All posts by Excel Physical Therapy

Physical Activity Improves Your Health

Video March 1, 2021 Excel Physical Therapy Leave a comment

APTA’s New ChoosePT Public Service Announcement Delivers the Movement Message.

The spot, to be distributed nationwide, is a call to increase physical activity—and seek PTs to help improve and restore movement. “It’s time to move, and keep moving, America — wherever you are, however you can.” That’s one of the key messages in APTA’s new ChoosePT public service announcement, which was unveiled online today and will be released to TV and radio stations nationwide.

Physical inactivity is a national health crisis. COVID-19 didn’t help.

It’s time to move more, wherever you are, however you can.

Better health is within your reach. Regular physical activity is one of the best things you can do for your health.

Whatever barriers prevent you from enjoying the many critical health benefits of physical activity, our physical therapists will partner with you to get you moving.

Choose more movement. Choose better health. Choose physical therapy.

You don’t need a referral to see a physical therapist. Call (866) 883-9235 or contact one of our physical therapists to get an evaluation and treatment that’s specific to you.

News

Avoiding Shoulder Injuries in Baseball

February 26, 2021 Excel Physical Therapy Leave a comment

Shoulder and elbow injuries are common in baseball players of all ages, however, this is increasingly common as youth players become more specialized and more competitive at earlier ages. Additionally, players may not have access to the same level of training that they usually would due to the COVID-19 pandemic.

Shoulder and elbow injuries can occur at the beginning of a season due to inadequate preparation during pre-season training. More often, however, injuries occur later in the season simply due to too much throwing without enough rest. The most common throwing-related injuries are muscle strains, biceps tendinopathies and labral tears of the shoulder, and ligament sprains or tears of the elbow (think Tommy John surgery).

Increased injury risk in baseball players is associated with increased throwing volume, not enough rest, increased pitching velocity, poor throwing mechanics, and poor conditioning.

You can reduce your injury risk by keeping these general guidelines in mind:

Participate in an off-season training regimen. This may include cardiovascular conditioning, mobility training, core strengthening, and weight/resistance training with a focus on the musculature involved in throwing.
Heavy weight-training should be avoided in the upper extremities, however, leaving the heavier weights for the legs.
Adequate time off from throwing between seasons is crucial to allow for the tendons, ligaments, and muscles of the arm to fully recover. A minimum of 4 months off from throwing per year is recommended for youth players, with 2-3 of those months being consecutive (MLB.com).
Monitor and limit pitch count. This becomes even more critical to a player’s health when they are playing for multiple teams as coaches may not always be on the same page. MLB.com is a great resource with detailed pitch count limits for each age group.
Allow for adequate warm-up prior to any bout of pitching or throwing. This may include, but is not limited to, a cardiovascular warm-up, dynamic mobility/stretching, and the use of light to moderate strength resistance bands to “prime” the musculature of the shoulder.

To summarize, the number one reason for injury is fatigue and overuse. This can be too many pitches in one game, not enough days off between throwing, or too many innings in one year.

Additionally, while much of the focus lies on the shoulder and elbow in baseball players, it is also critically important to address deficiencies throughout the rest of the body. In addition to assessing for weakness or inadequate range of motion of the shoulder, players should be assessed for adequate mobility and strength of the spine, trunk, hips, and ankles. If there are deficiencies in one or more areas of the body, they can contribute to pain, injury, and reduced performance of the throwing shoulder and arm. Working on sound throwing mechanics is essential as well, but one should use caution when attempting to drastically change a player’s throwing mechanics in-season.

Prior to the season, consulting with a physical therapist with knowledge of throwing mechanics may be beneficial. Additionally, if a player starts to feel any pain that does not go away with rest, a physical therapist may be able to help not only reduce the pain but also determine the root cause of the injury in order to prevent recurrence or a new injury in the future.

By Daniel Johnson, PT, DPT, Excel Physical Therapy Southampton

Health, News

Medical mystery: What was causing woman’s chronic hip pain?

February 15, 2021 Excel Physical Therapy Leave a comment

Brian Warenius, PT, DPT, COMT, CSCS, Clinic Director in Blue Bell was recently interviewed for an article in The Philadelphia Inquirer about a woman’s chronic hip pain diagnosis. “This case was a good reminder that it’s important to look beyond the site of pain when diagnosing and treating the body.

To ensure that the patient would be able to remain pain-free, I reached out to Brian Warenius, clinic director of Excel Physical Therapy in Blue Bell, for help. In non-traumatic injuries, most symptoms initially come on because the patient had developed a bad habit or some type of weakness in the area. Until these issues are addressed, the patient will often get temporary relief but have a flare-up a few months later.

