Foot & Ankle Conditioning Program

After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. Following a well-structured conditioning program will also help you return to sports and other recreational activities.

This is a general conditioning program that provides a wide range of exercises. To ensure that the program is safe and effective for you, it should be performed under your doctor’s supervision. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals.

Strength: Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. Keeping these muscles strong can relieve foot and ankle pain and prevent further injury.

Flexibility: Stretching the muscles that you strengthen is important for restoring range of motion and preventing injury. Gently stretching after strengthening exercises can help reduce muscle soreness and keep your muscles long and flexible.

Target Muscles: The muscle groups of the lower leg are targeted in this conditioning program, as well as the tendons and ligaments that control movement in your feet. These include:

  • Gastrocnemius-soleus complex (calf)
  • Anterior tibialis (shin)
  • Posterior tibialis (center of calf)
  • Peroneus longus (outside of lower calf)
  • Peroneus brevis (outside of lower calf)
  • Soleus (calf)
  • Dorsiflexors (ankle)
  • Plantar flexors (ankle)
  • Invertors (ankle)
  • Evertors (ankle)

Length of program: This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health of your feet and lower legs. Performing the exercises three to five days a week will maintain strength and range of motion in your foot and ankle.

 

Getting Started

Warm up: Before doing the following exercises, warm up with 5 to 10 minutes of low impact activity, like walking or riding a stationary bicycle.

Stretch: After the warm-up, do the stretching exercises shown on Page 1 before moving on to the strengthening exercises. When you have completed the strengthening exercises, repeat the stretching exercises to end the program.

Do not ignore pain: You should not feel pain during an exercise. Talk to your doctor or physical therapist if you have any pain while exercising.

Ask questions: If you are not sure how to do an exercise, or how often to do it, contact your doctor or physical therapist

 

1. Heel Cord Stretch

Repetitions 2 sets of 10
Days per week 6 to 7

Main muscles worked: Gastrocnemius-soleus complex
You should feel this stretch in your calf and into your heel

Equipment needed: None

Step-by-step directions

  • Stand facing a wall with your unaffected leg forward with a slight bend at the knee. Your affected leg is straight and behind you, with the heel flat and the toes pointed in slightly.
  • Keep both heels flat on the floor and press your hips forward toward the wall.
  • Hold this stretch for 30 seconds and then relax for 30 seconds. Repeat.

Tip Do not arch your back.

2. Heel Cord Stretch with Bent Knee

Repetitions 2 sets of 10
Days per week 6 to 7

Main muscles worked: Soleus
You should feel this stretch in your calf, the sides of your ankle, and into your heel

Equipment needed: None

Step-by-step directions

  • Stand facing a wall with your unaffected leg forward with a slight bend at the knee. Your affected leg is behind you, with the knee bent and the toes pointed in slightly.
  • Keep both heels flat on the floor and press your hips forward toward the wall.
  • Hold the stretch for 30 seconds and then relax for 30 seconds. Repeat.

Tip Keep your hips centered over both feet.

 

3. Golf Ball Roll

Repetitions 1
Days per week Daily

Main muscles worked: Plantar fascia ligament
You should feel this exercise along the bottom of your foot

Equipment needed: Golf ball

Step-by-step directions

  • Sit on a stable chair with both feet planted on the floor.
  • Roll a golf ball under the arch of your affected foot for 2 minutes.

Tip Sit up tall and keep your foot toward your chair.

 

4. Towel Stretch

Repetitions 2 sets of 10
Days per week 6 to 7

Main muscles worked: Gastrocnemius-soleus complex
You should feel this stretch in your calf and into your heel

Equipment needed: Hand towel

Step-by-step directions

  • Sit on the floor with both legs out in front of you.
  • Loop a towel around the ball of your affected foot and grasp the ends of the towel in your hands.
  • Keep your affected leg straight and pull the towel toward you.
  • Hold for 30 seconds and then relax for 30 seconds. Repeat 3 times.

Tip Sit up tall and keep your legs straight.

 

 

5. Calf Raises

Repetitions 2 sets of 10
Days per week6 to 7

Main muscles worked: Gastrocnemius-soleus complex
You should feel this exercise in your calf

Equipment needed: Chair for support

Step-by-step directions

  • Stand with your weight evenly distributed over both feet. Hold onto the back of a chair or a wall for balance.
  • Lift your unaffected foot off of the floor so that all of your weight is placed on your affected foot.
  • Raise the heel of your affected foot as high as you can, then lower.
  • Repeat 10 times.

Tip Do not bend the knee of your working leg.

 

5. Ankle Range of Motion

Repetitions 2 sets
Days per week Daily

Main muscles worked: Dorsiflexors, plantar flexors, invertors, evertors
You should feel this exercise at the top of your foot and throughout your ankle

Equipment needed: None

Step-by-step directions

  • Sit down so that your feet do not touch the floor.
  • Use your foot to write each letter of the alphabet in the air. Lead with your big toe.

Tip Keep the movements small, using just your foot and ankle.

 

 

6. Marble Pickup

Repetitions 20
Days per week Daily

Main muscles worked: Plantar flexors
You should feel this exercise at the top of your foot and toes

Equipment needed: 20 marbles

Step-by-step directions

  • Sit with both feet flat and place 20 marbles on the floor in front of you.
  • Use your toes to pick up one marble at a time and place into a bowl.
  • Repeat until you have picked up all the marbles.

Tip Do not place the marbles too far out in front or to the side.

 

 

7. Towel Curls

Repetitions 5
Days per week Daily

Main muscles worked: Plantar flexors
You should feel this exercise at the top of your foot and your toes

Equipment needed: Hand towel

Step-by-step directions

  • Sit with both feet flat and place a small towel on the floor in front of you.
  • Grab the center of the towel with your toes and curl the towel toward you.
  • Relax and repeat.

Tip You can make this exercise more challenging by placing a weight on the edge of the towel.

 

 

8. Ankle Dorsiflexion/Plantar Flexion

Repetitions 3 sets of 10
Days per week 3

Main muscles worked: Anterior tibialis, gastrocnemius-soleus complex
You should feel this exercise at your calf, shin, the back of your heel, and the top of your foot

Equipment needed: Use an elastic stretch band of comfortable resistance

Step-by-step directions

  • Sit on the floor with your legs straight out in front of you.
  • For dorsiflexion, anchor the elastic band on a chair or table leg, then wrap it around your foot.
  • Pull your toes toward you and slowly return to the start position. Repeat 10 times.
  • For plantar flexion, wrap the elastic band around your foot and hold the ends in your hand.
  • Gently point your toes and slowly return to the start position. Repeat 10 times.

Tip Keep your leg straight and heel on the floor for support.

 

If you are experiencing foot and/or ankle pain the experts at TOCA are here to help! View our website for more information or call our dedicated team to schedule an appointment today at: 602-277-6211!

 

#Recovery #Results #Relief #MyOrthoDoc #TOCA #TOCAMD#orthopedics #footpain #anklepain #injuryrecovery

 

Protect you and your Children from Injury this Fourth of July Holiday!

Protect you and your Children from Injury this Fourth of July Holiday: Celebrating our Independence with a Boom has been a tradition for many families for years over the July 4th Holiday season. Unfortunately every year thousands of children and adults are needlessly injured by not following basic fireworks safety tips. With the proper respect fireworks deserve, everyone can safely enjoy the show.

Children are most frequently injured by fireworks. Most are under the age of 15. You may think firecrackers or other types of explosive or rocket variety fireworks are most responsible for their injuries. In fact, the biggest risk of injury comes from sparklers. Sparklers account for roughly 16% of all firework related injuries. If you consider children alone, sparklers account for about 1/3 of all injuries and over half of the injuries to children under 5.

In order to prevent children from being injured by sparklers, it is important to consider following some very simple safety tips.

1. Never let children handle, light or play with sparklers without adult supervision.
2. Don’t let your child handle or light more than one sparkler at a time.
3. Don’t pass of a lit sparkler to someone else, have them hold the unlit sparkler while you light it.
4. Don’t hold your child in your arms while you or the child is using sparklers.
5. Keep your distance: its recommended children stay at least 6 feet apart from one another while handling sparklers.
6. Instruct your child to hold the sparkler away from their body keeping them at arm’s length.
7. Avoid waving the sparklers wildly through the air as children frequently lose hold of the sparkler causing injury to themselves or others around them.
8. Wear proper clothing and footwear. Many injuries occur when an burnt out sparkler is dropped on the ground causing foot burns or puncture wounds from stepping on them.
9. Once the sparkler flame goes out, the metal rod should be dropped directly into a bucket of water. The extinguished sparkler and metal rod remain hot for a long time.
10. Keep your fireworks out of the reach of children. Lock them up. Kids are creative and can easily find a source of fire to ignite fireworks, i.e. a lit candle.

