Snow Shoveling Injury Prevention

Snow Shoveling the Correct Way to Avoid Injuries

by Meryle Richman, PT, DPT, MS

Woman Shoveling Snow

Snow shoveling is a repetitive activity that can cause muscle strain to the lower back and shoulders. Back injuries due to snow shoveling are more likely to happen to people who may not know that they are out of condition. Following these tips can help you avoid injuries.

 

● Lift smaller loads of snow, rather than heavy shovelfuls. Be sure to take care to bend your knees and lift with your legs rather than your back.

● Use a shovel with a shaft that lets you keep your back straight while lifting. A short shaft will cause you to bend more to lift the load. Using a shovel that’s too long makes the weight at the end heavier. Step in the direction in which you are throwing the snow to prevent the low back from twisting. This will help prevent “next-day back fatigue.”

● Avoid excessive twisting because the spine cannot tolerate twisting as well as it can tolerate other movements. Bend your knees and keep your back as straight as possible so that you are lifting with your legs.

● Take frequent breaks when shoveling. Stand up straight and walk around periodically to extend the lower back.

● Backward bending exercises while standing will help reverse the excessive forward bending of shoveling: stand straight and tall, place your hands toward the back of your hips, and bend backwards slightly for several seconds.

Here are some Healthy Tips for Safely Shoveling Snow

Stretches that target the trunk, legs and upper body:

Counter-Top stretch (Low back): Place your hands on your kitchen counter and walk backwards until your body makes an L-shape. Bend or hinge forward from your hips, while keeping your back lengthened your arms forward. You will feel a stretch in your back and throughout your trunk. Hold this for 10 long, deep breaths.

Heel Up On a Chair stretch (hamstrings): While holding onto some support, straighten your leg out and place your heel up on a chair, tighten that thigh, and pull those toes towards your body. Feel the stretch in the back of your leg. There’s no need to bend forward and it’s better if you don’t. Just stand up tall and keep both legs active. Hold 10 breaths. Repeat other side.

Bent Knee with Ankle in Hand stretch (quadriceps): Keep holding onto some support as you grab one foot with one hand behind your buttocks and hold it as you bend that leg. You should feel this stretch in the front of the thigh of the bent leg as you hold for 10 breaths. Repeat other side.

Core Strengthening Exercise:

● While standing, imagine pulling your belly button in towards your spine and engage your abdominal muscles without letting your pelvis tuck under. Try holding this for 5-10 seconds while breathing normally and repeat this a few times until it makes sense. This exercise uses the innermost layer of abdominal and back muscles and reminds your body where the center of your core strength is.

Mindfulness:

● As you are shoveling snow, focus on the rotating movements happening in your  hip joints. You can place your finger on the front of your hip joints (located at the top of each thigh near the groin) and practice a few sways side to side, simulating raking. Avoid letting the rotation happen at your waist—this will cause unnecessary movement around your lumbar spine.

● Continue to focus on the core strength exercise above and engage your belly  button in towards your spine as you rake, activating those lumbar spine  stabilizers. Pay attention to loosening up any stiffness in your legs and trunk muscles and you will go a long way to preventing injury to your back!

If your back hurts from shoveling snow or you have complaints of neck or shoulder pain, call to make an appointment with one of our staff of knowledgeable physical therapists for a free 15 minute consultation. Our experienced and dedicated licensed physical therapists can also help you get started with treatment. With Direct Access a prescription is not required to be evaluated. . Most insurance plans are accepted. Contact IvyRehab Briarcliff (914) 762-2222 and IvyRehab Jefferson Valley (914) 245-8807 or visit our Website —www.ivyrehab.com — to learn more about Direct Access.

Reference: http://www.moveforwardpt.com/Resources/Detail.aspx?cid=bc1413cc-3ed6-4cf9-888f-3955df4a1b13

Benefits of Tai Chi

by Master Trainer and Exercise Physiologist, Jie Yang

Master Trainer Jie Yang

Master Trainer Jie Yang will be leading a New Tai Chi class at Club Fit Brircliff

Born in Xi’an, China, Jie Yang is trained in various martial arts forms including Taichi and Xingyi. He holds his Master’s in Exercise Science and Rehabilitation and is a Certified Exercise Physiologist by American College of Sports Medicine.

Jie will be leading a new Tai Chi fitness program at Club Fit Briarcliff, beginning October 21st.

The core training in this class involves a slow sequence of movements (solo form) which emphasize a straight spine, abdominal breathing, and a natural range of motion, with the form being performed over their center of gravity. Accurate, repeated practice of the routine can retrain posture, encourage circulation throughout our bodies and maintain flexibility through the joints.