Warenius said there are two simple and safe exercises that a patient can perform to strengthen and stabilize the back and hip.”

Read the full Inquirer story, here.

Uncategorized

What is Graston Technique?

February 5, 2021 Excel Physical Therapy Leave a comment

How the Graston Technique Can Help You Feel Your Best

Graston technique is a form of Instrument-Assisted Soft Tissue Mobilization (IASTM) often used by physical therapists when treating injuries involving soft tissue damage, including muscles and tendons.

How does it work?

There are 6 different Graston tools in a variety of shapes to help treat different areas of the body based on tissue composition. The instruments are very helpful compared to using the clinician’s hands because they can help detect abnormal tissue textures or bumps that are present in muscles. This can help the physical therapist better detect the problem area and also help the patient to recognize areas that are contributing to their pain.

How does it Help?
IASTM is often used to help treat inflamed tendons or fascia from overuse injuries, areas that are painful from sprains, areas that are tight from surgical scars, or areas that are causing nerves to be entrapped. This includes commonly known injuries such as tennis elbow, Achilles pain, plantar fasciitis, ankle sprains, and carpal tunnel, just to name a few.

In addition to helping find the areas that feel abnormal, there are many scientific reasons that IASTM is beneficial. IASTM has been proven to increase the activity of fibroblasts which are the cells that help produce collagen which makes up connective tissues, facilitating the healing of injured tissues. Additionally, the pressure applied when using IASTM causes the cells to respond and communicate more – the pressure to the area helps to increase blood flow which helps to increase the healing process.

The increased blood flow from IASTM can immediately provide temporary pain relief as well as improve the flexibility of the area. This then allows the patient to complete exercises or stretches with diminished or abolished pain as well as through an increased range of motion which can help improve recovery time.

Is the Graston technique right for me?

A typical treatment session at Excel that involves IASTM may start with a warm-up to get the treatment area moving – this can be active such as on a bicycle or passive such as with heat while in a stretch depending on the patient. Excel’s model allows for hands-on time and one-on-one time with the therapist to discuss causes of pain and activities that are difficult. If IASTM is appropriate, the therapist will spend a few minutes working on the area. IASTM can be applied while the patient is resting, while the physical therapist is stretching the patient, or even while the patient is doing an exercise depending on the stage of the injury. After IASTM, the patient will go through a series of exercises specific to their diagnosis and functional limitations. IASTM may help to reduce pain with these activities and allow the patient to use their muscles more efficiently to better heal.

At Excel Physical Therapy, the Graston Technique is one of many tools in our toolbox. If you are recovering from an injury or experiencing muscle aches and pain, give us a call for a complimentary screening at one of our 35 convenient locations.

Caroline Hodgins, PT, DPT

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Fitness, Health, News

Is Your Lower Back Ready For Winter?

January 12, 2021 Excel Physical Therapy Leave a comment

Your holiday shopping is done, but is your lower back ready for this winter?

Your hat and scarf were thrown aside after about 10 minutes of shoveling, once you started sweating. You got down the sidewalk with ease, breathing heavy but feeling good. It wasn’t until you tackled the ridge of packed snow, plowed around the cars into a dense mound, that you realized you were in for it. By the second to last ambitious shovel lift, you feel that familiar twinge in your lower back and by the next morning, you can hardly get out of bed!

Have you been in this situation before? If you have, you are not alone. Winters can be treacherous. Snow shoveling sends approximately 11,500 people to the hospital each year[1]. On top of that, slips on ice forced around 42,480 Americans to miss work in a 2014 study by the bureau of labor statistics[2]. Lower back pain is one of the leading causes of doctor’s office visits and results in work lost, pain medication and billions of dollars in US health care costs annually[3]. A curved snow shovel and some rock salt will only take you so far.

The good news is there are options. Whether you have a new injury, chronic pain, or are just having trouble moving around the way you used to, Excel Physical Therapy is here to help.

At Excel, your first visit will be a one on one, hour-long assessment with a doctor of physical therapy. Your physical therapist is specially trained to evaluate your core, alignment, strength, and flexibility. Any deficits in these areas can lead to injury-inducing lifting techniques. If these imbalances in your biomechanics are not addressed, they can lead to wear and tear in the future. On top of that, repetitive lifting required for common activities like snow shoveling, moving boxes, and even carrying small children can fatigue your muscles and place your joints in positions that are vulnerable to injury.

