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

Which Athletic Shoe Should I Buy?

Meryle Richman, PT, DPT, MS, CST, RYT
Senior Director at Ivyrehab Briarcliff and Ivyrehab Jefferson Valley

Buying an athletic shoe involves multiple considerations!

It is important to wear proper footwear to avoid ankle and foot pain or injury. Factors that should be considered in determining which shoe is right for you include:

The activities that will be performed, the construction of the shoe, what surfaces you will be on and the type of foot you have. Each sport or activity involves different movements or jumping and shoes are designed to fit the activity. Running, for instance, primarily involves movement in a straight line. Basketball and aerobics involve jumping and time spent on the forefoot. For example, playing tennis which involves side – to – side movements in a shoe with supports for straight movement could result in an ankle sprain. In addition, if you are involved in weight training activities for the lower extremities, wear different shoes than you use for impact sports. The extra weight from training compresses the cushioning and affects the shock absorption of the shoe. Cross trainers should only be used for short distance running (less than two miles). Some activities are similar so it may not be necessary to buy different shoes for each activity.

Uneven surfaces cause increased movement in the foot and ankle. This makes the ankle joint and the foot more vulnerable to injury. For example, running on rough terrain calls for an athletic shoe that is wider. This increases medial and lateral stability and decreases the risk for ankle injury.

Important tips to know before purchasing an athletic shoe:

● It is important to evaluate shoe construction prior to making a purchase

● Bend the shoe from toe to heel. It should not bend in places that your foot does not. In addition, if you push it down, it should not rock

● Place the shoes down and look at them from behind to assure the shoes are symmetrical

●You should also check wear patterns because this will tell you when to buy a new shoe

● There are 2 basic foot types: pronators and supinators:
(a) Pronator type foot is: limited big toe mobility, a heel that appears to turn out and the inner border appears to flatten when stepping. This type of foot requires a” motion control” athletic shoe. These shoes have firmer heels and a straight seam down the middle of the sole.

(b) Supinator type foot is: high and rigid arches and a heel that turns to the inside. This type of foot requires a shoe with more cushioning especially if you plan on using it for running. The sole of the shoe usually has a curved seam down the middle.

In summary, no two feet are alike even on the same person. However, by using basic guidelines, you can reduce the risk of injury.

For a free 10 minute screening, contact Ivyrehab Briarcliff at (914) 762 – 2222 or Ivyrehab Jefferson Valley at (914) 245 – 8807. With Direct Access a prescription is not required to be evaluated and treated. Visit our Website: www.ivyrehab.com to learn more about Direct Access.

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References:

1. Athletic Footwear and Orthoses in Sports Medicine – INDER https://www.google.com/search?q=D.G.+Sharnoff+Matthew+B.+Werd%2C+%E2%80%8EE.+Leslie+Knight+-+2010+-+%E2%80%8EMedical&ie=utf-8&oe=utf-8

Who needs Back Exercises?

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

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

Prevent Skiing – Knee Injuries on the Slope

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

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.