The U.S. Men’s National Soccer Team forward Jozy Altidore suffered a left hamstring strain in USA’s 2-0 victory against Jamaica on June 19, leaving him on the sideline for the next 4-6 weeks. This injury can cause problems for the U.S. due to specific CONCACAF Gold Cup Tournament rules prohibiting replacing a player on the roster during competition.
A hamstring strain is caused by a tear in one or many of the upper leg muscles. There are three different grades of strains, which also come with their own pain levels. The first consists of minor tears in muscle, the second is a partial tear, and the third is a full rupture or rigorous tear in the muscle. There are many ways to treat this type of strain including active release technique, a patented soft tissue manual therapy technique which re-aligns the muscle fibers, stretching, and functional exercises. A physical therapist can also provide one with stretches and exercises to prevent a pulled muscle.
Here’s a short video on how to properly stretch your hamstrings to help prevent injury:
Almost everyone experiences a few seconds of dizziness at some point in their lives. According to the National Institute of Health, about 90 million Americans report bouts of dizziness. Of those, 76 million suffer from inner-ear disorders. People with vestibular (inner ear) disorders often experience problems with balance and dizziness. Other symptoms include nausea, headaches, difficulty concentrating, and a sensation of ear fullness. Often these symptoms may be bad enough to affect employment, hobbies and everyday life activities.
To keep our vision clear and our balance and walking steady, the brain gets information from our eyes, postural muscles and our inner ears. (a system known as the Vestibular System). Our two ears must work together; if they do not communicate correctly with the brain, it causes problems with your balance and vision. The ears and eyes also work together to keep our vision clear with movement. A problem with this reflex can cause vertigo (spinning) or dizziness while changing positions such as lying down or getting up.
Vestibular rehabilitation is a specialized form of therapy designed to help with all the symptoms related to this disorder. It can include everything from simple exercises, to specific motions targeted at retraining the vestibular system. Often times, with certain conditions, people feel better in just a few sessions if not directly after the first. Physical therapist specializing in this area can provide this type of treatment. Excelcurrently has three therapists in Cherry Hill, Phoenixville and Villanova who are trained in this type of rehab. If you or someone you know has any of the mentioned symptoms they can call 1-866-88EXCEL for a free consult.
Throughout the summer, people have a tendency to become more active outside due to the nice warm weather, allowing them to exercise while enjoying the outdoors. What people tend to forget is that they must prepare their bodies for the excess heat they don’t face during the winter and colder days of spring. This excess heat can be avoided and prevented if simple actions are taken before and after exercises. First, it is important to understand what can happen to you and what to look for if you don’t prepare your body for the heat.
If preparation for outdoor activities isn’t taken, there could be consequences such as heat exhaustion and heat stroke. It is important to know and understand the signs of these consequences so if they do occur, you can take the proper actions to avoid these concerns. Signs of heat exhaustion include general fatigue, weakness, nausea, dizziness, muscle cramps, and an increase in body temperature. Signs of heat stroke can include an inability to sweat, temperatures above 104, acute respiratory distress and loss of consciousness. Keep in mind that everyone is different, and it is your job to know when your body is being over used to the point where it can become dangerous to your health.
While there are signs to warn you that your body is being affected by the heat, there are precautions to take before exercising in the heat that can prevent damage to your body:
• The biggest concern about summer exercise is keeping your body hydrated. Water is the best fluid to drink to maintain hydration. Drinking 20 ounces of water two hours before exercising, 8 ounces right before going out into the heat, and gulps every 15-20 minutes should preserve your bodie’s hydration.
• Become accustomed to the heat before putting your body through vigorous exercise. Getting your body used to the heat by going outside regularly allows you to be familiar with the heat, putting less stress on your body.
• Be aware of the temperature outside. If it is hotter then you are used to, don’t feel the need to push yourself as if it was a cooler day. Slow down your pace if necessary, there’s nothing wrong with finishing a little later than usual.
• Proper clothing is also very important when preparing for exercise in the heat. Light colors to reflect the sun and lightweight, breathable fabrics that wick away sweat are best for exercising in heat. Applying sunscreen to exposed areas helps as well.
• Exercising early or late in the day can also help with keeping your body temperature down. Before 7 a.m. and after 6 p.m. are the best times to exercise outside because those time frames are the cooler parts of the day.
• Altering your exercise route to keep you in the shade and out of the sun can also help keep your body cool.
• Exercising with a partner is also a good idea because they can monitor your performance, so if you seem to be lagging behind or struggling they can inform you to slow down and/or rest.
• Stretching is also vital before exercising. Preparing your muscles for strenuous activity can prevent injury.
