Better Balance Now!

August 22, 2016 by Liz

Ivy Rehab
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:

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

2. Get a yearly eye exam

3. Proper nutrition and hydration

4. Know the side effects of your medication

5. 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:
Screen Shot 2016-08-22 at 10.31.08 AM

If you want to determine your fitness level, refer to the reference guide from The Centers for Disease Control and Prevention.

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

Better Balance Now

July 26, 2016 by Jacquie

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

Who needs Back Exercises?

June 1, 2016 by Liz

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

We all do- whether we have a healthy back or a problem with our back. In order for your back to stay healthy and less prone to injury, you need strong, flexible muscles to support the spine’s natural curves.

Why all the fuss about back problems?

Statistics have shown that backaches are second only to the common cold as a cause of missed workdays. It’s estimated that 8 out of 10 Americans will have a back problem at some time in their lives. A large part of this is due to the neglect of their backs. Back disorders are the accumulation of months or even years of poor posture, faulty body mechanics, stressful living and working habits, loss of flexibility as general lack of physical fitness.

A balanced back is a healthy back:

It is time to take a new look at the prevention of back injuries rather than the treatment of back problems after they have occurred.

Back problems can be avoided by understanding what the problems are, how to prevent them and what to do if they do occur. It involves self-responsibility and a desire to have a healthy back

Basic Anatomy:

In order for your back to be healthy, there are three natural curves that must be in balanced alignment. This should occur at all times i.e., sitting, standing, lying down or moving. These curves are the cervical (neck), thoracic (middle back), and lumbar (lower back).

When your ear, shoulder, and hips line up straight, then the three curves are balanced and you have achieved “good posture”. To test whether your curves are in their natural alignment, imagine a line beside the mid-part of your body. If your ears, shoulders, pelvis, knees and ankles line up on this line (plumb line), your three curves are in their correct position. In order to maintain a balanced back you must also have strong and flexible muscles and joints:

●Muscles: A healthy spine is supported by a strong and flexible back, abdominals, hip and leg muscles. Muscles that lack strength and flexibility cannot maintain your back’s natural curves, which can lead to back problems, and possibly injury.

●Joints: Strong and flexible hip, knee, ankle, and back joints help balance your back curves ad allow movement. Joints that lack strength and flexibility fail to support your spine, and this can also contribute to back problems.

Other important structures to understand about the back:

●Vertebrae and facet joints: the vertebrae (or bones) provide the structural support for your back. The facet joints, which are located on the outside of the vertebrae, control the amount and direction of movement.

●Ligaments: These are tough and non-elastic bands that hold the vertebrae together. They connect to the discs and vertebrae, lending support and stability to the spine.

●Disc: The discs act as shock absorbers and allow normal motion to take place. The center of the disc is jellylike and is composed of water and fluid. It is surrounded by tough rubber-like bands that are attached to the vertebrae.

●Nerves: Provides the energy to make the muscles work. Once the goals of a well back are achieved the individual should follow up with a regular exercise program that includes an aerobic activity, such as walking or swimming.

Here are some tips that will prevent low back pain or its recurrence:

● Always bend with the knees, not from the waist when lifting

● When sitting, place at least one knee higher than your hips; either by crossing your legs or putting your legs with knees bent, on something like a foot stool

● When standing place one foot on a stool to keep the back straight

● Standing is better than sitting, and lying down is better than either; sitting puts 40% more pressure on the discs than standing and 75% more than lying

● When driving adjust the seat so you can sit closer to the pedals with the knees bent and back supported

● Avoid exercises that put excessive strain on the lower back. These include straight leg exercise such as leg raises, toe touching, or sit-ups with the legs straight on floor

● Additional suggestions include: changing the type of chair used at work, taking exercise breaks to stretch tight muscles and finding ways to handle stress.

