H.C. Martensen works in the AlloSource tissue processing core where he is faced with the powerful realities and possibilities of tissue donation and transplantation every day. He also has the utmost confidence in the allografts that he and his tissue bank colleagues produce, so much so that he recently requested one for his own transplant.

Over the summer H.C. returned to his former university, Colorado College in Colorado Springs, for an alumni soccer game. He played on the team in college, and since then remained very athletic, participating in triathlons and skiing. However, at the time of the game, it had been a while since he’d played soccer. Following a cutting motion on the field he felt his leg let go below the knee. H.C. instantly knew what had occurred, not only because of his work, but also because a close friend had sustained a torn ACL just
three days prior.

Shortly thereafter a surgeon confirmed it – H.C.’s ACL and lateral meniscus were torn
and he needed surgery and an allograft transplant. Although the surgeon did not
historically use allografts from AlloSource, H.C. made a special request to have his
graft come from the tissue bank. His surgery required a patella ligament bone-tendon-bone graft, which he received from a 33-year-old male donor.

“Just a few years older than me,” H.C. said. “It added to the perspective that I’ve had.

I’m presented with the reality of the business we’re in everyday. Seeing young donors come in is hard. Now that I’ve personally benefitted I’m further grateful for the gift of donation and even more aware of what we do.”

Since his surgery in June, H.C.’s recovery has been progressing very well and he just
completed his final functional evaluation in physical therapy. Although his knee isn’t yet 100%, he knows it shouldn’t be back to normal this soon after the injury, and his road to recovery has been swifter than other patients with similar injuries. Of course, H.C. intends to make the most of his gift of life – he will be training for triathlons.

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!

Cross Country Skiing: Benefits and Injury Risk

By Tara Hackney, PT, DPT, OCS, KTTP for Athletico Physical Therapy

Benefits of Cross Country Skiingcross country skiing benefits and injury risks

Cross country skiing is a relatively low risk sport and is great for people of all ages. Skiers can perform this activity for fun or for a workout in winter months. Skiing provides both an upper body and lower body workout and is also a great cardiovascular workout. It is a great activity for aerobic fitness and calorie burning. Cross country skiing does not stress one muscle group more than others, therefore it is a good option for longer duration workouts with low risk for traumatic injury.

In contrast to downhill skiing, crashes and falls are less frequent in cross country skiing. Downhill skiers generally sustain more severe and complex injuries due to the higher speeds than cross country skiers.

Possible Injuries in Cross Country Skiing

Although cross country skiing is lower risk than downhill skiing, injuries can still occur. Low back pain can be a concern for cross country skiers due to the repetitive nature of the sport in a forward flexed position. Compared to control subjects, cross country skiers reported significantly more back pain than their counterparts, however the long term consequence of this is unknown and may not be an issue.

For those that are worried about low back pain while cross country skiing, a good core strengthening program can help protect the back. An easy way to strengthen the core at home is by performing planks. Planks require no equipment and activate the abdominal muscles that support and help protect the low back.

There is also a risk of lower body injury in cross country skiing. One study found the foot and the knee to be the most common area reported for injury in cross country skiing. Injuries to these areas are generally foot/ankle sprains or sprains of the knee. This could be caused by a fall where the leg is twisted.

Lastly, there is a risk for “skier’s thumb” in cross country skiing. Skier’s thumb is a sprain of the ligament on the inside portion of the thumb. This injury can occur when a skier falls with a pole in hand. There are thumb stabilizers available to help prevent this injury, but skiers can also avoid putting their hands through the ski pole loops unless absolutely necessary.

An Activity for Every Winter

Nordic skiing is in the spotlight with the Winter Olympics, however it is not only reserved for Olympic athletes. Cross country skiing is a great option for winter workouts. With a relatively low risk for injury, you can enjoy the benefits of this sport every winter.

Should an injury occur, please visit your nearest Athletico for a complimentary injury screen.

