Are you in pain? Physical Therapy can help.

National Physical Therapy Month is an opportunity for BaySport to recognize physical therapy as an ideal solution to manage pain caused by an injury and get the patient back to work or play in a timely manner. Our licensed physical therapists have a common goal: to provide individual attention and quickly get the
patient back to optimum health and function. “Treating the cause of the pain can accelerate the healing process as opposed to simply treating the symptom“ says, Daniel Alvarez, D.P.T. “We spend one-on- one time with the patient to learn their history, concerns and goals for recovery.”

The American Physical Therapy Association (APTA) states the following advantages for working with a physical therapist to reduce pain:

Exercise – You can lessen the chronic widespread of pain by 28%, if you exercise more than 3 times per week.

Manual Therapy: From carpal tunnel syndrome to low back pain, this type of care can effectively reduce your pain and improve your movement.

Education: Physical Therapists will hep you to understand your pain history, and help set realistic expectations about your treatment.

Teamwork: Your Physical Therapist is able to directly work with you and assess how your pain responds to treatment.

If you’re in pain from an injury or have ongoing pain and you don’t know why, give us a call and schedule a complimentary injury assessment. You will have one-on- one time with a physical therapist to assess your injury. BaySport Physical Therapy Clinics are conveniently located near highways in Los Gatos, Santa Clara and Redwood Shores within facilities that provide top of the line fitness equipment, locker rooms, showers, and aqua therapy.

For more information about our physical therapy programs and to learn more about BaySport services, go to www.baysport.com or call (408) 395-7300.

Your Body Before and After Baby

By Tegan Johnson-Galvez, DPT, CCI, CSCS and Amy Lee, SPT

With pregnancy, women experience many changes to her body whether it’s physically or physiologically. For example, with approximately 25-30 lb. weight gain, the female body begins to produce various pregnancy hormones, such as the relaxin. Relaxin increases the elasticity of ligaments around the pelvic as well as other areas to accommodate for the pregnancy. As the women enter further into her trimester, their center of gravity shifts which can cause an increase in the lower back curve thus putting excessive strain on the sacroiliac joints and ligaments. Generally, our sacroiliac joints are very stable but the shift in the body’s center as well as the production of pregnancy hormones can alter the laxity of the joints causing pain.

Diastasis Rectus Abdominis
Another common occurring during pregnancy is Diastasis Rectus Abdominis (DRA). Rectus abdominis is a muscle in our body that attaches from our sternum and rib cage all the way down to our pubic bone. DRA is the separation of the rectus abdominis at the midline which is not an indication of a muscle tear nor a lesion. It is simply a separation of the connective tissue fibers that are able to come back together. You can check the width of separation by placing your fingers 4 cm from the belly button. Lift your head and if the width is two fingers or less, it is normal.

Exercise During Pregnancy
Exercise is an important component during pregnancy. According to Department of Health and Human Services, 50 minutes of exercise is recommended with moderate intensity. There is no heart rate restriction but it is not the time to pick up new cardio program. It is advised to avoid supine exercises during the first trimester due to the possible pressure of the enlarged uterus and the fetus on the inferior vena cava.

Examples of exercises you can perform are:

❏ Squats with variation
❏ You can hold a dumbbell for weighted intensity

 

 


 

❏ Lean on a swiss ball against the wall to go into a squat
*Use the counter for assistance as you progress through your pregnancy

 


❏ Bridges
*Keep the core engaged
*Lower yourself slowly so that your bottom is last to touch

 


❏ Standing Rows with Resistance Band

 

 

 



❏ Abdominal Crunch
❏ You may “splint” the abdominal wall with a towel to provide additional support to the linea alba to prevent further diastasis rectus abdominis.

 


Remember to stretch throughout your pregnancy in addition to the above exercises.

Post Natal Exercise
Wait approximately 6-8 weeks before returning to exercise after pregnancy. You can start pelvic floor exercises immediately to help prevent stress incontinence (ie. kegels exercise). Pregnancy hormones affect you over 6 months after birth, so avoid high impact exercise during this period.

Post-Natal Ergonomics
It is important to maintain good body mechanics and posture during and even after pregnancy to prevent injuries. Here are several tips regarding post-natal ergonomics:

Carrying the Baby
❏ Carry the baby at the center of your body
❏ Helps keep your center of balance
❏ Reduces strain on your back
❏ Do NOT carry your baby on your side with your hips out

Diapering/Bathing
❏ Table height should be slightly below elbows
❏ Place all necessary diaper materials within arm’s reach
❏ Place one leg on stool to relieve strain on low back

Car Seat Carry
❏ Always use two hands
❏ Keep infant carrier close to body
❏ Prop one foot on the floor of the car to reduce reaching
❏ For large vehicle, prop knee onto seat
❏ Brace abdominal muscle!!
❏ Don’t bend or twist spine too much

Pushing Stroller
❏ Adjustable handles are recommended
❏ Elbows slightly bent and shoulders relaxed
❏ Keep wrist straight
❏ Pull shoulders down and back
❏ Lead with chest with stroller close to body

Blocked Milk Ducts
When milk gets backed up, the duct can become swollen and inflamed causing a blockage. It may typically mean the breasts are not getting emptied regularly. If you are also stressed, it can lead to decreased production of oxytocin which is what helps produce milk.