Above all, use common sense, pay attention to children, and if alcohol is involved in an adult party with children, designate someone to remain sober and responsible while any and all fireworks are in use. Hopefully these simple tips can help you and your family avoid an unwanted trip to the emergency department, or worse yet, a permanent and disfiguring injury.

The Hand Surgeons at TOCA, as well as the rest of the Physicians and Staff with you and your family health and happiness as we celebrate with pride, our Independence Day.

To learn more or to schedule an appointment call our dedicated TOCA Team at: 602-277-6211!

#Recovery #Results #Relief #4thofJuly #IndependanceDay #FireworkSaftey #InjuryPrevention #4thofJulyInjuryPrevention #TOCA #TOCAMD

What you need to know: #NationalFlipFlopDay

What you need to know: #NationalFlipFlopDay

Flip-flops might make you feel like you’re on vacation, but they’re actually making your feet work overtime.

Fun and fashionable, flip-flops have their place in your shoe closet, experts say. But they’re not meant to be worn with abandon — or else you may be courting foot pain.

When you wear the thonged sandals, you have to slightly “clench” your toes to keep them on and that’s not a natural position for your feet.
See for yourself: Take your shoes off. Take a step, paying attention to how your midfoot and toes bend at the end as your heel leaves the floor.

Now slightly “clench” your toes, curling them down toward the pads of your feet. Take another step. It doesn’t feel the same, does it? Your foot will be stiffer, and the step won’t “flow” like the first step.

But let’s face it, Flip-flops are a summertime staple. So wear them—but put a cap on the distance you travel in the sandals. Like anything else, moderation is key: Slipping flip flops on by the pool or for a short jaunt likely won’t cause any harm — the problems arise when your thongs become your go-to summer shoes.

This constant tension alters your gait, eventually causing muscular issues in your feet and calves. That can lead to the painful condition plantar fasciitis—also called “jogger’s heel”—when you run. You’ll feel a sharp shooting pain in the bottom of your heels with each step. In extreme cases, flip-flops may even be the cause of other lower-body issues like knee pain.

What’s their best purpose?

“Flip-flops give you some basic protection to the bottom of your foot to walk around poolside or on a surface that may be warm during the summer,” says Jim Christina, DPM, director of scientific affairs for the American Podiatric Medical Association.Image result for flip flops and your foot health

They can also help prevent you from catching athlete’s foot or plantar warts in public showers, according to foot specialists.

Experts give flip-flops thumbs up for the poolside, thumbs down for foot pain

Why? “They let your foot be as flat as they can be,” Christina says. “For some people, that’s OK, depending on the structure of their foot. But if you have a foot that tends to over-flatten, then you’re not getting any support.

If you are walking in flip-flops for days on end with no support, it’s very common to see arch and heel pain.

Don’t overdo the flip-flops at home: everything in moderation. As long as you’re not doing a lot of walking, it’s probably OK. For example, To have flip-flops on for short periods of time to do errands, that’s usually not going to be a problem.

If you have foot pain and need an alternative to flip-flops and their flimsy support.

 

Flip-flop concerns and Safety.

Bacteria and Fungal Infections
Truth: Any open-toed shoe in a dirty environment (think: campgrounds, the beach, pool, or locker room) can lead to infections if your feet are exposed to fungus. Remember, fungus loves moist, warm environments. So to curb your risk of skin or toenail infections, keep your feet clean and dry.

Blisters
Flip flops tend to slip around on your foot more than a sneaker or flats, blisters are an inevitable part of wearing flip flops. Blame movement, moisture, and rubbing, says Ward. Of course, any shoe that doesn’t fit right can cause blistering, but flip flops are among the worst culprits because of their instability.

Heel and Toe Pain
Floppy sandals might not completely destroy your heels, but they could come close. Flip flops could cause serious pain or even conditions like plantar fasciitis, which occurs when the tissue that connects your heel bone to your toes becomes inflamed. See, the ligament that attaches your toes to your heel can stretch or even tear when it’s not appropriately supported. If you notice any redness, irritation or blisters developing between your toes, discontinue use of the flip-flops and find sandals that don’t separate your toes.

Posture Issues
Your feet are the building blocks for how your ankles, knees, hips, back, and shoulders are aligned. Take away the building blocks (which is what you do when you wear shoes with little support) and you’re left with a weak foundation. This can cause everything else in your body to collapse or be poorly aligned, leading to pain and issues with your posture.

Falling Objects

When you wear flip-flops, your toes and feet are exposed, making them susceptible to falling objects or people stepping on your toes.

Thin Soles

Unlike sturdy shoes, flip-flops aren’t good for extensive walking because they offer no arch support, heel cushioning, or shock absorption, according to the American Podiatric Medical Association (APMA). Wearers can suffer foot pain due to lack of arch support, tendinitis, and even sprained ankles if they trip.

When shopping for flip-flops, test their flexibility before buying them. Grab one end of the flip-flop in each hand and gently bend it. If the flip-flop bends in half, this means that it won’t offer any support for your foot. But if it gives a little in the ball of the foot, this means it will properly support your foot and will move with your foot while you’re walking.

Thong Effect

The Auburn study indicates that the thongs in the middle mean you have to grip the shoe to keep it on. The thong can actually rub against the skin and causes ulcerations and sores. Also, when you have a toe thong, you tend to grip the shoe with your toes to try and keep it on. That alters your gait and puts strain on muscles you don’t normally use when you walk in regular shoes.

Also, a recent study found that men and women who wear flip-flops actually strike the ground with less force than when they wear sneakers, again altering the way you walk and causing you to take shorter steps, which may account for why people who wear them for extended periods experience lower leg pain and have more heel problems, such as heel spurs (little bony growths on the heel) and plantar strain (inflammation of the sheet of tissue covering the bottoms of the feet).

Skin Cancer

If you flip-flop your way through lazy summer days, don’t forget: your exposed feet need sunscreen, too. Because your feet are exposed to the sun, it’s important to cover them with sunscreen when your wear flip-flops. It’s easy to forget your feet when applying sunscreen, but it’s a crucial area to protect. Those little brown spots of sun damage that can eventually turn into skin cancer can be difficult to detect on the feet, especially if they’re on or between the toes. So next time, you plan to have some fun in the sun, protect your feet first.

Skip The Flip-Flops If You Have Or Are Prone To Foot Injuries

If you have any foot injuries, it’s best to stay away from flip-flops until those injuries have healed. If you have diabetes, you should skip the flip-flops altogether as you may acquire an injury without feeling it. If you’re overweight, it’s best to wear a closed-in shoe that will provide more support for the feet, ankles and back.

[Related – Diabetic Foot Pain And Complications]

Driving Hazard (avoid driving in flip-flops)

Flip-flops can impair a driver’s control if they come off the foot and lodge under the brake or gas pedal, according to Bill Van Tassel, PhD, the American Automobile Association’s manager of driver training operations. “Whatever you wear on your feet, make sure it’s not so loose that it pops off and interferes with the pedals,” he says.

Decreasing the Dangers

  • Use sun block and check your feet for any suspicious moles.
  • Don’t walk long distances or play sports in your flip-flops – they’re really made for walking along the beach or by the pool or if you get into a public shower, not for long strolls.
  • Do not Spruce up the yard in flip flops – You may accidentally drop something on your foot, stub your toe, cut it on a piece of glass or get bitten by something you’re allergic to
  • Choose flip-flops with thick soles, which will provide more cushion for your feet and protect you from sharp objects you might encounter on the street.

 

How to Pick a Better Pair!

Don’t fret: There is hope for cute summer shoes. For one, look for a sandal with more than one strap, which will help with stability, suggests Ward. An ankle strap or latch behind your heel may also help cut down how much the shoe moves on your foot.

So, enjoy your flip-flops, but just not all the time and without giving them any thought!

Your foot health should always be a priority. If you suffer from a foot/ankle condition the dedicated team of physicians and staff here at TOCA are here to help! For more information, questions or to schedule an appointment call 602-277-6211!

 

 

Sources:

 

What Is Scoliosis, Causes and Treatment Options

What Is Scoliosis, Causes and Treatment Options: Scoliosis (pronounced sko-lee-o-sis) is a three-dimensional abnormality that occurs when the spine becomes rotated and curved sideways.