Schedule a Complimentary Injury Screen

Golf: Return to Play after Surgery, Winter Conditioning & New Teaching Technology; Avoiding Winter Sports Injuries

Episode 17.34 Rerun

Segment One (01:30): Dr. Nik Verma sitting in for Dr. Cole and Steve speakJames Standhardt with James Standhardt from GOLFTECabout returning to play after surgery, winter conditioning, importance of club fitting and new technology in golf instruction. James has taught for more than 14 years and has given over 19,000 lessons with GOLFTEC. Six time “Outstanding Achievement in Instruction” winner.

Segment Two (16:05): Dr. Julia Bruene from Midwest Orthopaedics at Rush talks about how to avoid skiing and other winter sports injuries.

Dr. Julia Bruene is a sports medicine physician with special interests in concussion management, care of female athletes, care of combat athletes/mixed martial arts, and special needs athletes.

In 2006, Dr. Bruene graduated magna cum laude earning her bachelor’s degree in health planning and administration, with a minor in chemistry from the University of Illinois at Urbana-Champaign. She went on to complete her medical degree at Rush University Medical College, Chicago, IL graduating in the top 20 percent of her class. Dr. Bruene served as chief resident in the Advocate Lutheran General Hospital Family Medicine Residency Program, Park Ridge, IL. She then completed a fellowship in primary care sports medicine at Rush University Medical Center.

A Brazilian Jiu-Jitsu practitioner and recreational runner, Dr. Bruene understands how vital physical well-being is to athletes. Dedicated to keeping fellow sports enthusiasts healthy, Dr. Bruene volunteers to provide medical coverage for Chicago-area sporting events such as the Chicago Style Gymnastics Meet and Bank of America Chicago Marathon. She has also participated in team coverage for local area high school, college, and professional teams, and is a team physician for the Chicago White Sox.

Hitting the Slopes? Consider these Expert Recommended Safety Tips

By: Brian Rog and Laura Waller, ATC, LAT for ATI Physical Therapy

Hitting the Slopes? Consider these Expert Recommended Safety Tips

Gasping that brisk winter air as your snowboard seamlessly rips through that freshly-packed powder at supersonic speeds sounds fun, right? Few would argue, but a lesser attractive reality of high-risk winter sports like snowboarding and skiing is assumed well before these euphoric moments on the slopes.

Regardless of skill level, it’s important to know that while activities like snowboarding and skiing vary in technique, they both demand superior agility, strength, balance, response time and endurance. For those thrill seekers destined to conquer the mountain, failing to fuse these physical requisites into your day can land you in serious trouble.

Anyone who’s navigated the slopes, will tell you that the inherent dangers on the slopes can be minimized with a bit of knowledge and preparation. Looking at this deeper, a rider’s physical aptitude, gear and body mechanics such as stances and riding styles ultimately decide a day’s outcome.

Injuries during or after a day on the slopes can happen to anyone, but with a few simple measures, you can consciously assume control of your adventure and work to lessen these risks. As with any sport, the levels of risk, set against reward, teeters on your willingness to establish and commit to a routine.

Common ski and snowboard injuries

It should come as no surprise that within the ATI clinics, injuries credited to skiing typically involve hip arthritis, hip labral tears, and ACL/MCL sprains and tears (knee injuries account for 30 percent of all skiing injuries). Since these areas of the body endure the most load and changes in motion, a blunder in form or technique puts the lower extremities at increased risk.

With snowboarders, since the motions and stances are fundamentally different than skiing, our clinicians see more wrist and back injuries than any other ailments. When a boarder falls, instinctively, the hands are used as a first line of defense to break the fall, ultimately resulting in a fracture or sprain.

With back injuries, this comes with its own grouping of challenges. Since both feet are anchored to the board, you see a lot of falling either directly on the butt or on the stomach, which lead to a menu of conditions.

We are also seeing an increase in tendonitis among snowboarders because of the hopping required just to get moving down the slopes.