There are always different ways to make exercising more enjoyable. If you follow these tips for exercising in the heat, being out in the sun won’t affect your performance.
Spring has finally sprung! With the sunnier skies, warm-weather sports such as running are gearing up. People are out in droves trying to shed off the winter pounds and get into shape. Unfortunately, running and other fitness activities can bring on overuse injuries in people’s lower legs and ankles. Excel’s physical therapist, Joe Zazworskey, DPT, was recently interviewed by Advance, a physical therapy industry magazine regarding common ankle injuries he treats. Click here to read his and other therapists’ prospective on ankle injuries and learn how you can avoid them this season!
Spring is here which means spring cleaning, gardening and the urge to get fit for summer. Because of these activities, spring can also mean back pain. Eighty percent of Americans will suffer from back pain in their lifetime and according to the North American Spine Society, back pain costs Americans $80 billion annually!
Don039#t become a statistic: Poor posture, tight muscles and decreased motion of your spine can all be contributing factors to back pain, but the good news is that stretching and exercises designed to improve your posture can prevent the onset.
Work these simple stretches/exercises into your daily routine and you can land in the elite 20% who never suffer from back pain!
In 1997, Congress passed the Balanced Budget Act that created an annual financial limit in Medicare for physical therapy and speech language pathology services combined. For 2011, that “cap” is $1860. This means that Medicare will pay for a combination of out patient physical therapy and speech pathology services up to $1860 for the calendar year.
The cap covers a patient for an entire year. For example, a patient receiving PT for a knee replacement in February and a rotator cuff injury in September would be limited to a combined total of $1860 for both episodes of care.
This cap does not apply to hospital outpatient therapy departments.
The Exceptions Process
In 2006, Congress recognized the flaws in an arbitrary cap and authorized Medicare to allow “exceptions” for patients needing additional therapy based on diagnosis, clinician evaluation and judgment. Physical therapists are now able to get the cap lifted for patients who require physical therapy services in excess of the $1860 by using specific documentation.
Most patients do not exceed the cap for one episode of care, like the knee replacement example above. Generally, most cases of PT resolve in 10-12 visits and generate a claim to Medicare of much less than $1860. But some of the more complex cases can exceed the cap. Most often, patients exceed the cap when they have two or more episodes of care for different diagnoses in the same year. In these cases, the cap exceptions process assures patients have access to the care they need.
The cap exceptions process puts outpatient PT providers on an even playing field with hospital based PTs. Non hospital based PTs can exceed the cap for patients by use of the exceptions process. Needless to say, non hospital-based PTs were pleased when Congress enacted the cap exceptions process.
Final Comment
An arbitrary therapy cap on PT without regard to clinical appropriateness of care discriminates against vulnerable Medicare patients. The therapy cap reduces Medicare beneficiaries039# access to PT either by limiting their choice of providers or by forcing them to bear 100% of the cost of care once they exceed it, or rationing their care to avoid exhausting their benefits. The exceptions process option does offer some relief of this dilemma. Nonetheless, we are finding misunderstandings about the therapy cap and the exceptions process from patients, PTs and physicians. I hope this explanation has been helpful in clarifying the issue.
Feel free to contact me at any time if you have any questions about the therapy cap at jostrowski@excelphysicaltherapy.com.
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After-Hamstring-Injury.aspx
Almost everyone experiences a few seconds of dizziness at some point in their lives. According to the National Institute of Health, about 90 million Americans report bouts of dizziness. Of those, 76 million suffer from inner-ear disorders. People with vestibular (inner ear) disorders often experience problems with balance and dizziness. Other symptoms include nausea, headaches, difficulty concentrating, and a sensation of ear fullness. Often these symptoms may be bad enough to affect employment, hobbies and everyday life activities.
Throughout the summer, people have a tendency to become more active outside due to the nice warm weather, allowing them to exercise while enjoying the outdoors. What people tend to forget is that they must prepare their bodies for the excess heat they don’t face during the winter and colder days of spring. This excess heat can be avoided and prevented if simple actions are taken before and after exercises. First, it is important to understand what can happen to you and what to look for if you don’t prepare your body for the heat.
lightweight, breathable fabrics that wick away sweat are best for exercising in heat. Applying sunscreen to exposed areas helps as well.
• Altering your exercise route to keep you in the shade and out of the sun can also help keep your body cool.
In 1997, Congress passed the Balanced Budget Act that created an annual financial limit in Medicare for physical therapy and speech language pathology services combined. For 2011, that “cap” is $1860. This means that Medicare will pay for a combination of out patient physical therapy and speech pathology services up to $1860 for the calendar year.