If you look at someone’s back, you’ll see that the spine runs straight down the middle. When a person has scoliosis, their backbone curves to the side.

Image result for scoliosisThe angle of the curve may be small, large or somewhere in between. But anything that measures more than 10 degrees is considered scoliosis. Doctors may use the letters “C” and “S” to describe the curve of the backbone.

You probably don’t look directly at too many spines, but what you might notice about someone with scoliosis is the way they stand. They may lean a little or have shoulders or hips that look uneven.

What Causes Scoliosis?

In most cases, doctors don’t find the exact reason for a curved spine. Scoliosis without a known cause is what doctors call “idiopathic.”

Some kinds of scoliosis do have clear causes. Doctors divide those curves into three types:

  • Infantile idiopathic scoliosis: develops from birth to 3 years old
  • Juvenile idiopathic scoliosis: develops from 4 to 9 years old
  • Adolescent idiopathic scoliosis: develops from 10 to 18 years old

Adolescent scoliosis comprises approximately 80% of all idiopathic scoliosis cases. Adolescence is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops.

Common Types of Curves

Image result for Common Types of scoliosis CurvesA scoliosis curve usually looks a bit like a backward C shape and involves the spine bending sideways to the right, which is also called dextroscoliosis. Sideways spinal curvature on the left side of the back is more like a regular C shape and called levoscoliosis. Here are four common types of scoliosis curves:

  • Right thoracic curve. If a straight line were drawn down the center of the back, this curve bends to the right side of the upper back (thoracic region).

See Thoracic Spine Anatomy and Upper Back Pain

  • Right thoracolumbar curve. This curve bends to the right side—starting in the upper back (thoracic) and ending in the lower back (lumbar).

See Lumbar Spine Anatomy and Pain

  • Right lumbar curve. This curve bends to the right side—starting and ending in the lower back.
  • Double major curve. Typically, a double curve involves right thoracic curve on top and left lumbar curve on bottom. People who have a double major curve may initially have a less obvious deformity because the two curves balance each other out more.

When Idiopathic Scoliosis Needs Treatment

Treatment options for idiopathic scoliosis could include:

  • Observation. Typically, a doctor will advise observation for a scoliosis curve that has not yet reached 25 degrees. Every 4 to 6 months, the doctor will take another X-ray of the spine to see if the scoliosis is progressing or not.
  • Bracing. If the scoliosis has progressed past 20 or 25 degrees, a back brace could be prescribed to be worn until the adolescent has reached full skeletal maturity. The goal of bracing is to prevent the curve from getting worse and to avoid surgery.

See Bracing Treatment for Idiopathic Scoliosis

  • Surgery. If the curve continues to progress despite bracing, surgery could be considered. The most common surgical option for scoliosis today is a posterior spinal fusion, which can offer better corrections with fewer fusion levels (preserving more back mobility) than what was done in years past.

In nonstructural scoliosis, the spine works normally, but looks curved. Why does this happen? There are a number of reasons, such as one leg’s being longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, this type of scoliosis often goes away.

In structural scoliosis, the curve of the spine is rigid and can’t be reversed.

Causes include:

Congenital scoliosis begins as a baby’s back develops before birth. Problems with the tiny bones in the back, called vertebrae can cause the spine to curve. The vertebrae may be incomplete or fail to divide properly. Doctors may detect this condition when the child is born. Or, they may not find it until the teen years.

Family history and genetics can also be risk factors for idiopathic scoliosis. If you or one of your children has this condition, make sure your other kids are screened regularly.

Scoliosis shows up most often during growth spurts, usually when kids are between 10 and 15 years old. About the same number of boys and girls are diagnosed with minor idiopathic scoliosis. But curves in girls are 10 times more likely to get worse and may need to be treated.

Scoliosis diagnosed during the teen years can continue into adulthood. The greater the angle of the spine curve, the more likely it is to increase over time. If you had scoliosis in the past, have your doctor check your back regularly.

Degenerative scoliosis affects adults. It usually develops in the lower back as the disks and joints of the spine begin to wear out as you age.

A mild scoliosis curve can go unnoticed to the untrained eye. However, if the curve progresses, various signs and symptoms can become obvious.

Common Early Signs of Scoliosis

Oftentimes scoliosis is first suspected when someone notices something slightly off and comments. Some examples could include:

  • Clothes fit awkwardly or hang unevenly. A parent, friend, or even the person with scoliosis might notice that a shirt or blouse appears uneven, which could be cause for further investigation.
  • Sideways curvature observed while in bathing suit or changing. For instance, a parent could first notice the sideways curvature in an adolescent’s back while at the pool or beach.

Even if a newly discovered asymmetry appears minor, it should be checked by a doctor because scoliosis is easier to treat when caught early.

Symptoms of Moderate or Severe Scoliosis

Only about 10% of people with idiopathic scoliosis have a curve that progresses beyond mild and needs treatment.3 If that progression happens, the deformity becomes more obvious to other people and more likely to cause noticeable symptoms.

Some of the more common symptoms present in moderate or severe scoliosis could include:

  • Changes with walking. When the spine abnormally twists and bends sideways enough, it can cause the hips to be out of alignment, which changes a person’s gait or how they walk. The extra compensating that a person does to maintain balance for the uneven hips and legs can cause the muscles to tire sooner. A person might also notice that one hand brushes against a hip while walking but the other does not.
  • Reduced range of motion. The deformity from spinal twisting can increase rigidity, which reduces the spine’s flexibility for bending.
  • Trouble breathing. If the spine rotates enough, the rib cage can twist and tighten the space available for the lungs. Bone might push against the lungs and make breathing more difficult.
  • Cardiovascular problems. Similarly, if the rib cage twists enough, reduced spacing for the heart can hamper its ability to pump blood.
  • Pain. If curvature becomes severe enough, back muscles could become more prone to painful spasms. Local inflammation may develop around the strained muscles, which can also lead to pain. It is possible for the intervertebral discs and facet joints to start to degenerate due to higher loads.
  • Lower self-esteem. This symptom is commonly overlooked or minimized by outside observers, but it can be a significant factor for people who have a noticeable spinal deformity. Especially for adolescents who want to fit in with their friends, it can be stressful and depressing to look different, have clothes fit unevenly, or wear a noticeable back brace that may be uncomfortable or limit activity.

Can It Be Prevented?

No. So forget the rumors you may have heard, such as, “Childhood sports injuries can cause scoliosis.” Not true.

Likewise, if your kids are in school, you may be concerned about the weight of the textbooks they carry. While heavy backpacks may cause back, shoulder, and neck pain, they don’t lead to scoliosis.

And what about poor posture? The way a person stands or sits doesn’t affect their chances for scoliosis. But a curved spine may cause a noticeable lean. If your child isn’t able to stand upright, ask your doctor to look at her spine.

Adam’s Forward Bend Test

Image result for Adam’s Forward Bend Test

involves a healthcare professional observing the patient bending forward at the waist 90 degrees with arms stretched toward the floor and knees straight. From this position, most scoliosis signs that present as asymmetry are clearly visible in the spine and/or trunk of the body, such as:

The first step toward getting an idiopathic scoliosis diagnosis is typically the Adam’s forward bend test, which primarily looks for abnormal spine rotation.

 

 

This test

 

  • One shoulder or shoulder blade is higher than the other
  • Rib cage appears higher on one side (also called a rib hump)
  • One hip appears higher or more prominent than the other
  • The waist appears uneven
  • The body tilts to one side
  • One leg may appear shorter than the other

The Adam’s forward bend test can be useful in detecting scoliosis located in the upper or mid back, which is where idiopathic scoliosis usually occurs. However, the forward bend test is not as effective at detecting scoliosis in the low back because it does not involve rib rotation.

Scoliometer to Measure Spine Rotation

As part of the forward bend test, the clinician might use a scoliometer, also called an inclinometer, to estimate the angle of trunk rotation (ATR). While the patient is still bending forward, the clinician can put the scoliometer flat on the back in the area or areas where the asymmetry looks the greatest.

As a general rule, if an ATR of at least 5 degrees is recorded, the patient will either be scheduled for a follow-up exam or referred to a doctor who can image the back for more accurate scoliosis testing.7,8 X-ray imaging is needed to measure the degree of the curve and confirm scoliosis.