Research-established benefits

  1. Promotion of balance control, flexibility, cardiovascular fitness, and has shown to reduce the risk of falls in both healthy young performers and elderly patients [2, 15], and those recovering from chronic stroke [3], heart failure, high blood pressure, heart attacks, multiple sclerosis, Parkinson’s, Alzheimer’s and fibromyalgia [4-5].
  2. Tai chi’s gentle, low impact movements burn more calories than surfing and nearly as many as downhill skiing [6].
    Tai chi, along with yoga, has reduced levels of LDLs 20–26 milligrams when practiced for 12–14 weeks [7].
  3. Compared to regular stretching, tai chi showed the ability to greatly reduce pain and improve overall physical and mental health in people over 60 with severe osteoarthritis of the knee [8]. In addition, a pilot study, which has not been published in a peer-reviewed medical journal, has found preliminary evidence that tai chi and related qigong may reduce the severity of diabetes [9].
  4. In a randomized trial of 66 patients with fibromyalgia, the tai chi intervention group did significantly better in terms of pain, fatigue, sleeplessness and depression than a comparable group given stretching exercises and wellness education [5].
  5. A recent study evaluated the effects of two types of behavioral intervention, tai chi and health education, on healthy adults, who, after 16 weeks of the intervention, were vaccinated with VARIVAX, a live attenuated Oka/Merck Varicella zoster virus vaccine. The tai chi group showed higher and more significant levels of cell-mediated immunity to varicella zoster virus than the control group that received only health education. It appears that tai chi augments resting levels of varicella zoster virus-specific cell-mediated immunity and boosts the efficacy of the varicella vaccine. Tai chi alone does not lessen the effects or probability of a shingles attack, but it does improve the effects of the varicella zoster virus vaccine [10].

Stress and mental health
A systematic review and meta-analysis, funded in part by the U.S. government, of the current (as of 2010) studies on the effects of practicing Tai Chi found that, “Twenty-one of 33 randomized and nonrandomized trials reported that 1 hour to 1 year of regular Tai Chi significantly increased psychological well-being including reduction of stress, anxiety, and depression, and enhanced mood in community-dwelling healthy participants and in patients with chronic conditions. Seven observational studies with relatively large sample sizes reinforced the beneficial association between Tai Chi practice and psychological health [11].”
There have also been indications that tai chi might have some effect on noradrenaline and cortisol reduction with an effect on mood and heart rate. However, the effect may be no different than those derived from other types of physical exercise [12]. In one study, tai chi has also been shown to reduce the symptoms of Attention Deficit and Hyperactivity Disorder (ADHD) in 13 adolescents. The improvement in symptoms seem to persist after the tai chi sessions were terminated [13].
In June, 2007 the United States National Center for Complementary and Alternative Medicine published an independent, peer-reviewed, meta-analysis of the state of meditation research, conducted by researchers at the University of Alberta Evidence-based Practice Center. The report reviewed 813 studies (88 involving Tai Chi) of five broad categories of meditation: mantra meditation, mindfulness meditation, yoga, Tai Chi, and Qi Gong. The report concluded that “the therapeutic effects of meditation practices cannot be established based on the current literature,” and “firm conclusions on the effects of meditation practices in healthcare cannot be drawn based on the available evidence [14].

In 2003, the National Library of Medicine, the largest medical library in the world and subdivision of U.S. Department of Health and Human Services, awarded a grant to American Tai Chi and Qigong Association to build a website titled “The Online Tai Chi & Health Information Center.” The information center was officially released in 2004 and has since then been providing scientific, reliable, and comprehensive information about various health benefits of Tai Chi – for arthritis, diabetes, fall prevention, pain reduction, mental health, cardiovascular diseases, fitness, and general well-being.

