Success stories from Dynamic Sports Physical Therapy in New York City: Brendan’s hard work pays off as he returns to activity after an ACL tear

Brendan Keevan is an active 27-year-old active tore the anterior cruciate ligament (ACL) of his left knee from a non-contact injury that he suffered while playing basketball. After the injury, he decided to undergo a common surgical procedure called ACL reconstruction in February of 2020. From there, Brendan came into Dynamic Sports Physical Therapy in New York City to begin his rehabilitation.

During his first visit, Brendan reported that he was unable to walk more than 10 city blocks and required a crutch and knee brace to get around. Brendan’s therapist, Jason, also performed an evaluation at this time to develop a clearer picture of his functional limitations. Results from this evaluation revealed that Brendan had significant swelling and weakness in his legs, which were related to his surgery. He also had difficulty walking and was unable to balance on one leg, bend, or squat.

Before beginning treatment, Brendan stated that his goals were to be able to start running and playing basketball again, and to feel the same level of confidence with his left (injured) leg as his right. With this in mind, Brendan’s treatment program included several phases, each of which featured a specific short-term goal and milestone that he worked towards in a progressive manner. Jason utilized a variety of interventions to help Brendan regain his abilities, such as blood flow restriction, resistance training, balance and proprioception training, walking and running gait assessments, plyometric training, and return to sport programing.

Brendan stayed committed to his rehabilitation program and regularly attended both virtual and in-person sessions for an entire year. After one year, he is now back to athletic activities and can run six miles without feeling any pain. Brendan is continuing his therapy to this day with return-to-sport phase, and he is now targeting a return to the basketball court.

See what we can do for you at Dynamic Sports Physical Therapy in New York City

It’s great to see that Brendan has been able to get back into his exercise routine, and we wish him continued success as he continues to work towards additional goals. If you’re dealing with a new injury or any lingering pain, we invite you to see how Dynamic Sports Physical Therapy in New York City can help you return to your pre-injury levels. Contact us at 212-317-8303 to schedule an appointment today or click here to read our last blog for more information on ACL injuries.

After ACL surgery, the best way to reduce the risk for another injury is by completing a rehabilitation program in New York City

Tears of the anterior cruciate ligament (ACL) get lots of attention in sports, and there are some very clear reasons why: these injuries are extremely common and usually put athletes on the sidelines for long periods. Discussions about ACL tears often focus on the severity of the damage to the knee and the timetable for when an athlete will get back on the field or court. But one thing that can get overlooked is the athlete’s risk for re-injury after they return, which can be fairly high in certain populations—especially young athletes. To ensure a successful recovery and avoid additional ACL tears, we strongly encourage completing a rehabilitation program in New York City.

The ACL is one of the four main ligaments within the knee that connects the tibia (shinbone) to the femur (thighbone). It runs diagonally in the middle of the knee and prevents the tibia from sliding forward on the femur, and it also provides a great deal of stability for the knee that keeps it from rotating out of position.

Injuries to the ACL can range in severity, but most are partial or complete tears. ACL tears are devastating injuries, and typically lead to significant pain, instability, swelling, tenderness, and muscle weakness. As a result, patients are often sidelined from physical activities for several months. Athletes and active individuals of just about any age can experience an ACL tear, but the chances are highest in those who participate in high-demand sports that involve lots of cutting motions, like basketball, soccer, football, and volleyball. In fact, about 1 of every 60 athletes will tear their ACL at some point in their career, and this figure is only expected to rise due to the increased intensity and growing participation in sports.

For most athletes that plan to continue playing sports, a surgical procedure called ACL reconstruction is often recommended as the best available option. The procedure does not repair the damaged ligament but instead creates a new one using other tissue from the leg (usually a tendon). ACL reconstruction is usually successful, and many athletes can return to their sport afterwards, but there are also some potential complications, like tearing the newly reconstructed ligament or the ACL or the other knee.

There are many factors that may be responsible for these additional injuries, but research has shown that younger athletes and those who return to high-risk sports are at a particularly high risk of re-injury. One study found that almost 25% of individuals under the age of 25 who return to a high-risk sport with lots of pivoting and cutting will either re-injure the reconstructed ACL or the opposite ACL.