And the final, most overlooked ailment, is a concussion. As CTE (Chronic Traumatic Encephalopathy) gains attention among the athletic community, skiers and snowboarders are learning they are also not immune to the effects of this disease. Given the high speeds involved in the sport, that soft, snow-covered surface can wreak major havoc on the body upon impact. While a helmet can help protect the brain from a major impact, it may not completely defend against a concussion.

One final thing to note is that for skiers and boarders who have successfully rehabbed an injury, overuse injuries (specifically of the lower extremities) are leading to more chronic instability. With this, it’s important to recognize the risks and preventive measures to take. You can always reach out to your nearest ATI clinic for next steps in care and assessment.

Leading contributors to ski and snowboard injuries

Injuries in both disciplines commonly result from improper form, fatigue or acting outside your limits – like taking on a more advanced slope. With improper form, weaknesses among certain muscle groups tends to occur, resulting in injury. Conditioning the larger muscle groups is not enough for these sports – it’s important to work on the smaller, more stabilizing muscles to retain peak performance.

Balance is also an important factor. The more stability and body awareness you have, the better your form, and the lower your chances become for muscle soreness and strains.

Ski and snowboard safety gear to consider

Above all else, the most important item to wear when skiing and snowboarding is a helmet. To be most effective, the helmet must be intended for snow sports – not biking, skateboarding, rollerblading, etc.

With the appearance of major concussions and probability of CTE, the industry has stepped up in big ways to produce helmets aimed at protecting the brain from major traumas. Of these advancements, most companies now manufacture helmets that feature the innovative Multi-Directional Impact Protection System (MIPS), which helps to protect against rotational motions transmitted to the brain from angled impacts to the head. So when choosing a helmet, make sure it is MIPS-equipped.

When considering braces and padding, it’s important to remember that while snow is relatively soft, it can still be unforgiving. With this, our specialists recommend wearing knee guards or braces, back protectors, wrist guards and protective shorts to support and cushion the impact of a fall. These items will also help to shield areas of the body that are most susceptible to injury.

Muscle groups deserving attention before hitting the slopes

Stretching before a day on the slopes can be the difference between a more agile and flexible ride or a more stiff and strenuous one. When stretching, be sure to focus on your hamstrings, IT band, hip flexors, calves, glutes, ankles, back and neck. These stretches should be done as dynamically as possible.

More specifically, consider incorporating squats, lunges, side lunges, hip rotations, upper body rotations, donkey kicks and fire hydrants. These exercises target mobility and flexibility, which help to support function, form and performance. If you have your own warm up routine that focuses on the areas of the body listed above, but doesn’t follow our suggested exercises, no problem – stick with it.

If you are planning a full day on the slopes, a good rest period should entail increments amounting to at least two hours. Taking enough time to make sure you can refuel your body correctly with food and possibly a nap (not to mention hydration) will give your body the recharge it needs. Most resorts have a lodge to set your equipment and an area to snack and rest.

A recommended ratio would be 3:1 hours of activity to rest. For those who only spend a few hours on the slope, just be sure to incorporate, at minimum, several 30-minute rest periods.

Stretching after a day on the slopes

You are exhausted, sore and fatigued, and the last thing you want to do is demand more of your muscles. But if you want to reduce soreness in the hours and days to come, stretching after a day on the slopes must be a priority. This will help maintain your mobility and ease muscle soreness during the recovery period.

In doing this, we recommend using a foam or handheld roller and rolling out the lower body to help loosen your muscles and reduce tissue tension. Rolling out to get the massage effect before stretching will allow for a deeper, better stretch. It’s also beneficial to take a warm shower after you roll out as it’ll help to complement your rolling efforts. After a shower is the best time to incorporate your stretches because that is when the deepest stretches will occur due to increased blood flow and muscle warmth.

If these options are readily accessible, just make sure your program targets the hamstrings, calf muscles, glutes, spine, rotators, quadriceps, and thighs. ATI specialists encourage people to stretch out what they feel like they need to stretch out after any activity, but given the lower body demands of these two activities, the lower body takes a lot of strain, so more emphasis is placed on that area.

Recover like an Olympian

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!