References
1. Wang, C; Collet JP & Lau J (2004). “The effect of Tai Chi on health outcomes in patients with chronic conditions: a systematic review”. Archives of Internal Medicine 164 (5): 493–501
2. Wolf, SL; Sattin RW & Kutner M (2003). “Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial”. Journal of the American Geriatric Society 51 (12): 1693–701.
3. Au-Yeung, PhD, Stephanie S. Y.; Christina W. Y. Hui-Chan, PhD, and Jervis C. S. Tang, MSW (January 7, 2009). “Short-form Tai Chi improves Standing Balance of People with Chronic Stroke”. Neurorehabilitation and Neural Repair 23(5): 515.
4. Taggart HM, Arslanian CL, Bae S, Singh K. Armstrong Atlantic State University, Savannah, GA, USA. Effects of T’ai Chi exercise on fibromyalgia symptoms and health-related quality of life. PMID: 14595996
5. McAlindon, T, Wang, C; Schmid, CH; Rones, R; Kalish, R; Yinh, J; Goldenberg, DL; Lee, Y; McAlindon, T (August 19, 2010). “A Randomized Trial of Tai Chi for Fibromyalgia.”. New England Journal of Medicine 363 (8): 743–754.
6. “Calories burned during exercise”. NutriStrategy. http://www.nutristrategy.com/activitylist3.htm.
7. Brody, Jane E. (2007-08-21). “Cutting Cholesterol, an Uphill Battle”. The New York Times. http://www.nytimes.com/2007/08/21/health/21brod.html?adxnnl=1&adxnnlx=1190862080-FWYKVQhkU70Kz/P+y3V9pw.
8. Dunham, Will (October 25, 2008). “Tai chi helps cut pain of knee arthritis”. Reuters.
9. Pennington, LD (2006). “Tai chi: an effective alternative exercise”. DiabetesHealth.
10. Irwin, MR; Olmstead, R & Oxman, MN (2007). “Augmenting Immune Responses to Varicella Zoster Virus in Older Adults: A Randomized, Controlled Trial of Tai Chi”. Journal of the American Geriatrics Society 55 (4): 511–517.
11. Wang C, Bannuru R, et al (2010). Tai Chi on psychological well-being: systematic review and meta-analysis.
12. Jin, P (1989). “Changes in Heart Rate, Noradrenaline, Cortisol and Mood During Tai Chi”. Journal of Psychosomatic Research 33 (2): 197–206.
13. Hernandez-Reif, M; Field, TM & Thimas, E (2001). “Attention deficit hyperactivity disorder: benefits from Tai Chi”. Journal of Bodywork & Movement Therapies 5 (2): 120–123.
14. Ospina MB, Bond TK, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, Bialy L, Hooton N,Buscemi N, Dryden DM, Klassen TP (June 2007). “Meditation Practices for Health: State of the Research (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. 290-02-0023)” .Evidence Report/Technology Assessment No. 155 (Rockville, MD: Agency for Healthcare Research and Quality) (AHRQ Publication No. 07-E010): 6
15. UMR 6152 Mouvement et Perception, CNRS and University of the Mediterranean, Marseille, France (April, 2008). How does practise of internal Chinese martial arts influence postural reaction control? Journal of Sports Sciences 26(6): 629 – 642

 

Bike Right, Bike Fit

by Meryle Richman, PT, DPT, MS, CST, RYT

With the beginning of fall and changing of the leaves, people enjoy being outdoors riding their bicycles. The physical therapists at Ivyrehab can teach you preventative measures to avoid bike injuries.

For the average bike rider cycling involves a limited repetitive motion. At an average cadence of 90 revolutions per minute (RPM), a bicycle rider cranks out 5,400 strokes each hour. This becomes 1.5 million strokes in 5,000 miles. So you can just imagine how this can lead to a lot of wear and tear on the cartilage, ligaments and joints of the knee.

I. What you need to know about for a proper Bike Fitting:

The most common bike fitting errors include a saddle that is too high or too low, excessive handlebar reach that causes you to lean too far forward, and improper alignment of the pedal and shoe.

The American Physical Therapy Association recommends that when evaluating a cyclist for a proper bike fit the following assessment be performed:

●Foot to Pedal: The ball of the foot should be over the pedal spindle (the bar in the middle of the pedal on which the pedal “spins”). For cleat users, it is important to establish a neutral position of the cleat on the shoe. This will allow for neutral tracking of the knee through the pedal stroke.

●Saddle and Knee/Pedal Position: Saddle height should allow the knee to be slightly bent at the most extended portion of the pedal stroke. A suggested knee angle at dead-bottom-center is 30- 35 degrees while the foot is in the pedaling position.

●Saddle tilt: Saddle tilt for normal-endurance bicycling should be level. Pay close attention to the portion of the saddle that will be supporting the ischial tuberosities, or “sitting bones.” Cut out saddles allow for better tissue oxygenation. A well-fit saddle will provide the best comfort and results.

●Saddle Position in relation to the handlebars: Saddle position should allow the knee to be over the foot (metatarsal heads, ball of foot) at the 3-o’clock position of the bicycle crank-arm. The foot should be in a normal pedaling position.

●Handlebars: The position of the handlebars will affect the comfort of the hands, shoulders, neck and back, as well as the overall handling of the bicycle. For the Recreational Rider the trunk angle (trunk from horizontal reference line) should be angled between 40-80 degrees, and the shoulder angle (trunk to humerus) should be between 80 and 90 degrees. The handlebar position, should allow the hands to be slightly wider than the shoulder width. This is for comfort of the hands, arms and shoulders. For the Road Rider the trunk angle (trunk from horizontal reference) should be between 30 and 40 degrees, and the shoulder angle (trunk to humerus) should be between 90 and 100 degrees. The handlebar position should be approximately 2 centimeters (or .79 inches) wider than shoulder width for comfort of the hands, arms and shoulders.

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The ideal position of the knee in pedaling is to have the knee over the pedal and ball of the foot at the 3 o’clock position.