Luckily, our treatment model is designed for precisely these kinds of issues. You’ll receive an individualized plan of care that’s centered on your functional goals as well as the measurements we take in your initial examination. Our certified specialists tailor treatment to a host of orthopedic issues including disc herniations, arthritis, pinched nerves, scoliosis, sciatica, and low back sprains. We utilize hands-on care with each patient to get to the cause of your problem and find the solution together.

If you have any concerns regarding your pain or mobility leading up to this winter season, don’t wait for it to worsen! A growing number of studies suggest that early physical therapy can help improve outcomes and help decrease health care costs[4]. Call today to schedule your first visit and take your first step to overcome any problems holding you back this winter.

Samuel Kelly, PT, DPT

Assistant Clinic Director

Certified Vestibular Therapist

Excel Physical Therapy – Levittown

[1] Watson DS, Shields BJ, Smith GA. Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006. Am J Emerg Med. 2011 Jan;29(1):11-7. doi: 10.1016/j.ajem.2009.07.003. Epub 2010 Mar 25. PMID: 20825768.

[2] 42,480 work injuries involved ice, sleet, or snow in 2014 : The Economics Daily: U.S. Bureau of Labor Statistics (bls.gov)

[3] Chou R, Deyo R, Friedly J, et al. Noninvasive Treatments for Low Back Pain [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Feb. (Comparative Effectiveness Reviews, No. 169.) Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK350262/

[4] Ojha HA, Wyrsta NJ, Davenport TE, Egan WE, Gellhorn AC. Timing of Physical Therapy Initiation for Nonsurgical Management of Musculoskeletal Disorders and Effects on Patient Outcomes: A Systematic Review. Journal of Orthopaedic & Sports Physical Therapy. 2016;46(2):56-70. doi:10.2519/jospt.2016.6138

Excel Physical Therapy is excited to offer an electronic version of our January Newsletter

Fitness, Health

Balance & Dizziness: How You Can Prevent Falls

December 1, 2020 Excel Physical Therapy Leave a comment

Falling is one of the most important day-to-day risks for individuals 65 and older. With as many as 30% of falls resulting in a moderate to severe injury, it’s not uncommon to see a single fall as the beginning of a vicious cycle.

Falls are not inevitable and, in the vast majority of cases, are easily preventable. Here are some tips to help prevent falls and keep yourself safe at home.

Warm-Up Before You Get Up

Sometimes, you can get lightheaded or dizzy when first standing up after sitting for a while, blood pools in your feet. When you get up too quickly, your body doesn’t have enough time to get the blood up to your brain before you stand up. You can help this by marching or kicking your legs before you stand up to help your blood circulate and prevent dizziness upon movement.

Keep Your Home Free of Tripping Hazards

-Keep a clear walkway throughout your home. Make sure there are not any objects or furniture that you have to step over. Make things easier on yourself!

-Rugs should lay flat. A rug pad will help if your rug tends to bunch up.

-Keep an eye on your pets. Know where they are so that they don’t try to trip you. Consider using a baby gate if they like to stay underfoot on the stairs.

Control Your Environment

-The majority of falls occur in the bathroom. Consider setting up a shower bar and some floor grip pads, even if you don’t feel unsteady right now. Make the change before you need it!

–Many people are hesitant to start using an assistive walking device. There will be bad days when you may feel off balance or dizzy. Even if you don’t use a mobility aid every day, it is good to have a cane around. Suppose you are concerned about getting tired or weak farther into a walk and needing rest. In that case, rollator walkers can double as a convenient seat.

Keep Moving!

Regular exercise will ensure that your body maintains the strength and conditioning necessary to keep yourself upright. Walk confidently and at a brisk pace. Balance deteriorates more quickly than strength or flexibility. If you don’t use it, you lose it!

Reach Out!

Treat falls seriously. If you or a loved one experiences a fall, please don’t shrug it off. A fall can mean that there’s an underlying issue at play that you may not even be aware of yet. If you’re feeling unstable or dizzy when walking around, don’t hesitate to seek help from a Physical Therapist. We can help improve your overall balance and conquer the specific challenges you face in your daily life.

Read the full article in our digital flipbook, Excel PT: Balance & Dizziness

Fitness, Health, News

Foot Focused: The Importance of a Strong Foot Core System

November 13, 2020 Excel Physical Therapy Leave a comment

Whether you are a school-aged child with chronic ankle injuries, a competitive athlete wanting to improve your skills, a “stand all day” hard worker with lingering back pain, or a retired grandparent concerned about changes in your balance, there is potentially a shared quality among you: a weak foot core system. Too often, the strength of the foot is completely neglected in exercise training programs. Recent research has pushed to bring attention and understanding to the importance of foot strength in treating musculoskeletal injuries and balance impairments.

