Featured Body Part: Head

By: Cori Cameron and Katie Varnado, ATC for ATI Physical Therapy

Featured Body Part: Head

The brain is one of the most important and powerful organs in our body. It’s also one that we may often take for granted; forgetting the fact that it’s responsible for everything from our movements to our thoughts. According to the Brain Facts from Medical Daily, 85 billion neurons must complete upwards of five trillion chemical reactions each second, at speeds of over 260 miles per hour to keep us going. That’s crazy impressive! With all of this power and responsibility, comes the fact that we need to be able to protect our head and brain. The more we know about prevention and the cause of injury, the better the chances are of avoiding an injury in the future.

Common Conditions

  • Hematoma – A collection of blood outside the blood vessels. This can cause pressure to build inside your skull, causing loss of consciousness or even permanent brain damage.
  • Hemorrhage – Uncontrolled bleeding can occur in the space around your brain or there can be bleeding within your brain tissue.
  • Concussion – A brain injury that occurs when your brain is jarred or shaken inside the skull. Loss of function is typically temporary, but repeated concussions could lead to permanent damage.
  • Skull Fracture – A break in one or more of the bones in the cranial portion of the skull. When the skull is broken it is unable to absorb the impact of a blow, which makes it more likely that there will be brain damage as well.

Common Causes
Head injuries can be broken into two categories:

  • Blows to the Head – Injuries are typically caused by:
    • Motor vehicle accidents
    • Falls
    • Physical assaults
    • Sports-related accidents
  • Shaking – While this is most common in infants and small children, they can occur any time one experiences violent shaking.

Injury Prevention
Katie Varnado, ATC, Midwest Director of Sports Medicine, gives us some tips to help prevent and rehabilitate head injuries:

  • Appropriate Equipment – Make sure to wear the appropriate protective equipment for your sport.  This could include helmets and mouthguards.  Equally as important as having the correct equipment is making sure it is fitted appropriately (not too loose).
  • Use Proper Technique – Make sure you have learned and practice proper technique for the sport you play. Do not lead with your head and do not use your head as a “weapon.”
  • Neck Strengthening Exercises – Some scholars believe that strengthening the neck musculature allows forces dissipate during a head collision or rapid rotation, thus reducing the force the brain sustains and lowering your risk of concussion.

Rehabilitation after a head injury is important and recognition of an injury is key:

  • Know the Signs and Symptoms of a Concussion – Headache, dizziness and nausea are just a few.
  • Discontinue Physical Activity – If you suspect you have sustained a concussion, it is important to immediately remove yourself from further physical activity.
  • Seek Appropriate Medical Evaluation – See an athletic trainer, physical therapist or a physician for a full evaluation.
  • Rest – Physical and cognitive rest are crucial to allowing the brain to heal. Follow physician instructions regarding gradually returning to taxing activities.
  • Vestibular Rehabilitation – If you have symptoms that do not resolve in a relatively short time span, vestibular therapy may help reduce symptoms.

When weighing your treatment options for head injury rehabilitation, consider physical therapy. Physical therapy offers a wide variety of treatment options including strengthening, stretching, and sustainable home exercise programs. Stop in or call any ATI location for a complimentary injury screen or to learn more about how physical therapy can help you overcome your pain.

Get your head in the game with ATI!

Tips for a Healthy Post-Marathon Recovery

By Brian Rog and Doug Adams (PT, DPT, SCS, OCS, CSCS) for ATI Physical Therapy

Tips for a Healthy Post-Marathon Recovery

In just a few short days, the streets of downtown Chicago will be filled with thousands of runners lining up for the 40th running of the Chicago Marathon. For those competing in this grueling 26.2 mile event, the spotlight shines on their abilities to power through the marathon and eclipse personal records, while remaining injury-free. However, through the training process, some runners seemingly place more emphasis on getting through the race and less emphasis on battling the compromising affects after the event.

In doing this, once the adrenaline dissolves and fatigue and achiness settles in, the days and weeks following the race may present a wave of challenges for a runner as the body’s muscles recover from the intensity of the race. The good news is that overcoming these challenges and preparing your body for the post-marathon recovery is well within reach. ATI’s Doug Adams (PT, DPT, SCS, OCS, CSCS) breaks down some post-marathon recovery tips to help alleviate the agonizing marathon aftershock.