II. Common Overuse Injuries with Biking

● liotibial Band Syndrome (IT Band):

Possible causes are too-high saddle, leg length difference, and misaligned bicycle cleat for those who use clipless pedals. Pain is caused when the band becomes tight and rubs over the bony prominences of the hip (greater trochanter) and/or the knee (lateral epicondyle). When the knee is flexed at 30 degrees and is at the bottom of the stroke motion, there is friction on the tendon attachment. Tight inflexible lower extremity muscles may also worsen the condition. The band becomes tight and pulls at the hip and knee causing pain. In order to minimize knee and hip pain, it is important to pedal with low resistance and keep the cadence at 80-90 rpm.

● Chondromalacia:
Another common knee injury is anterior knee pain, such as chondromalacia. This involves irritation of the cartilage behind the patellar and patellar femoral tracking of the knee. If there is a muscle imbalance of the muscles of the anterior thigh known as the quadriceps, the outside muscle (vastus lateralis obliqus) becomes tight and the muscle on the inside of the thigh (vastus medialis obliqus) becomes weak. This results in lateral movement of the patellar which does not “track” smoothly in the patellar groove and results in irritation to the patellar (patellar-femoral maltracking) and anterior knee pain.

● Hamstring Tendinitis
Possible causes are inflexible hamstrings, high saddle, misaligned bicycle cleat for those who use clipless pedals, and poor hamstring strength.
● Neck Pain
Possible causes include poor handlebar or saddle position. A poorly placed handlebar might be too low, at too great a reach, or at too short a reach. A saddle with excessive downward tilt can be a source of neck pain.
● Lower Back Pain
Possible causes include inflexible hamstrings, low cadence, using your quadriceps muscles too much in pedaling, poor back strength, and too-long or too-low handlebars.
● Hand Numbness or Pain
Possible causes are short-reach handlebars, poorly placed brake levers, and a downward tilt of the saddle.
●Numbness or Pain
Possible causes are using quadriceps muscles too much in pedaling, low cadence, faulty foot mechanics, and misaligned bicycle cleat for those who use clipless pedals.

III. Prevention of Injuries with Stretching & Exercising

●Warm up for 5 – 10 minutes with gentle movement. Stretch slowly and gradually. Also do some stretching after you ride
●Exhale as you gently stretch muscles. .Develop a stretching routine for the quadriceps, hamstrings, ilio-tibial band, piriformis and calves Also, do stretching for your neck, trunk, chest, wrists and hands.

●Hold stretches for 15 – 20 seconds; 2 – 3 repetitions

●Gradual resistive exercise for back musculature, abdominals, legs and arms

●Progress to closed chain exercises

●Progressive functional activities and agility skills

●Partial squats, step – ups and step – downs, lunges

●Proprioceptive training – balancing exercises

●Cross training: spinning, jogging, swimming

IV. Choosing a Correct Helmet

When you are choosing a helmet, fit is very important. For a helmet to protect you it must fit correctly. Other factors to know about a proper hat fit are:

●Make sure the helmet fits on the top of your head and does not tip backwards or forwards. It should be parallel to the ground. There should be about 2 fingers breadth between your eyebrow and the edge of the helmet
●The helmet should not move when you shake or move your head from side to side or up and down.
●Straps should always be fastened and fit snugly. It should also meet certain safety criteria. Look for “Snell Certified” or Meets ANSI Z904 Standard” on the box or on the helmet itself.
●There should be no cracks inside the helmet

Whether you are a beginning bicyclist or advanced rider and have and have an injury that is “holding you back from riding” our experienced and dedicated licensed physical therapists can help you get started. With Direct Access a prescription is not required to be evaluated. Contact Ivyrehab Briarcliff (914) 762 – 2222 and Ivyrehab Jefferson Valley (914) 245 – 8807 or visit our Website: www.ivyrehab.com to learn more about Direct Access.

Reference: www.apta.com

biking

biking

Better Balance Now

Better Balance Now!— Fall Prevention
Meryle Richman, PT, DPT, MS, CST, RYT

As we age the ability to maintain balance becomes more difficult. Many factors influence good balance, some of them are biological; and some we are able to influence and are able to improve. Balance and stability are important factors for aging adults to maintain a healthy lifestyle. Loss of balance is the primary factor in falls, which often results in serious injuries.

Good balance is dependent on sensory input form the eyes, the correct functioning of the balance system in the inner ear, posture and center of gravity and our ability to sense the position and movement in our feet, legs and arms. Vision affects the balance system, as the eyes send messages to the brain telling us where objects are in space.

Aging adults are affected by a loss of muscle mass and strength. This is associated with an increased risk of falls and hip fractures. It also has a great affect on maintaining a healthy lifestyle. Weakness in the ankle musculature may cause difficulty in recovering lost balance more quickly. Strong quadriceps muscles are necessary for good balance and walking. Evidence shows the strength and aerobic training can lead to a reduction in falls.

Loss of flexibility occurs with age. This may lead to difficulty climbing stairs, transferring from sit to stand and or getting out of bed without difficulty. Much of the loss of flexibility is due to inactivity. Flexibility exercises, stretches, gentle yoga will help improve flexibility of major muscle groups and therefore improve ones ability to complete everyday activities.