The foot is a complex structure that serves many diverse functions. It is rigid, dynamic, and flexible in adapting to the frequently changing demands.^1-3 Researchers equate the foot core to the well-known lumbopelvic core, proposing that the concept of core stability can be extended to the arch of the foot.¹ Of the foot’s 29 muscles, 20 are categorized as intrinsic muscles that control movements in the foot.² These intrinsic muscles are the local stabilizers that run along the foot’s bottom or plantar surface, making up four core layers. Without proper functioning of these muscles to provide stability, the foundation becomes unstable and misaligned, resulting in abnormal movement of the foot, ultimately leading to foot-related¹ and lower extremity-related problems.²

Foot core training has been found to have positive benefits for reducing the risk of injury and improving performance. Variations in foot posture correlate with pelvic alignment, lumbopelvic muscle activation during walking, and transmission of force during running, all of which can lead to low back pain.⁴ Foot core training has resulted in increased performance in 1-legged jump distance, greater vertical jump height, and shorter 50-meter dash time.⁵ Furthermore, foot strengthening can alter running performance by increases in quadriceps activation⁶, muscle volume, and vertical impulse.²

Another essential role of the foot core is the system of sensory receptors located in the plantar fascia, ligaments, joint capsules, muscles, and tendons. The sensory system of the foot is critical to gait and balance. The alignments of the intrinsic muscles along the plantar surface provide immediate sensory information via a stretch response about changes in the foot’s posture.¹ Specific training of these muscles via a short foot training program over the course of 4 weeks has resulted in reduced arch collapse or flattened arch and improved dynamic balance.⁷ Research suggests that foot and ankle strength exercise training may improve balance and functional ability and reduce the risk of falls in older adults.⁸ In younger populations, 4-week training of intrinsic strength during balance exercise demonstrated improved function in those with chronic ankle instability.⁹

Continued research introduces promising interventions for foot core training, offering substantial benefits to several populations with various conditions and goals. Excel Physical therapy can help you begin to stand strong on your feet by providing an individualized program based on your specific needs using research-proven evidence.

Jessica Hoerr, PT, DPT

McKeon PO, Hertel J, Bramble D, Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015; 49:290. Doi: 10.1136/bjsports-2013-092690.
Taddei UT, Matias AB, Ribeiro FIA, Bus SA. Effects of a foot strengthening program on foot muscle morphology and running mechanics: a proof-of-concept, single-blind randomized controlled trial. Phys Ther Sport. 2020;42:107-115.
Tas S, Unluer NO, Korkusuz F. Morphological and mechanical properties of plantar fascia and intrinsic foot muscles in individuals with and without flat feet. J Ortho Surg. 2018;26(1):1-6. Doi: 10.1177/2309499018802482.
Mentz HB, Dufour AB, Riskowski JL, et al. Foot posture, foot function and low back pain: the Farmingham foot study. Rheumatology. 2013;52:2275-2282.
Hashimoto T, Sakuraba K. Strength training for the intrinsic flexor muscles of the foot: effects on muscle strength, the foot arch, and dynamic parameters before and after the training. J Physc Ther Sci. 2014;26:373-376.
Kean CO, Behm DG, Young WB. Fixed foot balance training increases rectus femoris activation during landing and jump height in recreationally active women. J Sports Sci Med. 2006;5:138-148.
Lynn SK, Padilla RA, Tsang KK. Differences in static- and dynamic-balance task performance after 4 weeks of intrinisic-foot-muscle training: the short-foot exercise versus the towel-curl exercise. J Sport Rehabil. 2012; 21:327-33.
Spink, MJ, Fotoohabadi MR, Wee E, Hill, KD, et al. Foot and ankle strength, range of motion, posture, and deformity are associated with balance and functional ability in older adults. Arch Phys Med Rehabil. 2011;92:68-75.
Sauer LD, Saliba SA, Ingersoll CD, et al. Effects of rehabilitation incorporating short foot exercises on self-reported function, static and dynamic balance in chronic ankle instability patients. J Athl Train. 2010;45:S67.

