Featured Body Part: Foot


Our foot and ankle complex needs to be both dynamic and stable to allow for us to walkFeatured Body Part: Foot without stressing other areas in the body. The ankle may seem like a simple joint, but there are actually four bones that combine to provide the stability and motion necessary – tibia, fibular, talus, and calcaneus. The rest of the foot consists of multiple smaller bones that each must be able to withstand the movement and stress placed on it by the weight of our body. Your ankle is also an integral part of your daily function, as it is responsible for your ability to drive a car, climb stairs, and squat. If you suffer an injury to your foot/ankle it will likely become increasingly difficult to perform your normal activities without pain. The more knowledge we have regarding prevention and common causes of injuries, the better our chances are to avoid future injury.

Common Causes
Unfortunately, with the complexity of the foot/ankle joints it is often difficult to isolate a singular cause of injury. As with other body parts, increasing age leads to increased risk of injury from general wear and tear. After the ankle is injured there is a high likelihood that you can suffer another injury due to remaining deficits and/or poor healing.

  • Overuse (Chronic) Injuries – With age and use cartilage can wear down and the ligaments, muscles, and tendons can become damaged.
  • Sudden (Acute) Injuries  – During a fall or other injury, the bones of the foot/ankle can be fractured.  You can also have ligament tears and ruptures of the tendons.

Common Conditions
Foot/ankle pain can be caused by any one of these common conditions:

  • Adult Acquired Flat Feet (Fallen Arches) – Fallen arch, or flatfoot, is known medically as pes planus. This is characterized as a loss in arch height in the foot. There are many causes of this disorder, but among the most common is decreased muscular strength. The muscles in the foot and ankle are required to help support the arch and if the weaken the arch can collapse
  • Bone Fracture – There are multiple bones in the foot/ankle that can break and each needs to be managed differently. Most will require a period of not putting weight through the foot to allow for healing.
  • Metatarsalgia – Athletes who run and jump a lot may be susceptible to metatarsalgia, a type of foot injury that results in pain and inflammation in the ball of the foot.
  • Plantar Fasciitis – Affecting nearly 2 million Americans each year, Plantar Fasciitis is when there is an inflammation of the thick band of ligament that extends from the bottom of the heel to the toes (primarily the big toe).
  • Calcaneal Bursitis – In the heel, bursitis may cause bruise-like pain mostly on the bottom of the heel, but also at the back of the heel. This pain is most often felt at the end of the day, especially for people who spend much of their time on their feet.

Injury Prevention
Kurt Gengenbacher, PT, DPT, OCS, SCS, CSCS a Regional Director of Clinical Excellence, gives us some tips to help prevent and rehabilitate foot/ankle injuries:

  • Stay Flexible – Make sure to stretch your calves daily. Hold those stretches for at least 30 seconds and repeat 2-3 times.
  • Keep Your Foot Strong – Focus on functionally strengthening your foot.  The foot must be able to assist in stabilizing the body while standing, so the best exercises are often in a standing position.  Try to perform appropriate balancing tasks, standing toe crunches, heel raises, and toe raises.
  • Avoid Overtraining – Make sure you vary your exercises and don’t always do the same thing. If you have pain after exercising, stop the activity, rest, ice and elevate your leg.

If you have pain in your foot/ankle that isn’t going away, rehabilitation is a great step to take to improve your functionality. During rehabilitation:

  • A Strong Foot Is A Healthy Foot – Working on strength in the small muscles of the foot (intrinsics) can help your ability to walk barefoot and on uneven surfaces.
  • Be Balanced – Work on dynamic balance exercises to improve your proprioception and ability to stay upright.
  • Don’t Let Tightness Be Your Achilles Heel – Stretching your ankles can help to improve your ability to go down stairs and squat.
  • Stay On Your Toes – Strengthening of your calf muscles can help to improve your ability to walk, run, and climb stairs.
  • Wear Proper Footwear – It is important to provide appropriate support to your foot.

When weighing your treatment options for foot pain and injuries, consider physicalATI 300x250 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 foot pain.

Put your best foot forward with ATI!

5 ways to fuel up for exercise


work_out_imageWater, sports drinks, energy chews, protein bars, recovery shakes, bananas, carbohydrates – which should you put in your body before a workout? What about after? Which help aid weight loss? Which help aid muscle building?