Postural changes develop as people age but not because they age. Rounded shoulders, forward head postures, increased thoracic curves in the spine are common postural changes. These changes affect the center of gravity in the body moving it forward. With changes in the center of gravity, older adults are more prone to loss of balance and an increased risk of falls.

Medications also contribute to the deterioration of the balance system. Research has shown that adding new medications in the previous two weeks increases the risk for falling.

There are many ways we can adapt to the changes in our bodies as we age. Some helpful tips include:

Promote safety in the home by using non-skid surfaces, eliminating area rugs & improve lighting in the home

  1. Get a yearly eye exam
  2. Proper nutrition and hydration
  3. Know the side effects of your medication
  4. Use caution with pets running around in your home
  5. Different forms of exercise, such as strengthening exercises, flexibility and stretches, postural exercise, yoga, tai chi, and aerobic exercise such as walking, will all contribute to decreasing the risk of falls and improve your balance.

Guidelines from The American College of Sports Medicine suggest that:

1) Healthy adults under the age of 65 should aim for:

 – Moderate intense cardiovascular exercises 30 minutes a day (aerobic exercise), five days a week or vigorous intense exercises 20 minutes a day, 3 days a week and strengthening-exercises twice a week

– Flexibility or stretching exercises are also recommended a minimum of 2-3 days a week

 2) Healthy adults 65 years or older:

 – Low-to-Moderate aerobic exercises, 30 minutes a day, 5 times a week and gentle strengthening-exercises (very light weights), 2- 3 times a week

– Flexibility or stretching exercises at a minimum of 2-3 times a week

Types of Aerobic and Low-to-Moderate Exercises:

Moderate Intense Aerobic Exercises Low-to-Moderate Aerobic Exercises
  • brisk walking
  • running
  • swimming
  • cycling; spinning classes
  • water exercises
  • gardening
  • housework
  • dancing, yoga, tai chi

If you want to determine your fitness level, refer to the reference guide from The Centers for Disease Control and Prevention: http://www.cdc.gov/physicalactivity/everyone/measuring/index.html.

For beginners, you can simply start out by learning the basics of the talk test, which is a rule of thumb for doing moderate-intensity activity and you can still talk, but not sing during an activity. However, if you are doing a vigorous-activity you would want to learn how to find your target heart rate and determine what intensity range you should be exercising at for optimal cardiac performance.

Check out the Stay Healthy Website to determine a simple way to find your target heart rate at: www.cancer.org/healthy/toolsandcalculators/calculators/app/target-heart-rate-calculator. Once you find your target heart rate, wearing a heart rate monitor will make it easier to monitor your desired rate.

If you would like to improve your current level of fitness, but still have questions about how to begin a safe exercise program if you had an injury or illness, our experienced and dedicated licensed physical therapists can help you get started. With Direct Access a prescription is not required to be evaluated. Contact Ivyrehab Briarcliff (914) 762 – 2222 and Ivyrehab Jefferson Valley (914) 245 – 8807 or visit our Website: www.ivyrehab.com to learn more about Direct Access.

References:

(1) Exercise: Designing a Cardiac exercise Program. New York-Presbyterian Hospital. Retrieved September 2, 2011 from http://nyp.org/health/cardiac_exercis3.html

(2) American College of Sports Medicine Position Stand. Retrieved September 2, 2011 from http://www.mhhe.com/hper/nutrition/williams/student/appendix_i.pdf

Prevention Tips for Soccer Injuries

By Meryle Richman, PT, DPT, Senior Director at Ivyrehab Briarcliff & Jefferson Valley

Youth soccer injuries (ages 2 to 18) suffer around 120,000 injuries each year which are serious enough to require a trip to a hospital emergency room. The total number of soccer-related injuries, including those treated outside of a hospital ER, is estimated to be nearly 500,000 per year.A significant number of these injuries could be prevented if parents, athletes and soccer organizations employed the following safety measures:

Reduce injuries through proper strengthening and conditioning exercises, (especially building up hamstrings and inner quadriceps muscles) and teaching girls to pivot, jump, and land with flexed knees and employ a three-step with the knee flexed instead of a one-step stop with the knee extended have been shown to prevent some of these injuries. Stretching, particularly of the groin, hip, hamstrings, Achilles tendon, and quadriceps, during warm-ups before practices and games and during the cool-down after playing, is particularly vital in reducing the risk of strains and sprains.

To further reduce injuries properly maintaining the field, wear proper shin guards, and reduce injuries from goal post collisions with padding.

Stretching Tips:

Perform 3 repetitions of each stretch and hold 20-30 seconds

●Two Leg Hamstring Stretch
1. With both feet together and legs fully extended, hinge forward from your hips and reach forward with both hands towards your toes.
2. Tuck your chin towards your chest to increase the stretch. 3. Keep your toes pointed towards the sky.