Learn how Physical Therapy at Ivyrehab can help you:

For those individuals that suffer from prolonged back pain, the first goal of physical therapy is to reduce pain. The next step is to determine which muscles are tight and need to be stretched and which muscle groups are weak and could be strengthened. An evaluation of the individual postural and work habits should then follow. Based on all this information, corrective measures, which are tailored to the individual can then be recommended.

Other physical therapy measures can consist of any one of a combination of moist heat, ice, modalities, aquatic therapy, soft tissue massage, mobilization, stretching and gradual core and strengthening exercises.

If you would like to be seen right away for learning how to set-up an exercise program, prevent an injury or chronic pain under Direct Access (no prescription is required), contact us at: 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. 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”.

Ivy Rehab

Reduce Your Risk of Osteoporosis: Learn Preventative Exercise Tips

May 19, 2016 by Liz

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

Osteoporosis is a disease affecting approximately 10 million men and women in America. It is the progressive loss of bone mineral density. With bone loss over time the bones become weak and brittle leading to the increased likelihood of fractures, and bone deformation. The cost to our nation’s economy can be as much as 13 billion dollars per year in lost productivity and health care costs.

Who is at Risk for Osteoporosis?

Eighty percent of those with Osteoporosis are women. Women over 65 years of age are at much greater risk than men for Osteoporosis. Anyone diagnosed with Osteopenia, low bone density and a precursor to Osteoporosis is at greater risk. Other risk factors include women who are white or Asian, postmenopausal, cigarette smoking, sedentary lifestyle and some medication. Also women who have had long-term menstrual problems or have mineral absorption problems may also be at risk.

What can happen if you have Osteoporosis?

Osteoporosis causes a hunched forward posture and the formation of a hump, in the middle back and decreasing height. Poor posture and muscle tension due to the hunched posture can contribute to the increase of falling because the person’s center of gravity is shifted forward. Weak and brittle bones increase the likelihood of fracture during falls or fractures of the spine.

Some symptoms that may be caused by Osteoporosis include back pain, poor posture, lost height and decreased mobility. Anyone over 65 or postmenopausal women should be screened for osteoporosis even if symptoms are not present. Doctors will perform bone density scans to rate the persons bone density and determine their diagnosis based on that scan.

Tips on how Physical Therapy can help Osteoporosis:

1. Physical therapy can be utilized to manage to progression of Osteopenia, Osteoporosis and their symptoms. The patient’s goals include prevention of bone loss and increasing bone density.

2. According to the American Physical Therapy Association (APTA), “The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits”.

3. Avoid exercises and daily activities which round the spine, such as sit-ups, crunches, bending down to tie your shoes, certain exercise machines that involve forward bending of the trunk, and even movements and sports that round and twist the spine. Instead, hinge forward from your hips, while keeping your back straight.

4. Practice balance exercises (even at a wall or holding on) to reduce falls and resulting fractures. An individualized program may include a walking regimen, Tai Chi, yoga, Pilates and other exercises geared toward conditioning, balance, and coordination.

5. The APTA recommends: Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:
– Keep your back, stomach, and leg muscles strong and flexible.
– Do not slouch.
– Use good body positioning at work, home, or during leisure activities.
– Ask for help when lifting heavy objects.
– Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.

6. Always consult with your physician or physical therapist before beginning an exercise program, if you have osteoporosis, are at high risk for a fall, fracture, or have a medical condition that might affect your ability to exercise.

If you would like to be seen right away for learning how to set-up an exercise program, prevent an injury or chronic pain under Direct Access (no prescription is required), contact us 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. National OP foundation, www.nof.org/osteoporosis.
2. Meeks, Sara Walk Tall. Triad Publishing Company (FL); 1st edition (June 15, 1999).
3. Bassey E. Joan, Exercise for prevention of osteoporotic fracture. Age and Aging. Nov. 2001: 29-31.
4. Rahmani, Poupak, Morin, Suzanne. Prevention of osteoporosis-related fractures among post menopausal women and older men. CMAJ. 2009:181; 815-820.
5. American Physical Therapy Association, Bone Health.http://www.moveforwardpt.com/Resources/Detail/bone-health-2

Prevention Tips for Soccer Injuries

February 18, 2016 by Liz

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

February 11, 2016 by Liz

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 Tips for Tennis Injuries

January 28, 2016 by Liz

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”.