We know there’s a lot to take in. That’s why our athletic trainer Jessica Thompson weighed in with these five tips for fueling up for exercise…

  1. Water is the way to go during a workout: During an actual workout or game, water is the way to go. It helps replenish and hydrate you throughout your exercise session.
  2. Save your sports drinks for before or after your sweat session: Studies have shown that the nutrients in sports drinks aren’t absorbed in your system right away, says Jessica. Therefore, use it before or after a workout when your body has time to absorb the nutrients and properly replenish.
  3. Power through strength training with protein: Hitting the gym to lift weights and do some strength training? Try to eat about 90 minutes before your workout. The pre-workout snack should consist of a protein or energy bar and some fruit, Jessica says. Protein helps you build muscle and fruit contains natural sugars to give you an energy boost.
  4. Kill your cardio workout with carbs: Ramping up for a cardio workout? Be sure to get some carbohydrates before your workout. A small meal of whole grain carbohydrates (like wheat bread or crackers) along with fruit can help you power through a cardio workout and give you the energy you need.
  5. Carbohydrates key after a workout: When recovering from a workout, it’s important to replenish yourself with plenty of carbohydrates and some proteins within 30 minutes of finishing. With its mix of carbs and protein, chocolate milk is a great recovery food. And, even though you just worked out, it’s important to avoid anything with a lot of fat, says Jessica. Your body needs nutrients after exerting itself, and that’s not something fatty foods can typically provide.

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Meniscal Tear: Is Physical Therapy a Good Option?

Authored by Dennis Carter, PT, MPT, physical therapist and clinic director at ATI Naperville South

meniscalA meniscal tear in the knee is an injury to the cartilage that absorbs weight through the joint. Tears can occur as a result of sudden trauma such as twisting, or over extending the knee. Tears can also develop due to degenerative changes over time. Meniscal tears can limit a person’s ability in squatting, twisting, athletics, or performing activities at work and at home. A recent article in The New England Journal of Medicine supports that there is a high percentage of successful outcomes for patients seeking physical therapy as their first choice of care for a torn meniscus in the knee. This is a welcome statement to those who may have been recently given the diagnosis of a meniscal tear, and are weighing options for a plan of care.

Many times when patients are given a diagnosis, they form the opinion that they are set on a defined path without options.  A diagnosis of a “tear in the knee” is often associated with it getting “fixed”, which can be upsetting and discouraging when patients consider their future activity level.

Growing evidence supports physical therapy as a viable alternative to early surgical intervention. Physical therapy can provide treatments that reduce the pain and inflammation associated with the acute nature of a tear. Modalities such as electrical stimulation, compression, and ice are frequently used to reduce acute swelling and pain. Manual care provided by a Physical Therapist can help to restore range of motion, improve joint mechanics, decrease swelling, and increase muscle flexibility. Specifically prescribed therapeutic exercises can address deficiencies in strength and muscle control that may have resulted from, or even contributed to events leading to the tear.

Physical therapy has been a successful option for many. More research is needed to identify what factors determine the characteristics that will identify who will be successful with either treatment option. Deciding if it is right for you should be done as part of a team. The decision should be made with your doctor and therapist based on several factors: the mechanism of injury, history of progressive symptoms, a thorough clinical examination, diagnostic studies (x-rays, MRI), and your goals/aspirations for future activity level. The decision is not simply black and white and often comes down to individuality.

When the conservative approach of therapy is chosen, patients should be well educated in the nature of the injury, the avoidance of activities that could negatively impact their progress, and the expected progressions they will encounter. Treatment will focus on progressive strengthening, range of motion, flexibility, balance, gait training, and functional activities. Considerations are also given to address individual deficiencies that may have contributed to the nature of the injury: weakness of hip and thigh muscles, foot mechanics such as over pronation (flat feet), inflexibility of the calf and hamstring muscles.

ATI 300x250Whenever affected by any health issue or concern, awareness of options is prudent. Meniscal tears are no different. Custom treatments in physical therapy and dedication to prescribed home program allow many people to return to a high functional level following a meniscal tear in the knee. Please be sure to discuss details of your injury and all options with your doctor. If you have more questions please reach out to one of your local physical therapists who can help to answer your questions.

The Ergonomically Correct Home Office

By Grace Wang and Dr. Chris E. Stout for  ATI Physical Therapy

home-officeWhether or not you realize it, you probably have a home office. You might not telecommute, and you might not have a corner, L-shaped desk or a computer with dual monitors, but most likely, there is a place in your home where you browse the web, check Facebook, answer emails, update your blog, or write the next chapter of your 200,000 word fan-fiction novel. There is a place in your home where you spend a lot of time sitting down, facing a screen. You’re thinking about it right now, aren’t you?

The fact is, people are spending more time in front of screens than ever before. According to a recent BBC article, adults in the UK are now spending more time on devices than sleep, and the New York Times reports that statistics in the U.S. are similar. Studies have shown, and it’s not too difficult to believe, that people are not just dependent on their devices, but also emotionally attached to the connectivity that they provide.

“But,” some might say, “I’m not wasting time on my device. I’m forced to be in front of my screen for work/school.” This may very well be true, but whether screen time is due to stacks upon stacks of paperwork or due to an unhealthy emotional attachment to connectivity with the virtual world, the result, at least for the human body’s ergonomic health, is the same. If we can’t tear ourselves away from our screens (for whatever reason), the very least we can do is make sure that our “home office” allows for the body posture that is least harmful to our health.

The Chair
Mayo Clinic says that the height of a chair should allow for feet to rest on the floor and for knees to be level with hips. A good chair also provides lumbar/lower back support.