●Hamstring Split Stretch
1. Bending on one knee, extend the other leg out in front of you.
2. Reach with both hands towards your outstretched foot.
3. Keep your toes towards the sky and tuck your head to increase the stretch. Remember to breathe!
4. Repeat for the opposite side.

●Lying Quadriceps Stretch
1. Lying on one side grasp your ankle and pull your heel towards your buttocks.
2. Keep your back straight and the other leg bent.
3. Do not grab your foot. Grab just above the ankle joint (the bottom of your leg).
4. Keep the thigh in line with your body. To increase the stretch push your hips forward (only a slight movement).
5. Repeat for the opposite side.

●Standing Groin Stretch
1. Stand with your legs wider than shoulder width apart.
2. Shift your weight onto one side as you bend your knee.
3. Reach with one hand towards your outstretched foot.
4. You should feel the stretch right down the inside of your outstretched leg.
5. Repeat for the opposite side.

●Sitting Groin Stretch
1. Sit with knees bent at 90 degrees.
2. Place the soles of your feet together to ‘splay’ your knees outwards.
3. Gently use your hands or elbows to push your knees downwards

●Lower Back Stretch
1. Sit with the legs straight out in front of you.
2. Bend the right knee so the sole of your foot is flat on the ground.
3. Turn your upper body towards your right knee and place your right hand on the floor for support
4. Place your left forearm on the outside of your right knee and gently pull your knee towards you
5. Resist with your knee and left hand to feel the tension in your lower back.
Repeat for the opposite side.

●Standing Calf Stretch
1. Using a wall or bar to support you, place one leg outstretched behind you.
2. Keeping the other leg bent lean against the wall to apply pressure to your beg leg.
3. Make sure you keep your back heel flat on the ground.
4. Repeat for the opposite side.

●Chest & Back Stretch
1. This stretch can be performed kneeling or standing. Take your boots off if you kneel.
2. Clasp your hands behind your back, keeping your arms as straight as possible.
3. Try to straighten your arms and raise them.
4. From this position bend forward from the waist also tucking your head towards your chest.
5. Hold this position for the recommended amount of time.

● Shoulder Stretch
1. Place one are outstretched across your chest.
2. Place the hand or forearm of your other arm on your outstretched elbow to apply pressure.
3. Gently pull your outstretched arm closer to your chest, keeping it as straight as possible.

Call to set up a free appointment if you would like to attend this free Soccer Screening at Ivyrehab Jefferson Valley (914) 245-8807 on March 16, 2016 from 8:15-8:45 PM. In addition, if you would like to be seen right away for an injury or chronic pain under Direct Access (no prescription is required), contact us at or Ivyrehab Jefferson Valley (914) 245-8807 or Ivyrehab Briarcliff at (914) 762-2222. You can also visit our website at: www.ivyrehab.com.

Ivyrehab accepts most insurance plans (which our office obtains pre-approval from your insurance carrier) and will submit your office visit treatments for payment. You will be responsible for your co-payment depending on your particular insurance policy.

With one-on-one care this permits the therapist to construct a personalized program for the individual. After all, when it comes to rehabilitation, “it’s all about the people”.

Reference:
http://www.momsteam.com/sports/soccer/ten-ways-to-reduce-or-prevent-soccer-injuries

Free Soccer Injury Prevention Screening
March 16, 2016 from 8:15-8:45 PM with Jacek Golis
inside Ivyrehab Jefferson Valley
(Located inside Club Fit Jefferson Valley)

Ivy Rehab

Prevention Tips for Tennis Injuries

By Meryle Richman, PT, DPT, MS, Senior Director at Ivyrehab Briarcliff & Jefferson Valley

Tennis elbow (lateral epicondylitis) typically affects middle aged (40 to 60 years of age) adults and only 1 in 20 play tennis. If you have pain and/tenderness on the inside of your elbow, that is not going away it could be caused by different reasons such as improper techniques, poor physical conditioning, weight of the tennis racquet, too much tension on the strings of the racquet, balls are too heavy, type of court surface you are playing on and the grip size of the racquet. Other causes for lateral epicondylitis come from repeated forcible extension of the wrist such as using a screwdriver, heavy lifting and shoveling snow. Overuse of the muscles that extend the wrist usually has no pain at rest, but will increase with activity.

Treatment of tennis elbow focuses on relieving pain, controlling inflammation, promoting healing, improving local and general fitness and controlling force loads and repetitive movements with the wrists. Physical therapy uses a variety of modalities to relieve pain and decrease inflammation, massage and soft tissue mobilization techniques to heal the tissues. In addition, the following stretching and exercises are also recommended:

NOTE: the recommended stretching and exercises should not cause any increase pain. In the event that they do, you should stop immediately and consult with your physician.