What happens to the body after a marathon?

  • Rhabdomyolysis (breakdown of muscle tissue) and muscle damage
  • Changes in blood volume with 29-50 percent of people showing symptoms of acute stage 1 kidney injury
  •  Immunity is down after a race for up to three days. Be careful around sick relatives and friends who came out to cheer you on, they might give you more than a high five

How long does it typically take to recover from a marathon?

  • Typically, muscle strength is restored in 14 days
  • Cellular recovery of mitochondria (produces energy currency of the cell) in 3-4 weeks
  • Improved markers of recovery evident within 8-12 weeks

What can a runner do to speed up the recovery process?

  •  Before the race
    • Proper training is key, which can include levels of cross and strength training
    • Know your sweat rate for the race environment
  •  During the race
    •  Sports drink with CHO (carbohydrate) concentration of 6-8 percent
    •  Avoid hyponatremia (low sodium level in the blood) as much as you can by limiting fluid intake – 13 percent of Boston marathon runners suffered from this 

Overcoming dehydration

  •  After the race
    • Immediate nutrition intake is crucial 30-60 min after the race: 4:1 Carb to protein ratio drink (chocolate milk) to help restore depleted glycogen stores
    •  Tart Cherry Juice shows evidence of reduced inflammation and quicker returns of strength
    •  Compression reduces soreness for the first 24 hours and improve running function two weeks after the marathon, but no physiological changes
    • Make sure you stretch and/or use a foam roll
    • Consider an ice bath
    •  Within 3-4 hours, consume a large meal

When should someone return to running after a marathon?

  •  This varies depending on experience levels, though we suggest taking a complete week off from running and rest for at least 3-4 days – depending on how you feel, a short walk may help with active recovery.
  •  Around the 14-day mark when muscle function is beginning to reach pre-marathon levels, you may incorporate some short, low-intensity cross training exercises.

What to do if you’ve sustained an injury?

Lower body injuries following a major race are not uncommon. While it’s important to rest to help reduce damaged tissue, your body will still remain vulnerable to reinjury. Injuries tend to be unique by nature, so self-treatments may not be the most effective option for your body. Consider stopping by your nearest ATI clinic to undergo a complimentary screening or call us at (855) 692-8478 to schedule an appointment.

How Physical Therapy is Helping to Fight the Opioid Crisis

How Physical Therapy is Helping to Fight the Opioid Crisis

By Brian Rog for ATI Physical Therapy

For decades, long-term chronic pain management was widely believed to be controlled through opioids, such as Hydrocodone, Methadone and Oxycodone; however, new research suggests that opioids may only serve to merely mask or block the perception of pain. With more than 30 percent of Americans suffering from acute or chronic pain, the CDC has seen a major spike in opioid overuse and addiction cases, which should come to no surprise given the disabling effects of chronic pain.

In 2016 alone, opioids contributed to about 17,000 deaths, and recently, authorities are estimating that deaths in the related overdose epidemic are likely to increase by more than 70 percent. Opioid abuse was also just recently classified as an epidemic by the federal government. While many experts question the lack of long-term favorable results among most opioid users, the physical therapy industry is stepping up to be that beacon of hope for those in need. With a proven history in combatting aches, pains and discomfort, physical therapy is becoming a viable, non-medicated solution for those in search of remedying this physical and mental agony.

How can physical therapy fight pain?

Physical therapy is playing a leading role in tackling the opioid epidemic by restoring wellness and mobility in the lives of those suffering from the effects of opioid overuse. Unlike opioids, physical therapy doesn’t mask pain. In its full capacity, physical therapy may contribute to major reductions in pain and significant gains in physical independence through the use of effective, individualized treatments. Clinicians work with patients to develop calculated and adapted programs that progress patients from rest to unrestricted, and in many instances, pain-free activity.

ATI Physical Therapy, in particular, employs research-driven treatment methods derived from its in-house research and data teams, which has shown to improve rehabilitation outcomes. As a result, these methods have effectively helped millions of patients get back to significantly reduced and/or pain-free living.