Undergoing rehabilitation in New York City will minimize re-injury risk

For an ACL reconstruction surgery to be successful, a patient must allow enough time for the new ligament to become part of the knee (a process called graft incorporation) and restore the normal muscle strength of the knee to ensure it is properly protected. For this reason, physical therapy is essential to help patients get back to their pre-injury levels and not return to sports until they have completely recovered. Our rehabilitation program in New York City will guide you every step of the way, identify any potential issues, and address them with comprehensive interventions that will all reduce the risk of ACL re-tears in the future. Each ACL rehabilitation program may vary from patient to patient, but common elements include the following:

  • Strengthening exercises to build back up the weakened muscles of the leg
  • Stretching exercises to increase flexibility and regain normal mobility that may have been lost during the injury and surgery
  • Plyometrics, or jump training, which are crucial for patients recovering from ACL tears
  • Recommendations on how to modify your activities to minimize the risk for future injuries
  • Exercises to improve neuromuscular control, which is the body’s ability to stay in a strong and stable position regardless of what movement it’s making

ACL tears are rough injuries that can have a significant impact on an athlete’s career, but the situation can be made far worse if another ACL tear is sustained after returning to play. This is why it’s crucial to take your recovery seriously, complete all the necessary steps, and never return to play until you’ve been cleared to do so. Dynamic Sports Physical Therapy can help during this process with a comprehensive rehabilitation program in New York City that takes these factors into consideration. Contact us at 212-317-8303 to schedule an appointment today, or click here for more information on ACL re-tears.

Success stories from Dynamic Sports Physical Therapy in New York City: Rose sees a major decrease in headache intensity and frequency after six weeks

Rose is a 50-year-old hospital administrator with a history of severe headaches. She had been previously diagnosed with migraines, and after her symptoms got particularly bad over more than three months, she decided to visit Dynamic Sports Physical Therapy in New York City to address them.

To develop a clearer idea of Rose’s condition, her physical therapist performed a thorough physical examination and asked her a series of questions regarding the occurrence of headaches and any other potentially related problems. The therapist discovered a few abnormal findings with Rose’s neck, including limited range of motion, weakness, and palpable trigger points. Rose also had some weakness in her core muscles and told the therapist that recently started menopause and had increased stress levels in her life due a recent breakup and the COVID-19 pandemic. Based on these findings, the therapist determined that Rose’s headaches were likely induced by stress, and that her neck issues and posture dysfunction may be contributing to the headaches as well.

Before beginning treatment, Rose stated that her primary goal was rather straightforward: reduce the number and severity of headaches. Since both physical and psychological factors were playing a role in the development of these headaches, Rose’s therapist designed a treatment program that addressed both of these causes. The physical components of the program included manual therapy applied by the hands of the therapist to the neck muscles and joints, as well as neck strengthening exercises and posture training. The psychological components included biofeedback with a body scan and paced breathing, pain education, and both mindfulness training and cognitive behavioral therapy practices that were intended to reduce stress levels and alleviate pain.

After six weeks of treatment, Rose’s headaches decreased from a frequency of once a day and a pain scale of 8 of 10 to having occasional headaches once or twice a week, which only registered at a 2-3 of 10 on the pain scale at their highest. She is currently also working full time and exercising regularly.

“I am so glad I finally found something that can help my headaches,” Rose said. “It restores my faith in our healthcare system to treat the entire person rather than just a diagnosis.”

Experience similar improvements at Dynamic Sports Physical Therapy in New York City

Here at Dynamic Sports Physical Therapy in New York City, we’re thrilled to see how quickly Rose was able to improve and get back to her life without being held back by headache pain. We’re glad that she also recognizes the value of not only treating patients’ physical complications, but also addressing any psychological impairments that could also influence the problem. If you’re dealing with pain from headaches or any other condition, we invite you to come in for a visit and see how we can help you improve as well. Contact us at 212-317-8303 to schedule an appointment today or click here for more information on biofeedback for headaches.

We use a multifaceted approach of physical therapy plus mental health techniques to treat migraines in New York City

Headaches can be relentless. For many individuals, a headache can ruin their day or even leave them incapacitated for an extended period. They are also infamous for being difficult to treat, as many factors contribute to headaches and all patients respond to treatments differently. The most common way to manage headaches is with various medications, but there are numerous other treatment options that may be used either instead of or in addition to this approach. Here at Dynamic Sports Physical Therapy, we treat headaches and migraines in New York City with traditional therapy techniques combined with psychological interventions like cognitive behavioral therapy and mindfulness-based practices.

About 90% of Americans will experience at least one headache in their lifetime, but 45 million suffer from chronic headaches, meaning the issue is ongoing and persistent. Tension headaches affect more than one-third of men and more than one half of women, which makes them the most common type overall. The main symptom of a tension headache is a dull, aching pain and tightness across the forehead, which is similar to the characteristic symptoms of a migraine.