Stretching Tips

Forearm stretch:
Hold arm straight out, fingers pointed towards the floor. Use your opposite hand and pull the fingers towards the body until a stretch is felt. Hold 10 seconds, repeat 3 times.
Repeat same as above, but fingers are pointed towards the ceiling. Use the opposite hand to fingers towards you. Hold 10 seconds, repeat 3 times.

Racquet stretch:
Stand with your feet shoulder width apart. Hold your racquet at the top of its frame with the right hand behind your head. Grasp the grip of the racquet with the left hand and slowly pull the racquet down the back. Hold 15 – 20 seconds. Repeat 3 times. Switch hands and do in the opposite direction

Scapular Stretch:
Cross the right arm in front of the left shoulder letting the elbow bend so that the hand droops over the left shoulder. With the left hand on the right elbow, push your arm in towards the back of the room. Hold for 15 – 20 seconds. Repeat 3 times.

Arm overhead stretch:
Take your left hand over your head. Bend it at the elbow, so that your left hand is over your head near your right ear. Then take the right hand and push the left elbow with it more toward the right. Hold for 15 – 20 seconds. Repeat 3 times

Hands behind the back stretch:
Grasp your hands behind your back while holding them at the wrist. Pull your left hand more towards the right and then do in the opposite direction. Hold 10 – 15 seconds. Repeat 2 -3 times

Recommended Strengthening Exercises

Ball Gripping: Use a soft ball and repetitively squeeze to strengthen the forearm muscles. Do 100 – 200 times a day.

Wrist curls: Support your forearm on a table and stabilize your wrist with your other hand. Hold a 1 – 2 pound weight and bring your wrist up toward the ceiling and then back down. Now turn your palm up and once again bend your wrist toward the ceiling. Do 10 times/ 3 sets. Increase in 1/2 pound increments.

Broom – Handle Exercise: Take a stick and hang a 1 – 2 pound weight from a string to the stick. Keep the arms held out in front, with the palms down and attempt to roll the weight up and then back down. Repeat with palms up. Do 10 times/3 sets.

Call to set up a free appointment if you would like to attend this free Tennis Screening at Ivyrehab Jefferson Valley (914) 245-8807 on February 23, 2016 from 7:15-7:45 PM. In addition, if you would like to be seen right away for an injury or chronic pain under Direct Access (no prescription is required), contact us at or Ivyrehab Jefferson Valley (914) 245-8807 or Ivyrehab Briarcliff at (914) 762-2222. You can also visit our website at www.ivyrehab.com.

Ivyrehab accepts most insurance plans (which our office obtains pre-approval from your insurance carrier) and will submit your office visit treatments for payment. You will be responsible for your co-payment depending on your particular insurance policy.

With one-on-one care this permits the therapist to construct a personalized program for the individual. After all, when it comes to rehabilitation, “it’s all about the people”.


Free Sport Readiness and Injury Prevention Screening
Location: Inside Ivyrehab Jefferson Valley
February 23, 2016 at 7:15 -7:45 PM with Deborah Cohen, MSPT

Ivy Rehab

Prevention of Golf-Related Injuries

Meryle Richman, PT, DPT, MS, Senior Director of Ivyrehab Briarcliff and Jefferson Valley

“Golf is a game now enjoyed by over 29.3 million golfers of all ages, shapes, and levels of physical fitness”. Although most people would agree that golf is not a rigorous sport, there is a wide range of musculoskeletal ailments associated with the full golf swing. Contrary to the slow nature of the game, the explosive action of the full swing places significant stress on shoulder, elbow, and wrist joints as well as producing high torque forces on the low back and hip structures.

Golfers of all levels could benefit from an effective golf-training program that serves a dual purpose of improving performance and reducing the risk for injury. Golfers have learned that it is much easier to make a mechanically correct swing when the body is strong and flexible. Golf fitness should include three major components: (1) maintaining and improving flexibility, (2) improving golf specific strength, and (3) improving postural balance and stability.

Flexibility & Strengthening Exercises:

Pre-season is a good time to begin a generalized stretching and strengthening program for your neck, back and extremities. For example, increasing joint flexibility can lengthen your swing; thus increasing the club head speed and result in longer shots. Increasing golf specific muscle strength requires an integrated, multi-joint strengthening program to allow for coordinated actions of major muscle groups of different body segments. The golf swing can also inherently create postural imbalances, which can lead to injury.

The most common injuries are discussed with stretching and exercise tips can help to prevent or reduce pain and/or injuries resulting from the repetitive nature of the golf swing coupled with the high velocity forces:

(1) Medial epicondylitis, or “golfer’s elbow”:
This ailment involves increased inflammation and pain on the inside of the right elbow (for right-handed golfers). Exercise Tip: A proper conditioning program will include wrist flexion/extension and supination/pronation (rotation of wrist clockwise and counter-clockwise) strengthening and stretching.