Cobb Angle Measurement

The lateral curve of scoliosis is described by the Cobb angle. Using an X-ray of the full spine, the Cobb angle is found by drawing a perpendicular line from the spine’s most-tilted vertebra above the sideways curve’s apex and a second perpendicular line from the most-tilted vertebra beneath the apex. The angle formed where those two lines meet is the Cobb angle.

A Cobb angle of at least 10 degrees is typically considered the borderline for a scoliosis diagnosis.

Key Components of a Scoliosis Diagnosis

When diagnosing idiopathic scoliosis, there are 3 key components to take into consideration:

  • Lateral curvature. The lateral (sideways) curvature of the spine is measured by the Cobb angle. The bigger the Cobb angle, the greater the spinal deformity.
  • Axial rotation. In addition to the sideways curvature, the spine abnormally rotates along the vertical axis. Spinal rotation can affect rib rotation, as well as curve rigidity.
  • Skeletal maturity. Often estimated by the Risser sign (amount of calcification at the hip bone’s ridged top as seen on the same X-ray as the Cobb angle), the amount of skeletal maturity remaining is critical to making scoliosis treatment decisions in children and teens.

Understanding these components of a scoliosis diagnosis can help the medical team evaluate the severity of the curve, likelihood for progression, and which treatment options could be best.

Idiopathic Scoliosis Is a Diagnosis of Exclusion

Idiopathic means a condition is of unknown cause. As such, idiopathic scoliosis technically cannot be diagnosed until other types of scoliosis are ruled out. Other types of scoliosis could include:

  • Congenital scoliosis. This type of scoliosis is present from birth and is the result of the spine not forming properly.
  • Neuromuscular scoliosis. Many types of neuromuscular conditions can lead to muscle problems in the back that result in scoliosis. A few examples include cerebral palsy and myelodysplasia.
  • Degenerative scoliosis. Also called adult onset scoliosis, this type of scoliosis results from the deterioration of the facet joints in the spine.
  • Nonstructural scoliosis. This type of scoliosis, also known as functional scoliosis, occurs due to a temporary cause that only affects lateral curvature without spinal rotation. For example, a difference in leg heights could potentially cause a sideways curve in the spine that is corrected with a shoe insert.

If scoliosis starts to cause a noticeable deformity or is at high risk of doing so, a doctor might prescribe a brace to prevent the curve from getting any worse. Typically, a brace is worn until the adolescent has reached full skeletal maturity.

Knowing if a person’s scoliosis curve is likely to worsen is crucial to developing a treatment plan. Bracing is a major time commitment and uncomfortable for adolescents—both physically and emotionally—and is usually not prescribed unless the curve is at significant risk for progressing.

Brace Options

There are two general treatment options for scoliosis bracing:

  • Full-time bracing. These braces are designed to be worn 16 to 23 hours a day. The goal is to wear them all the time with exceptions for bathing, skin care, and exercising.
  • Nighttime bracing. These braces use hyper-corrective forces (which put the body out of normal balance and cannot realistically be applied while a person is standing and/or performing daily activities) and are to be worn at least 8 hours a night.

Choosing between full-time bracing and nighttime bracing can depend on size and location of curves, as well as what the patient is willing to do. Some studies have found that nighttime bracing tends to be more effective because patients are more likely to wear a brace at night as prescribed, but other studies have found that full-time bracing—when adhered to as directed—could work even better.

Other Nonsurgical Treatments Unproven

While some people claim that treatments such as physical therapy and manual manipulation can help stop the progression of scoliosis, there is little scientific evidence to support these claims. Bracing is currently the only nonsurgical treatment that has been proven to reduce the natural progression of idiopathic scoliosis curves.

However, if given the okay by a doctor, exercise is healthy for people with scoliosis and helps keep the back strong and flexible.

When Bracing Fails

Sometimes an idiopathic scoliosis curve continues to progress despite bracing. If this happens and the curve progresses past 40 or 50 degrees, surgery may be considered.

3 Goals of Scoliosis Surgery

Scoliosis surgery typically has the following goals:

  1. Stop the curve’s progression. When scoliosis requires surgery, it is usually because the deformity is continuing to worsen. Therefore, scoliosis surgery should at the very least prevent the curve from getting any worse.
  2. Reduce the deformity. Depending on how much flexibility is still in the spine, scoliosis surgery can often de-rotate the abnormal spinal twisting in addition to correcting the lateral curve by about 50% to 70%. These changes can help the person stand up straighter and reduce the rib hump in the back.
  3. Maintain trunk balance. For any changes made to the spine’s positioning, the surgeon will also take into account overall trunk balance by trying to maintain as much of the spine’s natural front/back (lordosis/kyphosis) curvature while also keeping the hips and legs as even as possible.

In addition, any adjustment of the spine must also consider the possible effect on the spinal cord. The health of the spinal cord must be monitored throughout the surgery.

Surgical Options for Idiopathic Scoliosis

There are 3 general categories of scoliosis surgery:

  • Fusion. This spinal surgery permanently fuses two or more adjacent vertebrae so that they grow together at the spinal joint and form a solid bone that no longer moves. Modern surgical approaches and instrumentation—rods, screws, hooks, and/or wires placed in the spine—have enabled spinal fusion surgeries to achieve better curvature correction and faster recovery times than in the past.

An advantage to spinal fusion surgery is that it has a long-term record of safety and efficacy for treating scoliosis. While a drawback to the procedure is that any fused vertebrae will lose mobility, which can limit some of the back’s bending and twisting, today’s spinal fusions tend to fuse fewer vertebrae and maintain more mobility than in the past.

  • Growing systems (to delay fusion). Rods are anchored to the spine to help correct/maintain the spine’s curvature while the child grows. Every 6 to 12 months, the child has another surgery to lengthen the rods to keep up with the spine’s growth. Once the patient is close enough to skeletal maturity, the patient will usually get a spinal fusion.

If a spinal fusion is done at too young of an age (typically younger than age 10 in girls or less than 12 in boys), that could leave less room for the lungs to develop in addition to the child having an unusually short trunk compared to the limbs. To avoid these complications, the growing systems method helps guide the spine as it grows, preventing the curve from worsening as the spine matures and eventually becomes ready for a fusion if needed.

  • Fusionless. Current fusionless surgery methods employ growth modulation on the spine similar to what has been done in the past to treat unequal leg heights in growing children. The theory is that by putting constant pressure on a bone, it will grow slower and denser. By applying such pressure on the outer side of a spinal curve, the surgeon aims to slow or stop the growth of the curve’s outer side while the curve’s inner side continues to grow normally. As the spine continues to grow in this manner, the lateral curvature should reduce as the spine becomes straighter.

One fusionless method uses a vertebral tethering system, which involves placing screws on the outer side of the curve and then pulling them taut with a cord so the spine straightens. Compared to spinal fusion, fusionless surgery has the potential benefit of retaining more spinal mobility. However, this is a newer approach and long-term data about the risks and benefits are not yet available.

For an adolescent or young adult opting for scoliosis surgery today, by far the most commonly performed surgery is a spinal fusion.

 

If you or a family member are experiencing symptoms or discomfort from Scoliosis or suspect scoliosis, the experts in Spine Care,  Interventional Spine and Back, Orthopedics and Physical Therapy here at TOCA are here to help! For questions or to schedule an appointment call us today at: 602-277-6211!

 

#Results #Recovery #Relief #painfree #scoliosis

Cast Away: Fishing Safety & Boating in Arizona

Cast Away: Fishing Safety & Boating in Arizona! Arizona is blessed with diverse fishing opportunities, from the large reservoirs to the trout lakes in the mountains, and plenty of low-elevation fishing holes in between. Go out and catch a memory!

Recreational fishing (especially angling) is one of the most popular activities in the world, but as with other sports, it’s not without its risks. Most anglers are careful to avoid the obvious and most dramatic of fishing dangers (dehydration, hooking a finger, boat motor fires, accidental drowning, etc.). However, if you want to keep yourself in top fishing shape, you also have to protect yourself from more mundane fishing hazards – overuse injuries.

As the name states, overuse injuries are caused by too many uninterrupted repetitions of an action. The body parts involved become fatigued to the point of injury; this effect is intensified if the repeated action requires awkward or unnatural movements, such as is sometimes seen in bowling or pitching a baseball. Overuse injuries are notoriously stubborn to cure – but then again, it’s often those with the injuries that are stubborn. Because you must treat an overuse injury with rest (which means taking a sometimes lengthy break from the beloved activity that cause the injury in the first place), many people make the mistake of returning to activity before their injury is fully healed, creating a vicious cycle that can be difficult to break.