View our flipbook for the full article, Excel PT: Foot & Ankle Pain

Employee News, Health, News, Staff News, Videos

Tips for Picking the Right Shoe for Walking or Running

October 9, 2020 Excel Physical Therapy Leave a comment

A lot of people are interested in improving their fitness by adopting a walking program, but sometimes don’t know how to start. For many of us, it can be really scary and a bit intense to think about moving more and making changes to improve our health and fitness. But, where do you start? How long do you walk? How fast? How often? There can be a lot to think about, which can be quite intimidating.

Everyone Starts Somewhere

First, talk with your PT about starting this program!

Research shows total steps are what matters most, not speed. What’s the recommended amount of steps? 8,000 steps per day! More movement equals better health. If you are active, stay active. If you need to get more active, here are some tips:

Start slow! Gradually increase your activity weekly
Walk with a partner or in a group
Go at your own pace
Wear good shoes

Check out this video for tips for choosing the best shoe featuring Dr. Nicholas Romansky, DPM from Healthmark Foot & Ankle Associates. Running shoes are for walking as well. Running shoes are designed to help manage the stress of running, making them perfect for walking.

In Good Health

Fitness, Health, News, Recent Announcements

Is Your Back Pain Really Coming from Your Back?

September 14, 2020 Excel Physical Therapy Leave a comment

Have you ever had pain in the base of your spine, going into your buttock, pelvis, or leg? Everyone says it’s your back, but is it? How do you find out?

The key to resolving your symptoms is an accurate diagnosis. Let me walk you through the in-depth evaluation that you will receive at our office. We start with the McKenzie Method of Mechanical Diagnosis and Treatment by taking a thorough history of your pain and any other issues such as numbness, tingling, unsteadiness, and falls or trauma. We then look at your sitting, standing, walking, and sleeping posture to see if your upper body, legs, or pelvis are shifted or tilted. We next check your sensation and your reflexes. While standing, we assess your ability to bend forward, backward, rotate and side bending to each side, once and up to 10 repetitions while carefully assessing the effects on the location and level of your symptoms. Then, while lying down, we check your spine flexion and extension motion, strength, and joint mobility. We may perform a prone instability test if we suspect you have weak core muscles that are not properly stabilizing your spine.

Next, we move on to check the flexibility and strength of your hip in all 6 directions as well as your hamstring flexibility and dural tension. If your symptoms are in the sacrum, we may add sacroiliac joint testing. We also fully assess your motion and strength in your knees, ankles and even your toes. We will check for any tenderness in the regions where you have symptoms to determine the status of the back and hip muscles and tendons. If you have X-rays or MRI results, we do integrate those tests into our assessment; however, our full evaluation is the key to knowing what motions cause and what motions will improve your symptoms.

We then combine your personal history with your full evaluation results, to arrive at your specific PT diagnosis and custom treatment plan. We start on the first day with hands-on treatment for soft tissue and joint mobilization, education in proper posture, and instruction in a home exercise program. Often, we find that patients that have back symptoms that peripheralize or move into the leg with the repeated motions have symptoms caused by lumbar or lumbosacral discs protruding on the nerves.

Sometimes we find that patients have a large imbalance in the strength and flexibility of hip rotator muscles, such as the piriformis muscle. A tight piriformis muscle can cause piriformis syndrome where the sciatic nerve gets compressed under a tight piriformis muscle. Other times, we see the pelvis tilted forward making it difficult to stand straight, and find that the patient has a tight iliopsoas muscle. The iliopsoas muscle is a hip muscle that originates on all the lumbar vertebrae and a tight iliopsoas can create a lot of back pain! You may have weak core muscles that are not properly stabilizing your spine and your PT might work on your transverse abdominal muscles and other core muscles to stabilize your spine. Bottom line, you may have pain originating from your lumbar spine, sacrum AND/OR your back or hip muscles.

Your personalized one-on-one evaluation at Excel will let you know what is causing YOUR pain and get you the most effective treatments such as the McKenzie method, stabilization, Graston Technique or Active Release Therapy. Our mission is to get you BACK to doing what you want to do pain-free!

Jean Scott, PT, DPT, OCS, Cred MDT, Graston Cert, ART cert

Excel PT: Is Your Back Pain Coming From Your Back?

Health, News, Recent Announcements, Staff News

2019 Medicare MIPS Program Exceptional Performers

September 11, 2020 Excel Physical Therapy Leave a comment

We are pleased to announce that Excel Physical Therapy has achieved Exceptional Performance in the 2019 Medicare MIPS program. The MIPS program tracks the clinical success of medical providers in improving patient function. As ‘Exceptional Performers’, our therapists have successfully proven that we are one of the top providers for getting patients better.

Your holiday shopping is done, but is your lower back ready for this winter?

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