(2) Shoulder tendonitis, or “rotator cuff tendonitis”:

This can be a chronic problem for those with tight shoulder internal/external rotators and weak shoulder girdle stabilizers. Exercise Tip: The golfer who has concentrated his efforts in developing maximum strength and flexibility of the levator scapulae, rhomboids, sternocleidomastoid, rotator cuff muscles, and trapezius muscles will enjoy the greatest success.

(3) Low back pain:
This can affect most golfers at one time or another. The golf swing combines “unnatural” spinal movements of bending forward, bending backward, bending sideways, and rotating. Exercise Tip: A preventative-conditioning program will incorporate multi-directional stretching and strengthening 2-3 times a week with an 8-minute warm-up routine before playing. For example, a before round warm-up exercise routine would include knee to chest, modified squats, back extensions, shoulder stretch, and low back/neck rotations and sidebands. All exercises would be done in sets of five performed in a smooth, controlled manner.

(4) Neck Pain:
One important aspect often overlooked when striving for the pain free neck is unrestricted cervical spine rotation. The ability to “retract” your neck (or slightly tucking your chin) and fully rotate your chin to the left is necessary to achieve a good “top of back swing position” (for the right-handed golfer). Any limitation in flexibility in either plane of motion can cause muscle strain/or nerve pinching. The shearing and rotational stresses occurring at the lower neck at the top of backswing will be minimized with good muscle flexibility. Exercise Tip: Gentle rotation and side bending neck stretches done two times daily for duration of twenty seconds each will help eliminate pain and restriction.

Another reason for neck pain is mechanical in nature, often caused by overstretching of ligaments due to postural stresses. The golfer who spends countless hours practicing with the head in a forward, protruded position will always be at high risk to develop cervical (neck) pain. The walker versus the cart rider has far greater neck support as the postural muscles hold the head directly over the vertebral column, receiving maximum muscle support. The golf cart rider sits and relaxes in a cart approximately 75 times during a round. Exercise Tip: To avoid and minimize the forward head position, slightly tuck the chin and do this 2-3 times and hold for several seconds, while sitting in the golf cart.

Posture awareness and physical preparedness are key elements to pain free golf. If you have questions concerning screening examination or treatment of golf-related injuries feel free to contact our office and speak to a physical therapist.

Call to set up a free appointment if you would like to attend this free Golf Fitness Screening located inside Ivyrehab Briarcliff at (914)762-2222. In addition, if you would like to be seen right away for an injury or chronic pain under Direct Access (no prescription required), contact us at Ivyrehab Briarcliff at (914) 762-2222; or Ivyrehab Jefferson Valley at (914) 245-8807. You can also visit our website at www.ivyrehab.com.

Ivyrehab accepts most insurance plans (which our office obtains pre-approval from your insurance carrier) and will submit your office visit treatments for payment. You will be responsible for your co-payment depending on your particular insurance policy.

With one-on-one care this permits the therapist to construct a personalized program for the individual. After all, when it comes to rehabilitation, “it’s all about the people”.

References:
1) http://www.statista.com/statistics/227420/number-of-golfers-usa/
2) Batt, M., A Survey of Golf Injuries, British Journal of Sports Medicine 63-65, 1992
3) www.livestrong.com

Free Golf Screenings held inside Ivyrehab Briarcliff with Brian McLean, DPT, Director:
Monday, March 7, 2016 4:00- 7:00 PM
Tuesday March 8, 2016 9:00-11:00 AM
Wednesday, March 9, 2016 4:00-7:00 PM

Ivy Rehab

Stretch Your Way Into Wellness

by Meryle Richman, PT, DPT, MS, CST, RYT

According to the Mayo Clinic, although studies have shown that the benefits of stretching are mixed, stretching has great benefits. Stretching can help you improve your joint range of motion, which in turn may help improve your athletic performance, decrease your risk of injury, improve flexibility and increase the blood flow to your muscles. Understand and learn how to stretch safely by using proper techniques.

Here are some tips to know about stretching:

How long?

– Hold the stretch 15 to 30 seconds is ideal
– Repeat 3 to 5 repetitions each time

How?

– Gentle
– Sustained
– No bouncing
– Slow
– Use proper posture/technique

REMEMBER TO BREATHE while stretching!

Stretch with Caution!

In some cases, you may need to approach stretching with caution. If you have a chronic condition or an injury, you may need to adjust your stretching techniques. For example, if you already have a strained muscle, stretching it may cause further harm. Also, don’t think that because you stretch you can’t get injured.

If you would like to learn more about stretching stop by Physical Therapy at Briarcliff (914)762 – 2222 or Physical therapy at Jefferson (914) 245 – 8807 or visit our website at www.ptrehab.com.

Ivy Rehab
Stretch Your Way into Wellness. FREE presentation by Jacek Golis, M.S.P.T. 10:30 am–11:00 am. Sign up in IvyRehab office. 914-245-8807.

Mayo Clinic: the art of stretching