Angling provides the perfect conditions for an overuse injury thanks to the repetitive movements of casting coupled with the bad body mechanics that are common to so many people. As is often said, prevention is the best medicine. With a few simple tweaks, you can help stop overuse injuries from ruining your fishing trips.

Although it might sound silly, you should prepare in advance of a fishing trip the way you would for other athletic events. Keeping yourself in good physical condition will give you the endurance you need for long fishing sessions, and you will be less plagued by the aches and pains that can make your trip less enjoyable. Besides eating a balanced diet and exercising regularly, you should include stretching and strengthening exercises specifically geared for the muscles you will use during angling – your abdominals, back, and upper body.
Because fishing trips are often all-day affairs, it’s important to change up your activity. Alternate sitting and standing – but do both with good posture – to avoid unnecessary stress on your back and feet. Switch your grip and casting style throughout the day so no one motion or position is repeated excessively (and as an added bonus, this will help you master a diversity of fishing styles). And perhaps most important of all, take breaks to rest, even if you don’t feel tired. Remember that most people don’t realize they are developing an overuse injury until it’s too late.

Lastly, be realistic about your abilities. Seek coaching to fix any bad body mechanics you may have during casting. Shooting heads and sinking weights put extra strain on the wrists, elbows, and shoulders of anglers who aren’t adept at their use, so avoid them for all but short periods of time if you fall into this category. In addition, using heavy or long rods, longer lines, and fishing for heavy fish should all be engaged in sparingly unless you are expert enough to do so correctly.

Fishing memories can last a lifetime, so don’t let an overuse injury keep you from enjoying the water with your friends and family.
You throw a hook into the water, you sit and wait for a bite or you reel back in. Fishing is a great pastime, but in order for it to be truly enjoyable, you must be safe. Keep these important guidelines and tips in mind for a safe fishing experience.Image result for arizona fishing

1. Get physically prepared.
You don’t necessarily need to be in top physical shape to catch a fish, but you do need to be able to navigate in and out of a boat or possibly across rocks to your favorite fishing spot. Since regular physical activity is essential for your family’s health, make sure you stick to a daily fitness routine leading up to fishing season. Consider visiting the local pool to brush up on your swimming strokes in the case you fall out of the boat or into the water from the shore.

2. Check your fishing gear.
Fishing lines get old and tangled, fishing poles get worn, and lures can break. Open up your tackle box and discard broken fishing tackle. Restring your pole if the line looks ragged and replace your reel or pole if showing signs of damage. The last thing you want to do is cast out and hook someone or yourself due to faulty fishing gear. If you are going out on a boat, do a boat safety check and make sure your life vests are in good condition.

3. Dress up for the occasion.
Sturdy, protective footwear is especially important when fishing. It can keep you from cutting your foot on obstacles in the water or on shore, keep your feet warm, and prevent slipping. Wear clothing according to the weather conditions, choosing attire that will keep you cool in the heat and warm in the cold. Wear sunscreen regardless of temperature and consider a hat that shades your ears and face. Be sure you and the kids don those life vests if you are on the water. Life jackets are also important if you are wading in deep waters that have strong currents. Even if you are an excellent swimmer, a life jacket can help keep you safe in the event that you fall and hit your head.

4. Pack a first aid kit.
Image result for first aid kitWhile you are hoping for the big catch, you may fall and sustain a cut, get bit by insects, or get a hook in the hand. A first aid kit can come to the rescue for many injuries.
For scrapes and cuts, rinse the wound with clean water (this doesn’t mean pond water) and stop the bleeding by compressing with a clean cloth. Apply an antibiotic cream and cover with a bandage. Try to keep the area dry, changing bandage as needed.

For insect bites and stings, clean area with water, apply a cold compress if available, apply antibiotic cream, and take acetominophen or ibuprofen for pain. Be sure to remove ticks and stingers, if present, before treating. To avoid bites and stings, apply an insect repellent before you start fishing.

When it comes to fishing hooks, if the hook is embedded in the head or face, in a joint, or near an artery, seek medical help immediately. If the hook is embedded in the finger or elsewhere in the skin, clean area with soapy water. Tie a long piece of fishing line to the rounded part of the hook. Push the hook shank parallel with the skin and give the fishing line a firm, sharp yank. The hook should come right out of the entry point. Wash the area again and apply an antiobiotic ointment and bandage to keep it clean and dry.
Note: Be sure your family is current on your tetanus vaccinations.

5. Stay aware of your fellow fishers.
Keep distance between you and your fellow fishers to avoid hook or pole injuries when casting. Safety glasses are a good idea for kids to protect their eyes, especially as they hone their fishing skills. In addition, always know where your family members are and don’t let your kids fish alone. Employ the buddy system.
New anglers. Should always learn how to cast overhead first. This cast teaches the proper technique and is safer than side casts.

6. Never go fishing alone. Always fish with someone else and, ideally, with two other people. If one person is injured or in danger, a second person can stay with them while the third person seeks help. This is especially important when rock fishing. Let somebody know the location of your fishing trip, who you are going with and an approximate time you will be back.

7. Weather and fishing
Staying aware of weather conditions is an important part of fishing safety. Make sure you have the most up-to-date local weather information available and be prepared for sudden changes. For coastal locations, take particular note of unexpected tide and swell conditions.

Additional Fishing and Boating Safety Tips: 
• No drinking or using drugs while driving a boat.
• Abide by boat speeds and wake zone laws.
• Stay alert of debris, stumps, boulders when boating.
• Stay off of the water if there are lightning storms.
• Use your boat lights at night.
• Keep an extra fully-charged battery on board.
• Use caution with hooks, like baiting, knot tying, rigging.
• Don’t fish in unrestricted zones.
• Be sure you keep your area organized and clean.
• Carry maps of the areas you will be at.
• Bring a cell phone.
• Stay hydrated.

Arizona fishing and boating trips can range from a day of casting for trophy largemouth bass to fly-fishing for brown trout on Woods Canyon Lake. In order to experience the best fishing in Arizona, check for updates to fishing regulations, read local fishing reports, and find the best spot.

These 11 Amazing Spots In Arizona Are Perfect To Go Fishing
Image result for arizona fishing• Big Lake
• Cluff Ranch Ponds
• Dead Horse Lake
• Dogtown Lake
• Lake Pleasant
• Lake Powell
• Oak Creek
• Peña Blanca Lake
• Riggs Flat Lake
• Saguaro Lake
• Tonto Creek

 

 

If you experience an injury during your summer activities the Team at TOCA is here to help! Learn more about our Orthopedic Surgeons, Sports Medicine Physicians and Physical Therapy Team. To schedule an appointment call 602-277-6211!

Read more about summer time outdoors in Arizona: Arizona Hiking Tips: Take a Hike. Do it Right.     10 Common Summer Injuries  Men’s Summer Health & Common Sports Injuries

#Results #Recovery #Relief #family #summer #fishingfun #fishingsafety #TOCA #TOCAMD #AZFishing

Ankle Sprain

Ankle Sprain

Ankle sprains are very common injuries. There’s a good chance that while playing as a child or stepping on an uneven surface as an adult you sprained your ankle–some 25,000 people do it every day.​​​

Sometimes, it is an awkward moment when you lose your balance, but the pain quickly fades away and you go on your way. But the sprain could be more severe; your ankle might swell and it might hurt too much to stand on it. If it’s a severe sprain, you might have felt a “pop” when the injury happened.

Even though ankle sprains  are common, they are not always minor injuries. Some people with repeated or severe sprains can develop long-term joint pain and weakness. Treating a sprained ankle can help prevent ongoing ankle problems.

A sprained ankle means one or more ligaments on the outer side of your ankle were stretched or torn. If a sprain is not treated properly, you could have long-term problems. Typically the ankle is rolled either inward (inversion sprain) or outward (eversion sprain). Inversion sprains cause pain along the outer side of the ankle and are the most common type. Pain along the inner side of the ankle may represent a more serious injury to the tendons or to the ligaments that support the arch and should always be evaluated by a doctor.

With a mild sprain, the ankle may be tender, swollen, and stiff. But it usually feels stable, and you can walk with little pain. A more serious sprain might include bruising and tenderness around the ankle, and walking is painful. In a severe ankle sprain, the ankle is unstable and may feel “wobbly.”