Typical signs:
❏ Small, hard lump that are sore/tender to touch
❏ Redness
❏ Relief of symptoms after breast feeding
You can treat this through frequent pumping, breast massage, anti-inflammatory meds, or contacting your local lactation specialist at: www.ilca.org/home

About the Author:

Tegan encourages her patients to incorporate their rehabilitation and fitness goals into their daily activities. Tegan uses a multitude of treatment techniques including but not limited to manual therapy, Pilates-based exercise, therapeutic exercise, manual lymphatic drainage, multi-layered bandaging, taping techniques, custom orthotic evaluation, habituation exercises, gait training, sports specific injury prevention, and postural education. At home, Tegan is a wife and mother of three very active and healthy children.

Specialties include: General Orthopedic, TMJ Dysfunction, Vestibular and Lymphedema Care.

Professional Honors and Credentials: Credentialed Clinical Instructor, Member of the American Physical Therapy Association (APTA)

Amy is a student at University of St. Augustine in San Marcos, CA who will be receiving her Doctorate of Physical Therapy in Dec of 2017. During her time in school, she worked as a student physical therapist in various rehabilitation settings including skilled nursing facility, workers’ compensation, and an outpatient orhopedic. When she is not busy studying for school, she enjoys outdoor rock climbing and looking up new recipes for baking.

Concussion Awareness: Recognition and Treatment

By Michael Marcello, DPT 
The start of fall brings on the start of a new school year and student athletes are returning to the classroom and field. Student athletes from all sports are susceptible to sustaining a concussion and it is important for parents, coaches and those close to the student athlete to be aware of the signs and symptoms of a concussion.
What is a concussion:
A concussion is a form of traumatic brain injury caused by a direct trauma to the head, neck or face. A concussion can cause physiological effects on the brain that can prompt short or long terms physical, cognitive and behavioral symptoms. As no two concussions are exactly the same, people can experience varied symptoms such as:
1. Headaches
2. Light-headness
3. Nausea
4. Dizziness
5. Mental fatigue
6. Fogginess
Other associated symptoms are behavioral changes, stimuli sensitivity, sleep pattern disruption (increased and/or decreased), blurred vision, balance challenges, and seizures.

According to moveforwardPT.com, symptoms can progress and lead to post-concussion syndrome and/or second-impact syndrome. Post-concussion syndrome refers to headaches and/or dizziness that persists for weeks to months after injury. Second-impact syndrome refers to sustaining another concussion after the initial concussion has yet to resolve. The Second-impact syndrome can prompt significant brain damage and potentially cause death if the student
athlete is allowed to return to sport prior to a full resolution of symptoms.

What screening can be performed?
With concussions, there is no single test that can be performed to diagnose a concussion and its severity. Suspected concussions are primarily screened by a healthcare provider like a medical doctor. Diagnostic imaging like a CT scan and MRI will not show significant abnormalities and thus may not be efficacious.

What to do if a student athlete sustained a concussion?
If a student athlete is suspected to have sustained a concussion, remove them from participation immediately. Once removed from sport, the student athlete should be allowed to rest and recover until a full resolution of symptoms occurs. Rest can involve longer sleep, more naps and decreasing cognitive demand and stimuli (less TV/phone/computer time).

Can physical therapy help with concussions?
Physical therapists can help in addressing a student athlete’s concussion symptoms in several ways.

If balance deficits and dizziness is significant, seeing a vestibular physical therapist will be the first option. A vestibular physical therapist knows how to address the vestibular system (the inner ear and balance) and its ability to regulate balance and decrease dizziness. This will include balance exercises and formal techniques that can be performed at home.

Once the vestibular symptoms have improved, seeing a physical therapist that has treated patients with concussions is appropriate. A physical therapist will help manage headaches and improve neck pain that can be associated with a concussion. This is achieved with strength and endurance exercises and providing  patient education.

A student athlete can also progress through a concussion exertional physical therapy protocol in order to return to sport. An exertional physical therapy program is a 5 stage protocol that will appropriately acclimate and de-sensisitize a student athlete to their symptoms with sport specific exercises and drills. Return to sport will be decided by the medical doctor after reviewing tolerance and progress with exertional physical therapy.

Concussions can be fatal or can result in permanent brain damage. Seek medical help from a licensed health care provider following any suspected head injury.

Resources:

Mucha, A., and the APTA Neurology Section. A Physical Therapist’s Guide to Concussions.
Retrieved from http://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=4f2ebb00-f1c0-4691-b2ab- 742df8dffb99#.VFEjy2fII9Q on September 26,2017.

About the Author:

Michael Marcello earned his Bachelor of Science degree in Kinesiology at San Jose State University and his Doctorate in Physical Therapy at the University of the Pacific in Stockton. Michael is experienced in sports medicine, orthopedics, and concussion exertional physical therapy. Michael appreciates and utilizes current evidence-based treatment/interventions, continuing education courses and exercise to promote optimal function and performance. Michael, a Bay Area native, enjoys exercising, watching sports and spending time with his family and friends. Michael is a 49ers, Giants, Warriors and Sharks fan as well.