The Phone
Mayo Clinic also says that if one regularly uses a phone at the same time as a computer, the phone should have a headset so as to protect the neck from strain.

The Monitor
The same article indicates that the monitor should be an arm’s length away and the top of the screen should be just below eye level.

No matter how flawlessly a workspace is set up, joint health still relies heavily on correct body posture. In other words, we can easily find ways to sit in our ergonomically correct home office that are not ergonomically correct. Three few helpful posture rules are:

  1. Don’t slouch. It sounds obvious, but still difficult to remember!
  2. Center your body in front of your monitor/keyboard.
  3. Keep your thighs and knees level with your hips.

Take Breaks
Taking a break to move around, even if it’s just to stand up and walk or stretch, is not only good for the body, but it’s been proven to increase the ability to focus, to decrease fatigue, and to improve mood.

So, do your best to separate yourself from your computer, phone, and television when possible, and when you can’t find enough willpower to say no to Facebook, or when deadlines are approaching, do your body a favor and relax or work in a position and location that optimize skeletal and muscular health.

Our Approach
A great way to improve health (and productivity) is to incorporate a culture of fitness. ItATI 300x250 does not need be anything too challenging to get things going. At ATI Physical Therapy’s Corporate Offices we have a fully equipped fitness center on the premises and encourage all to take advantage of it. We also do a simple and easy set of exercises each day at 1:55pm. We call it the “ATI-5.” It is five minutes of five one minute exercises that most anyone can do in any attire at their work area or office. At 1:55pm each day employees hold a plank position for one minute, then do one minute’s worth of squats, followed by a minute of in place lunges, then a minute of wall (or regular) push-ups, and ending with a one minute set of tricep dips using the edge of their desk. The comradery and mutual encouragement helps to make everyone feel more comfortable than if they were to do it one their own or without having the corporate recognition that it’s a fine thing to be doing.

For more information on avoiding pain at your desk and more quick tips on office ergonomics click here.

Lying ChEats: Foods You Thought Were Healthy That Aren’t

By Grace Wang and Dr. Chris E. Stout for ATI Physical Therapy

If you’ve been inside a grocery store lately, chances are you’ve been barraged by labelsgranola-bars like, “Made with All Natural Ingredients!” or “Made with Whole Grains!” You’ve seen ice cream claiming to be a great source of calcium or gummy snacks exclaiming in bright colors that they are “Made with REAL Fruit!”

The sad truth is, potato chips that come in earth-toned, papery bags are still potato chips. The FDA considers high-fructose corn syrup to be “natural”, and nutrition labels don’t have to be accurate in order to be compliant with national regulations. We’ve been tricked over and over, and it’s time to put an end to it. Here are a few foods you may have thought were healthy that really aren’t:

Dave Ensign, the Director of Workers’ Compensation Case Management at ATI Physical Therapy says, “You can’t expect your body to stay healthy when what you put into it is unhealthy.” His wife’s blog, “Good Food and Gratitude” is an excellent source of nutritious recipes.

  • Frozen Veggie Burgers. Most frozen veggie burgers don’t contain vegetables at all. Instead, they are made from highly-processed soy or a mysterious-sounding product called “textured vegetable protein”. Seriously, if Dickens had written a dystopian novel, “textured vegetable protein” would be eaten for every meal.

If you need your frozen veggie burger fix, try to find one that’s actually made of vegetables. That’s kind of the point, isn’t it? Prevention.com recommends Hilary’s Eat Well Adzuki Bean Burger.

Healthy eating can be a complicated business. Before your next shopping trip, ATI 300x250remember these three rules that will help you navigate through all the lies. First, companies aren’t trying to keep you healthy – they are trying to sell their products. Second, if they have to convince you that their products are healthy, they probably aren’t. Thirdly, and most importantly, instead of agonizing over whether or not the gummy snacks are really, truly made of real fruit…just put down the box and buy some real fruit.

Sports Therapy by ATI

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ATI Sports Medicine athletic trainers work with athletes at all levels of competition to prevent, evaluate and treat sports injuries.

One of the largest employers of certified athletic trainers in the country, ATI offers:

  • On-site services at practices, games and events
  • Communication with coaches, physicians, parents and athletes
  • Clinical evaluation and diagnosis
  • Immediate and emergency care
  • Treatment, rehabilitation and education
  • Organizational and professional health and well-being
  • Conditioning program development
  • Therapeutic massage
  • Nutrition programs
  • On-call accessibility
  • Comprehensive concussion management

Highly Qualified, Coordinated Care

ATI’s athletic trainers are allied healthcare professionals, and must meet qualificationsSports Therapy - Highly Qualified, Coordinated Care set by the Board of Certification, Inc. in most states. Also, our athletic trainers:

  • Coordinate care under the direction of a physician and other healthcare professionals
  • Are members of the healthcare profession and are recognized by the American Medical Association
  • Have a bachelor’s or master’s degree from an accredited college or university, and must pass a comprehensive exam to earn their credentials and practice athletic training
  • Are experts at recognizing, treating and preventing musculoskeletal injuries

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