at Rush University Medical Center

Last year, Holly Barocio, 34 of Chicago, skated with gusto onto the ice, ready to defendHolly2.jpg her co-ed hockey team’s championship title. She never thought that rather than skating away with a trophy in hand, she would be carried off the ice by an ambulance.

Holly remembers the moment she was injured vividly. “Every part of me went left except for my foot. My blade got caught in a groove in the ice and I immediately felt acute pain. After that, I think I was in a state of shock trying to understand what happened.”To make matters worse, her team lost by a two point margin. She says it didn’t help that her teammate and husband, Jason, also left the game when he accompanied her to the hospital. “My husband and I have this brain synergy. We always know where the other is on the ice without even looking.”

At the emergency room, Holly was told she had a clean break and likely wouldn’t need surgery. However, she was not confident in this assessment and sought a second opinion.

“Without a doubt Rush kept coming up, specifically Dr. Kamran Hamid’s name,” she explains. “I liked him right out of the gate; he had great bedside manner and a level of attention and care that I found unique.”

“I liked him right out of the gate; he had great bedside manner and a level of attention and care that I found unique.”

Dr. Hamid took thoughtful measures to consider how Holly’s treatment would affect her commitment to return to hockey. He performed a “Stability Test” to definitively determine whether she needed surgery or not. The results confirmed that her ankle was unstable and would benefit from a surgery.

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Dr. Hamid used a special low-profile metal plate that he felt would best accommodate Holly’s ability to skate. This plate lies closer to the bone to have less irritation with a skate while still providing excellent stability.

Holly’s recovery revolved around her passion for hockey. “I was direct with Dr. Hamid and told him, this is not a deterrent for me. I will return to hockey.” In fact, she was determined to help her team qualify for playoffs. “I am going to play hockey again no matter what. That is how much I enjoy the sport,” she remembers telling Dr. Hamid. “I have a hard time seeing myself as a non-hockey player.”

Now, equipped with her newly repaired ankle, Holly has officially returned to her second home on the ice and reports, “I have been smiling non-stop! No pain, no discomfort.”