Ivy Rehab

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

Prevent Skiing – Knee Injuries on the Slope

January 19, 2016 by Liz

Screen Shot 2016-01-19 at 12.37.05 PMBY: Meryle Richman, PT, DPT, Senior Director of Ivyrehab Briarcliff and Jefferson Valley

As the cold weather approaches, many of us turn out thoughts and energy to the ski slopes. With this ever increasing interest, we gathered information to enhance conditioning for downhill skiing to help prevent common knee injuries.

The most common skiing injuries that occur in the lower limb, as a result of collisions and falls, are knee sprains/tears, which include Medial Collateral Ligament (MCL) and Anterior Cruciate Ligament (ACL) sprains/tears. With new advances in ski equipment today such as releasable bindings, the statistics have changed to decreasing leg fractures to 90% and 30% for knee injuries.

According to the American Physical Therapy Association, (http://www.moveforwardpt.com/resources), (1) Medial Collateral Ligament (MCL) injuries are more common in the beginner and intermediate skier when the ski tips are pointed towards one another in a snow plow positon, when the skier is trying to slow down or stop.

Prevention Tips for MCL injuries:
● Make sure your weight is balance when you are in a snowplow position
● Stay on comfortable terrain

(2) Anterior Cruciate Ligament (ACL) injuries occur when the skier lands from a jump with their weight back on the boot. This causes a significant force on the back of the boot and the force pushes on the calf, which results in spraining or tearing the ACL

● Another common ACL tear is the “phantom foot” phenomenon. This occurs when the skier tries to stand up in order to prevent a fall. All the weight goes on the outside of one ski, and the arms and trunk rotates away from that leg.

Prevention Tips for ACL Injuries:
● Land safely with your weight forward. Start with simple jumps and gradually advance to more difficult jumps

● Do not try to stand up and go with the momentum of the fall and maintain good ski technique

Tips for Preparing for the slopes:

1. Make sure you have the proper equipment and take a skiing lesson if you have not skied in a while. Prepare yourself to three to four weeks before you go skiing with the recommended flexibility, strengthening and endurance program recommended below:

2. A safe and enjoyable ski season begins with a pre-slope program designed to promote adequate flexibility, strength and endurance. The scope of the conditioning program is dependent upon the physical condition of each individual.

Flexibility is among the most vital components of an effective conditioning program. Primary consideration should be given to maximizing the flexibility of the quadriceps, hamstrings, gastrocnemius, soleus, trunk rotators, shoulder girdle and low back musculature. Long, slow static stretching of these muscle groups is recommended.

Strength is another consideration. The quadriceps muscle group is of primary concern to the heavy demand placed on it when downhill skiing. Strengthening of the gluteals, hip adductors and the arms are also recommended. Inadequate strength affects ski technique and increases injury risk.

Endurance should also be addressed in a ski conditioning program. As with the other components of strength and flexibility, the amount of endurance training is relative to the fitness level of the individual. One can choose from running, swimming, cycling, rowing and Elliptical trainer. Endurance workouts may also incorporate a plan that strengthens the muscles used in skiing, as well as increasing endurance. Examples of ski- oriented training are: traverse running; box jumping.

Skiers should also prepare themselves with an adequate warm-up of stretching the upper extremities and the back before getting the skis on in the morning and can even include jumping jacks or jogging in place. Due to the nature of the physical demands of the sport, a run or two on an easier slope is recommended as a final warm-up.