More about Your Injury

There are 3 grades of ankle sprains:

  • Grade I sprains: Your ligaments are stretched. It is a mild injury that can improve with some light stretching.
  • Grade II sprains: Your ligaments are partially torn. You may need to wear a splint or a cast.
  • Grade III sprains: Your ligaments are fully torn. You may need surgery for this severe injury.

The last 2 kinds of sprains are often associated with tearing of small blood vessels. This allows blood to leak into tissues and cause black and blue color in the area. The blood may not appear for several days. Most of the time it is absorbed from the tissues within 2 weeks.

If your sprain is more severe:

  • You may feel strong pain and have a lot of swelling.
  • You may not be able to walk, or walking may be painful.

Some ankle sprains may become chronic (long-lasting). If this happens to you, your ankle may continue to be:

  • Painful and swollen
  • Weak or giving way easily

What to Expect

Your health care provider may order an x-ray to look for a bone fracture, or an MRI scan to look for an injury to the ligament.

To help your ankle heal, your provider may treat you with a brace, a cast, or a splint, and may give you crutches to walk on. You may be asked to place only part or none of your weight on the bad ankle. You will also need to do physical therapy or exercises to help you recover from the injury.

Self-care

You can decrease swelling by:

  • Resting and not putting weight on your foot

Ice it to keep down the swelling. Don’t put ice directly on the skin (use a thin piece of cloth such as a pillow case between the ice bag and the skin) Apply ice every hour while you are awake, 20 minutes at a time and covered by a towel or bag, for the first 24 hours after the injury. After the first 24 hours, apply ice 20 minutes 3 to 4 times per day.

  • Compression can help control swelling as well as immobilize and support your injury.
  • Elevating your foot on a pillow at or above the level of your heart
  • Pain medicines, such as ibuprofen or naproxen, may help to ease pain and swelling. You can buy these medicines without a prescription. DO NOT use these drugs for the first 24 hours after your injury. They may increase the risk of bleeding. DO NOT take more than the amount recommended on the bottle or more than your provider advises you to take. Carefully read the warnings on the label before taking any medicine.

Getting Active

The pain and swelling of an ankle sprain most often gets better within 48 hours. After that, you can begin to put weight back on your injured foot.

  • Put only as much weight on your foot as is comfortable at first. Slowly work your way up to your full weight.
  • If your ankle begins to hurt, stop and rest.

 

Rehabilitating your Sprained Ankle

Every ligament injury needs rehabilitation. Otherwise, your sprained ankle might not heal completely and you might re-injure it. All ankle sprains, from mild to severe, require three phases of recovery:

  • Phase I includes resting, protecting and reducing swelling of your injured ankle.
  • Phase II includes restoring your ankle’s flexibility, range of motion and strength.
  • Phase III includes gradually returning to straight-ahead activity and doing maintenance exercises, followed later by more cutting sports such as tennis, basketball or football.

Once you can stand on your ankle again, your doctor will prescribe exercise routines to strengthen your muscles and ligaments and increase your flexibility, balance and coordination. Later, you may walk, jog and run figure eights with your ankle taped or in a supportive ankle brace.

It’s important to complete the rehabilitation program because it makes it less likely that you’ll hurt the same ankle again. If you don’t complete rehabilitation, you could suffer chronic pain, instability and arthritis in your ankle. If your ankle still hurts, it could mean that the sprained ligament has not healed right, or that some other injury also happened.

To prevent future sprained ankles, pay attention to your body’s warning signs to slow down when you feel pain or fatigue, and stay in shape with good muscle balance, flexibility and strength in your soft tissues.

Talk to your provider before returning to more intense sports or work activities.

When to Call the Doctor

You should call your provider if you notice any of the following:

  • You cannot walk, or walking is very painful.
  • The pain does not get better after ice, rest, and pain medicine.
  • Your ankle does not feel any better after 5 to 7 days.
  • Your ankle continues to feel weak or gives away easily.
  • Your ankle is increasingly discolored (red or black and blue), or it becomes numb or tingly.

 

If you have an Foot or Ankle Injury, the dedicated team of Orthopedic Physicians and Physical Therapists are here to help. For questions or to schedule an appointment call 602-277-6211!

 

#Results #Recovery #Relief #anklesprain #injuryprevention #sportsinjury #orthopedicinjury #TOCA #TOCAMD #physicaltherapy #healmyankle

 

Men’s Summer Health & Common Sports Injuries

The summer is a great time to build up your fitness program, enjoy fresh fruits and vegetables, take a vacation, and have fun. It’s also a time to pay attention to your health and safety. Below are tips to help you stay safe and healthy this summer and all year long.

Sprains, strains, tendonitis, and even broken bones are all consequences of living an active and athletic lifestyle. Luckily, with the right knowledge and preparation, many injuries can be diminished or entirely prevented.

There are two classes of injuries: traumatic and cumulative. Traumatic injuries are those accidents that happen in sport or daily life, such as rolling your ankle on a trail run or crashing your bike on the morning commute. Cumulative injuries relate to tissue damage that occurs over time as a result of repetitive strain. These types of injuries creep up and may be a function of poor posture, faulty movement patterns, or improper training.

 

The Seven Most Common Sports Injuries

What weekend warriors need to know about preventing and treating the seven most common sports injuries!

After a sedentary work week, end-zone catches and 36-hole weekends can take their toll in common sports injuries. The seven most common sports injuries are:

  1. Ankle sprain
  2. Groin pull
  3. Hamstring strain
  4. Shin splints
  5. Knee injury: ACL tear
  6. Knee injury: Patellofemoral syndrome — injury resulting from the repetitive movement of your kneecap against your thigh bone
  7. Tennis elbow (epicondylitis)

To see how to prevent and treat these common sports injuries — and to learn when it’s time to look further than your medicine cabinet to treat sports injuries— read on.

The most common sports injuries are strains and sprains

Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Suddenly stretching ligaments past their limits deforms or tears them. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. Strains are called “pulled muscles” for a reason: Over-stretching or overusing a muscle causes tears in the muscle fibers or tendons.

“Think of ligaments and muscle-tendon units like springs,” says William Roberts, MD, sports medicine physician at the University of Minnesota and spokesman for the American College of Sports Medicine. “The tissue lengthens with stress and returns to its normal length — unless it is pulled too far out of its normal range.”

Preventing the most common sports injuries

Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable. “Some injuries,” Roberts says, “we bring on ourselves because we’re not conditioned for the activity.” His advice: “Work out daily and get double benefit — enjoy your weekend activities and garner the health benefits.”

Every workout should start with a gentle warm-up to prevent common sports injuries, says Margot Putukian, MD, director of athletic medicine at Princeton University. “Getting warmed up increases blood flow to the muscles, gets you more flexible, and could decrease injuries,” she adds.

Overuse injuries are common and preventable, according to Putukian. “Don’t come out and hit the ball for an hour after not playing for a while,” she says. Whether it’s hiking, running, or team sports, do some “pre-participation training” first by lightly working the relevant muscle groups in the weeks before the activity.

And learn to recognize when you’ve already left it all on the field. Stop when you are fatigued. Muscle fatigue takes away all your protective mechanisms and really increases your risk of all injuries. You can always come out to play again next weekend — if you don’t get injured today.

Treating the most common sports injuries

Usually, common sports injuries are mild or moderate — there’s some damage, but everything is still in place. You can treat them at home using the PRICE therapy method described later in this article. But you should expect that some common sports injuries may take months to heal, even with good treatment. If a sprain or strain is severe, however, the entire muscle, tendon, or ligament is torn away, and surgery may be needed.

Here are some specific tips for treating each of the most common sports injuries:

1. Ankle sprain

What it is: Most athletes have experienced a sprained ankle, which typically occurs when the foot turns inward. This turning stretches or tears the ligaments on the outside of the ankle, which are relatively weak.

What you can do: With an ankle sprain, it’s important to exercise to prevent loss of flexibility and strength — and re-injury. You can ask your doctor or physical therapist to help you know what kinds of exercise you should do.

When to see a doctor: It’s important to note where the sprain has occurred. A ‘high ankle sprain’ is slower to heal and should probably be seen by a doctor to make sure the bones in the lower leg did not separate. One way to recognize a high ankle sprain is that this sprain usually causes tenderness above the ankle.

2. Groin pull

What it is: Pushing off in a side-to-side motion causes strain of the inner thigh muscles, or groin. Hockey, soccer, football, and baseball are common sports with groin injuries.

What you can do: Compression, ice, and rest will heal most groin injuries. Returning to full activity too quickly can aggravate a groin pull or turn it into a long-term problem.