A recent study by ATI Physical Therapy, My Health First Network, BCBS and Greenville Health System (GHS) found that 70 percent of patients that utilized physical therapy first for spine, shoulder and knee pain were successfully treated without the use of imaging, prescription medicine or additional physician visits. Access to physical therapy is a cost-effective way to address many common aches and pains that affect much of the population. In many cases, a doctor’s referral is not required, though it’s recommended to consult with your insurance carrier to determine if a referral is necessary as well as a primary physician to see if physical therapy is an option for you.

How opioids cause addiction

 Opioid overuse cases lie in the tolerance trajectory, which in the short-term proves to be effective in small doses. Over time, small doses become unsuccessful in providing therapeutic effect, causing users to increase intake (and in some cases, potency), which evolves into a vicious dependency that becomes growingly difficult to vacate. While short-term opioid use may help post-surgery conditions, long-term use can prove to be fatal. It’s estimated that one in every four opioid users fall victim to the dangers of abuse and more than 1,000 people are treated daily in ERs for prescription opioid misuse.

“In my practice, the first concern is to understand what is causing the patient’s pain and then look to treat the cause rather than the symptom,” said Dr. Wajde Dabah, medical director of Pain Therapy Associates. “Physical therapy is an under-utilized option that should be considered as a first line treatment for pain. It offers an opioid-free, long-term solution for approaching the primary cause of the pain. Physical therapy is one of the fundamental pillars I use to address pain and should be part of every comprehensive treatment plan.”

Hear the interview with Dr. Wajde Dabah on SportsMedicineWeekly Episode 17.23

Given the severity of this opioid overuse surge, the Centers for Disease Control and Prevention (CDC) is urging health care providers to reduce the use of opioids in favor of safe, non-medicated alternatives such as physical therapy.

Let’s make a goal and tackle it together

If you are struggling with managing your chronic pain, ATI Physical Therapy can help! To schedule a complimentary screening, make an appointment, or ask your doctor about ATI for your therapy needs, visit atipt.com or call (855) MY-ATIPT (855-692-8478).

A therapeutic technique to help rid you of strains, sprains and pains

By Kraig Bano, MPT, CHT director of hand therapy at ATI Physical Therapy. Bano is also a course instructor for HawkGrips, an international IASTM company based in Conshohocken. PA

With warm weather comes the excitement of returning to our favorite outdoor activities such as walking, running, biking, playing sports, or gardening. But getting back to pursuits that you love can be tough on your body following a period of inactivity that winter often fosters.

Injuries that stem from quickly increasing your activity level may start as simple aches and pains, but stiffness and weakness could become more involved if not appropriately addressed.

Fortunately, a technique called instrument assisted soft tissue mobilization (IASTM) has proven to be very effective in both enhancing mobility and alleviating injury, enabling pain-free participation in activities as quickly as possible. IASTM is proven to treat joint and ligament sprains, muscle and tendon strains, neck and back injuries, and tendinitis.

Trained clinicians — including physical and occupational therapists, chiropractors, massage therapists, and athletic trainers — can use IASTM to assist in detecting and treating soft tissue dysfunction. Specially designed tools commonly made from metal, plastic, stone, or even bone are used to identify and target areas of soft tissue dysfunction commonly known as fascial adhesions.

Fascia is a tissue found throughout the body that attaches, supports and separates muscles and organs. With injury, the healing response can cause scar tissue formation along the fascia, referred to as adhesions, which can limit range of motion (ROM), flexibility, and the ability of muscles to contract normally. These limitations lead to deficits that can prohibit participation in daily activities. Research has demonstrated the ability of IASTM to:

  • Reduce pain thresholds
  • Decrease muscle guarding
  • Increase ROM
  • Increase muscle function (as well as inhibit hypertonicity)
  • Improve ligament healing
  • Decrease scarring
  • Decrease tendinitis symptoms

By utilizing a variety of treatment strokes, a trained clinician can decrease muscle and joint tenderness, with results evident during the first treatment session. Ideally, IASTM is coupled with other treatment techniques such as manual stretching and joint mobilization, along with a specific exercise prescription that addresses stretching to maintain flexibility and strengthening to improve stability and function. Typically, a series of treatments may be required to achieve full return to activities. IASTM will get you back out on the road, field, or in the garden faster than traditional methods alone.