Fatigue is inherent in a full day of skiing. Studies have shown that injury rates are increased toward the end of the day. Beginners should consider skiing a half day until their endurance improves. Care should be taken to monitor physical status and pacing your runs on the slopes with adequate food and water breaks in order to have a safe day.

Recommended Flexibility Program:
• Standing quadriceps stretch – pull heel toward buttock until a stretch is felt in front of thigh, hold 30seconds, repeat on opposite side.

• Standing hamstring stretch – Place heel on a bench. Slowly lean forward reaching down towards your shin until a stretch is felt at the back of the thigh. Keep the knee straight and back straight, hold 30 seconds, repeat on opposite side.

• Calf stretch – Keeping back leg straight, with heel on floor and turned slightly outward, lean into wall until a stretch is felt in calf, hold 30 seconds, repeat on opposite side.

• Standing trunk rotation stretch – Turn shoulders to one side while keeping hips forward, hold 30 seconds, repeat on opposite side.

• Standing trunk lateral flexion stretch – Reach over and upward while sliding opposite arm down leg, hold 30 seconds, repeat on opposite side.

Recommended Strengthening Exercises:

• Circuit training

• Free weights

• Isometric strengthening in the “downhill position”

Have fun on the slopes!
Ivy Rehab

National Physical Therapy Month is Celebrating Healthy Aging

September 21, 2015 by Liz

By Meryle Richman, PT, DPT, Senior Director
Screen Shot 2015-09-21 at 11.03.49 AM

National Physical Therapy Month (NPTM) is hosted by The American Physical Therapy Association (APTA) each October to recognize how Physical Therapists help transform society by restoring and improving motion in people’s lives. This October the focus is on Health Aging.

As movement experts, the goal of the Physical Therapists at IvyRehab Briarcliff and IvyRehab Jefferson Valley, which are now located inside Club Fit, will be offering free 10 minute screenings and advice to its’ club members to overcome pain, gain and maintain movement, and preserve their independence-without the need, in many cases, for surgery or long-term prescription drug use.

If treatment is required individuals now have the opportunity under the Direct Access Law in New York State to be evaluated and treated without a prescription for 10 visits or treatment within 30 days before seeing their physician.

Exercise may be the closest thing we have to the fountain of youth. The right type and amount of it, prescribed by a physical therapist, can help prevent or manage many age-related health conditions.

Stop by the lobby at Club Fit Briarcliff on the following days/times to learn tips on aging well and about Direct Access. You can also sign up for a 10 minute free screening for sports, balance and/or spinal screening by our Licensed Physical

Therapist:
10/05/15 9:00 – 10:30 AM (Monday) Meryle Richman, PT, DPT, Senior Director
10/15/15 8:30 – 10:00 AM (Thursday) Meryle Richman, PT, DPT, Senior Director
10/19/15 9:00 – 10:30 AM (Monday) Meryle Richman, PT, DPT, Senior Director
10/29/15 5:00 – 6:00 PM (Thursday) meet our NEW Director Brian McLean, DPT

OR Stop by the lobby at Club Fit Jefferson Valley:
10/01/15 7:30 – 8:30 AM (Thursday) Jacek Golis, PT
10/06/15 9:00 – 10:00 AM (Tuesday) Meryle Richman, PT, DPT, Senior Director
10/12/15 9:00 – 10:30 AM (Monday) Meryle Richman, PT, DPT, Senior Director
10/22/15 4:00 – 5:00 PM (Thursday) Deborah Lenihan, PT, Director
10/26/15 9:00 – 10:30 AM (Monday) Meryle Richman, PT, DPT, Senior Director

At either location fill out a free raffle and win a chance for a free gift ($75.00 Basket/gift card), when you stop by to say hello and learn more about how the staff at IvyRehab can help you. Any questions please contact us at IvyRehab Briarcliff (914) 762 -2222 or IvyRehab Jefferson Valley (914) 245 – 8807. Visit our website at www.ivyrehab.com.