When to see a doctor: Any groin pull that has significant swelling should be seen early by a physician.

3. Hamstring strain

What it is: Three muscles in the back of the thigh form the hamstring. The hamstring can be over-stretched by movements such as hurdling — kicking the leg out sharply when running. Falling forward while waterskiing is another common cause of hamstring strains.

What you can do: Hamstring injuries are slow to heal because of the constant stress applied to the injured tissue from walking. Complete healing can take six to 12 months. Re-injuries are common because it’s hard for many guys to stay inactive for that long.

4. Shin splints

What they are: Pains down the front of the lower legs are commonly called “shin splints.” They are most often brought on by running — especially when starting a more strenuous training program like long runs on paved roads.

What you can do: Rest, ice, and over-the-counter pain medicine are the mainstays of treatment.

When to see a doctor: The pain of shin splints is rarely an actual stress fracture — a small break in the shin bone. But you should see your doctor if the pain persists, even with rest. Stress fractures require prolonged rest, commonly a month or more to heal.

5. Knee injury: ACL tear

What it is: The anterior cruciate ligament (ACL) holds the leg bone to the knee. Sudden “cuts” or stops or getting hit from the side can strain or tear the ACL. A complete tear can make the dreaded “pop” sound.

When to see a doctor: Always, if you suspect an ACL injury. ACL tears are potentially the most severe of the common sports injuries. “A completely torn ACL will usually require surgery in individuals who wish to remain physically active.

6: Knee injury: Patellofemoral syndrome

What it is: Patellofemoral syndrome can result from the repetitive movement of your kneecap (patella) against your thigh bone (femur), which can damage the tissue under the kneecap. Running, volleyball, and basketball commonly set it off. One knee or both can be affected.

What you can do: Patience is key. Patellofemoral pain can take up to six weeks to clear up. It’s important to continue low-impact exercise during this time. Working out the quadriceps can also relieve pain.

7. Tennis elbow (epicondylitis)

What it is: Repetitive use of the elbow — for example, during golf or tennis swings — can irritate or make tiny tears in the elbow’s tendons. Epicondylitis is most common in 30- to 60-year-olds and usually involves the outside of the elbow.

What you can do: Epicondylitis can usually be cleared up by staying off the tennis court or golf course until the pain improves.

The PRICE principle for treating common sports injuries

The U.S. Marines say that “pain is weakness leaving your body.” Most of the rest of us would add, “OK, but can’t we hurry it up a little?” The answer is yes. Using the PRICE method to treat any common sports injury will help get you back in the game sooner.

First, it’s important to know that swelling is a normal response to these injuries. Excessive swelling, though, can reduce range of motion and interfere with healing. You can limit swelling and start healing faster after common sports injuries by using the PRICE principle:

  • P — protect from further injury
    For more severe injuries, protect the injured area with a splint, pad, or crutch.
  • R — restrict activity
    Restricting activity will prevent worsening of the injury.
  • I — apply ice
    Apply ice immediately after a common sports injury. “Ice is the miracle drug” for sports injuries, says Putukian. “It’s an anti-inflammatory, without many side effects.” Use ice for 20 minutes every one to two hours for the first 48 hours after the injury. Don’t use heat during this time — it encourages swelling and inflammation.
  • C — apply compression
    Compression with an elastic bandage will help reduce swelling.
  • E — elevate the injured area
    Elevating the injured area above the heart will also reduce swelling.

Over-the-counter pain relievers usually relieve the pain of common sports injuries to a tolerable level. If they don’t, it’s probably time to see a doctor.

When to get medical attention for common sports injuries

We know you’re tough — but you also need to be smart. If you suspect a serious injury or if you have any of these signs, see a doctor:

  • Deformities in the joint or bone — it looks “crooked,” or moves abnormally
  • You cannot bear weight or can’t use the limb without it “giving way”
  • Excessive swelling
  • Changes in skin color beyond mild bruising
  • It’s not getting any better after a few days of PRICE therapy

 

If you are injured the Team of Orthopedic Physicians here at TOCA are here to help! To learn more or schedule an appointment call: 602-277-6211.

 

#Results #Recovery #Relief #Injuryprevention #Menshealth #ShowUsYourBlue #SportsMedicine #SportsInjury #TOCA #TOCAMD

National Senior Health & Fitness Day – Exercise Ideas for Older Adults!

National Senior Health & Fitness Day – Exercise Ideas for Older Adults!

Senior Health & Fitness Day is a time to explore the many senior-friendly physical activity options, and to understand the importance of exercise and nutrition for ongoing health and illness/injury-prevention. A healthy diet can boost energy and immunity, and regular exercise is necessary to retain bone mass and lower the risk of fractures, and to build muscle strength and reduce the risk of falls.

Finding ways to get exercise as you get older is a smart and easy way to stay fit and improve your health. Exercise is just as important in your older years as when you were younger.

Research shows that an exercise routine offers a wealth of health benefits. One study found that adults ages 75 and older who exercised lived longer than older adults who didn’t exercise. Another study discovered that older women who squeezed in resistance, or strength, training workouts each week improved their cognitive function.

It’s also well known that regular exercise can help to boost heart health, maintain a healthy body weight, keep joints flexible and healthy, and improve balance to reduce falls.

Exercise does not take as much time as you may think. For general health benefits, older adults need about 2½ hours of aerobic (walking, running, and other activities that get the heart pumping faster) activity per week. These activities should be combined with activities that strengthen muscles at least 2 days per week.

Joining a gym and making use of the machines, trainers, and classes is 1 way to exercise. But you can also have fun there, meet new people, and do a variety of different activities that keep you healthy and strong.

Easy ways to exercise –

Exercise actually comes in many forms, including activities that feel more like fun than hard work:

* Dance. Sign up for a dance class with your spouse or a friend or carve out some dance time at home.

* Go bowling. Join a bowling league or make a weekly date with some of your friends. If you have grandchildren, bring them along.

* Rediscover a favorite sport. Whether you love the elegance of golf or the challenge of tennis, make time for these leisure activities. If possible, vary your activities over the course of each week to work different muscle groups.

* Enjoy the great outdoors. When the weather cooperates, ride your bike, visit a local park for a hike, or simply go for a walk. These are all great exercises that get you outside and into the fresh air.

* Get in the swim. Swimming is an excellent exercise choice, particularly if you have arthritis joint pain. Join a local fitness center with a pool. Work in regular swims to meet your cardiovascular needs without straining your joints.

Balance and strengthen count, too –

To help prevent falls, you also want to practice exercises that improve your balance. Yoga and tai chi fit the bill. They will also help you manage stress, feel more relaxed, and improve muscle tone. Yoga or tai chi classes are widely available in many areas, from senior centers to the Y.

Taking some time to stretch every day can also help keep your joints flexible and keep you moving well. It’s also important to lift some light weights. Canned goods from your cupboard are a fine substitute. You can also use a resistance band to tone your muscles.

Add a little “elbow grease” when doing chores and these regular activities will count as a workout:

* Cleaning the house

* Raking leaves in the yard

* Gardening

* Mowing the lawn

* Sweeping and dusting

Remember that getting older doesn’t mean slowing down. You’ve got to keep moving to stay young at heart…as well as in mind, body, and spirit.

#Results #Recovery #Relief #seniorhealthandfitness #exercise#injuryprevention #TOCAMD #TOCA #TheOrthopedicClinicAssociation

Memorial Day Safety and Injury Prevention

This Memorial Day, at TOCA and around the Nation we honor those Americans who have put their lives on the line to bravely defend our country’s freedom. Each day and especially on Memorial Day we take a moment to remember the men and women who served and sacrificed their lives to protect our great Nation and hard-won freedom.

Memorial Day Safety and Injury Prevention: The first three-day holiday weekend of the summer and the unofficial “kickoff” to summer is upon us. We all have various activities scheduled for the weekend, which may include cookouts, picnics, boating, swimming, motor sports, work around the house, etc. No matter what you have planned, please make safety a part of your weekend.

DRIVING SAFETY: This weekend, 33 million Americans are expected to hit the roads, according to AAA, but more traffic means more traffic accidents.

  • Be well rested and alert, use your seat belts, observe speed limits and follow the rules of the road.
  • If you plan on drinking alcohol, designate a driver who won’t drink.
  • Give your full attention to the road. Avoid distractions such as cell phones.
  • Use caution in work zones. There are lots of construction projects underway on the highways.
  • Don’t follow other vehicles too closely.
  • Clean your vehicle’s lights and windows to help you see, especially at night. Turn your headlights on as dusk approaches, or during inclement weather. Don’t overdrive your headlights.
  • Don’t let your vehicle’s gas tank get too low. If you have car trouble, pull as far as possible off the highway.
  • Carry a Disaster Supplies Kit in your trunk.
  • Let someone know where you are going, your route and when you expect to get there. If your car gets stuck along the way, help can be sent along your predetermined route.

GRILLING SAFETY: Hot dogs, hamburgers, and corn on the cob; nothing says summer like grilling!

  • Ensure that the grill has been thoroughly cleaned. Dirty grills cause many injuries, particularly propane grills.
  • Always supervise a barbecue grill when in use.
  • Never grill indoors – not in your house, camper, tent, or any enclosed area.
  • Make sure everyone, including the pets, stays away from the grill.
  • Keep the grill out in the open, away from the house, the deck, tree branches, or anything that could catch fire.
  • Use the long-handled tools especially made for cooking on the grill to keep the chef safe.
  • Do not wear loose clothing while you grill
  • Never add charcoal starter fluid when coals have already been ignited.
  • Always follow the manufacturer’s instructions when using grills.

WATER SAFETY: The beginning of summer also means the start of pool or beach season for many in the U.S.

  • Do your part, be water smart! Ensure that everyone in the family learns to swim well.
  • Appoint someone as lifeguard, rather than assuming one of your partygoers is keeping an eye on swimmers.
  • Adults: actively supervise children; stay within arm’s reach of young children and newer swimmers. And kids: follow the rules.
  • Don’t just pack it; wear your U.S. Coast Guard-approved life jacket – always when on a boat and if in a situation beyond your skill level. Inflatable children’s toys and water wings can be fun, but they are no substitute for a life jacket and adult supervision.
  • Swim as a pair near a lifeguard’s chair – everyone, including experienced swimmers, should swim with a buddy in areas protected by lifeguards.
  • Reach or throw, don’t go! Know what to do to help someone in trouble, without endangering yourself; know how and when to call 9-1-1; and know CPR.
  • Don’t fool with a pool: fence it in. Enclose your pool and spa with four-sided, four-foot fencing and use self-closing, self-latching gates.

Use Extra Caution with Fireworks: Nothing wraps up a great Memorial Day party better than a blazing fireworks display. Some towns and cities allow for select smaller fireworks to be enjoyed at home. If that’s the case, follow your local laws about what kind of fireworks are permitted.

  • Fireworks should be lit outside in an area without flammable branches or grass. Have a water hose or bucket of water handy to extinguish spent fireworks.
  • After you light a firework, get away to a safe distance. Don’t try to hold a firework in your hand after it’s lit, and do not light it into a container of any kind. Only responsible adults should light fireworks. Always ensure they are safely disposed of after the fun is over.

Stay Safe Under the Sun: There’s no better feeling than soaking in the new summer sun on Memorial Day — but don’t forget sunscreen and keep hydrated.

  • Skin can become severely burned after just a few hours in the sun, which can increase your risk of skin cancer in the long run.
  • Consider providing or looking for available shade, like umbrellas or covered picnic areas, to reduce sun exposure for yourself and your guests. A hat and sunglasses can offer extra coverage.
  • Don’t forget to reapply the sunscreen after two hours of sun exposure.
  • Drink plenty of water before, while, and after you are active. This is very important when it’s hot out and when you do intense exercise. You can drink water or rehydration drinks.
  • Encourage your child to drink extra fluids or suck on flavored ice pops, such as Popsicles.
  • Stop working outdoors or exercising if you feel dizzy, lightheaded, or very tired.

Injury prevention is not only part of our mission here at TOCA, the TOCA team and physician group are dedicated to adult and youth safety. Our experts work with and in the community year-round and emphasize injury prevention over the summer and around holidays.

Have a safe and enjoyable holiday!

“In the End, we will remember not the words of our enemies, but the silence of our friends.” ~Martin Luther King, Jr.

 #thankyouforyoursacrifice #injury prevention #holidaysafteytips #Recovery #Results #Relief #TOCA 

10 Common Summer Injuries

10 Common Summer Injuries – Summer is a season full of beautiful weather, vacations, sports, and other enjoyable outdoor activities. Unfortunately, summer also means an increase in injuries. There are many ways to prevent the injuries that are most common during the summer months, as you and your family enjoy the warm weather. Here you can find helpful tips and facts to help you have a safe and injury-free summer.

1. BICYCLE INJURIES: Wearing a helmet will reduce the chance of a head injury by 85 percent, according to the Bicycle Helmet Safety Institute. The use of a bicycle helmet also seriously reduces the chance that a bike accident, which often involves a motor vehicle, will be fatal for the cyclist

2. BASEBALL AND SOFTBALL INJURIES: Since baseball is a non-contact sport, injuries happen with unintentional contact, according to the American Academy of Orthopedic Surgeons. Warming up and stretching can help prevent common strains and sprains. Coaches are also advised to become very familiar with the conditions of their field, and to be prepared for emergency situations with an on-hand first aid kit along with a medical response plan.

3. PLAYGROUND INJURIES: Studies indicate that roughly 7 out of 10 playground injuries happen because of a fall or an equipment failure. Pediatricians are acutely aware of such hazards.

* Ground cover is important. Stay away from concrete and grass. The best ground covering is rubber or wood chips. Also, look for rusty nails or broken equipment.

* Remember to apply sunscreen regularly while enjoying an outdoor playground.

4. ATV, MOPED AND MINI BIKE INJURIES: The U.S. Consumer Product Safety Commission advises against using ATVs on paved roads, allowing children under the age of 16 to ride adult ATVs, or riding an ATV as a passenger. Additionally, that government agency urges ATV enthusiasts to always wear helmets and protective gear.

5. SOCCER INJURIES: Proper conditioning, stretching, warmups and cool-downs are key to preventing many of these injuries including the severe sprains, torn cartilage and damaged anterior cruciate ligaments (ACLs).

6. SWIMMING INJURIES: When spending time at a pool, lake or shoreline with family and friends, designate brief shifts in which an adult is always serving as a “water watcher.”

Here are some other swimming safety tips:

* Never dive into shallow water.

* Jump into lakes, rivers or the sea feet-first, particularly in dark waters, where you can’t see what’s below.

* Stop swimming during inclement weather.

* Try to avoid crowded swimming spots where it’s hard to monitor your group.

* Avoid wearing headphones at the pool or beach, so you can hear any developing trouble.

7. TRAMPOLINE INJURIES: On average orthopedic physicians see one to three patients each week with a trampoline injury. Sprains and fractures are the most common among them but bruises, bumps and bloody noses are also a concern. Here are some of this doctor’s trampoline safety recommendations:

* Allow only one person on a trampoline at any given time.

* Use a trampoline net to minimize falls.

* Make sure the trampoline is situated on a relatively soft surface such as a lawn.

* Make sure the trampoline is secure.

* Keep the trampoline well-maintained. Any damage to the supporting bars or mats present a fresh safety danger.

* Untrained tumblers should avoid somersaults and other “high-risk maneuvers.”

8. VOLLEYBALL INJURIES: Staying fit during the off-season is the best way for regular players to avoid injury during games. Recreational players should remember to stretch and warm up before a game, wear sunscreen and stay hydrated.

9. AM– USEMENT PARK, STATE FAIR AND CARNIVAL RIDE INJURIES: The following are the top ride safety tips from the International Association of Amusement Parks and Attractions (IAAPA).

* Mind the posted height, weight and health restrictions on each ride.

* Read any posted safety rules for each ride. Responsible parks also have attendants who remind riders about safety rules at the start of each ride.

* Never dangle your hands or feet outside of a ride.

* Always stay in your seat during a ride.

* Always use the straps, belts, crossbars and any other ride safety equipment.

* Make sure your possessions are secure.

10. WATER SPORTS INJURIES: Many of these injuries can be prevented with preseason conditioning and a purposeful warm up before your exercise.

Although doctors regularly treat cuts, strains, sprains and orthopedic injuries from such water sports as jet-skiing and wakeboarding, they also caution against dehydration, which outdoor enthusiasts may forget about while frolicking in or near water.

The team members at TOCA and our Physicians are here to help! To learn more about TOCA and our physicians visit more of our webpages here on: www.tocamd.com or call 602-277-6211!

#Recovery #Results #Relief #TOCAMD #SummerFun #InjuryPrevention#PlaySmart #PlaySafe #SummerSaftey