Migraines affect up to one in seven adults and are the second most common type of headache. Women are about three times more likely to get them than men. Migraines are usually described as a throbbing, pounding pain that can last from hours to several days, sometimes multiple times each month. They also tend to be more intense and severe than other types of headaches. A unique sign of migraine is that many patients experience other symptoms, such as sensitivity to light, noise, or smells, nausea or vomiting, loss of appetite, or upset stomach.

Our therapists attack migraines in New York City with a variety of techniques

Most patients will consult with their primary care physician or see a headache specialist or neurologist for their condition, and this is usually a good starting point. But not all patients improve with medications and require additional care. Physical therapists are also capable of effectively treating headaches and migraines, and they can prescribe a unique management program that attacks the problem from a different angle with other interventions.

At Dynamic Sports Physical Therapy, we treat patients with headaches and migraines in New York City with a combination of traditional physical therapy techniques plus some psychological interventions, which are intended to teach individuals the mechanisms behind these issues to reduce their occurrence. A typical treatment program will likely include the following components:

  • Physical therapy techniques
    • Soft tissue and neck mobilization: this manual technique involves a physical therapist moving the muscles and soft tissue of the neck and upper back
    • Strengthening and stretching exercises: these are performed by patients to increase the strength and range of motion of the muscles that stabilize the chest, upper back, and neck to improve posture and endurance
    • Posture education: if posture is believed to be a contributing factor to your headaches, your therapist will teach you how to make slight modifications to the home or office to improve your overall spinal posture, reduce stress, and increase your body awareness
  • Psychological interventions
    • Biofeedback: this treatment teaches patients to control certain functions of their involuntary nervous system with an instrument that measures a bodily response—like heart rate, skin temperature, muscle tension, or blood pressure—as the patient tries to modify that response; the goal is to provide the patient with immediate information that shows how stress and other factors can contribute to their headaches, and then teaches them how to make changes that will prevent future episodes
    • Cognitive behavioral therapy (CBT): since many headaches are related to anxiety, stress, and other mental health issues, effectively treating them often requires addressing these underlying causes; CBT is an intervention in which the therapist uses various behavioral strategies to help you understand the psychological triggers of your headaches and teaches you how to better cope with these contributing factors
    • Mindfulness-based practices: mindfulness essentially means “paying attention to the present moment without judgement,” which is another strategy that can help patients alleviate headache-inducing stress; our therapists educate patients on how to be more mindful in their daily lives with mental exercises and discussions that will help them avoid thinking traps that keep their minds in the past or future, which research shows can reduce the occurrence of migraines

If you’re affected by headaches or migraines in New York City, we can help. Contact Dynamic Sports Physical Therapy at 212-317-8303 to schedule an appointment today or click here for more information on CBT for migraines.

Find effective solutions for your lingering COVID-19 symptoms now at Dynamic Sports Physical Therapy in New York City

Over the better part of the past year, the effects of the COVID-19 pandemic have extended into nearly every aspect of our lives. For most Americans, work, childcare, family life, and social or public engagements have all changed to some degree or been completely overhauled in ways that we never thought possible. On top of this, some people’s bout with SARS-CoV-2—the virus that causes the respiratory disease COVID-19—does not end once they are free of the virus, with lingering effects continuing to bother them for weeks or months afterwards.

The term used to describe this condition is post-acute COVID-19 syndrome (PACS), or long COVID. These “long haulers”—as they are commonly known—have already “recovered” from COVID-19 and no longer test positive for the virus, but report dealing with a range of symptoms that can last up to several months after their initial experience with the disease. The various physical and mental symptoms of PACS often takes an additional toll on these patients and further degrades their quality of life, which in many cases was already impacted by their first run-in with COVID-19.

Fortunately, physical therapists have been paying close attention to the emergence of this novel complication and are perfectly equipped to manage patients who are impaired by PACS. Here at Dynamic Sports Physical Therapy in New York City, we’ve partnered with Mt. Sinai Hospital to offer a comprehensive treatment program for PACS that addresses patients’ functional limitations through a variety of strategies. With that in mind, we’d like to take a closer look at the wide-ranging effects of PACS and explain the steps that we take to address this bothersome condition.

An abnormal path from an elusive disease

Individuals who have been diagnosed with COVID-19 may or may not experience symptoms at any time, and about 40 to 50% of patients are classified as asymptomatic, or symptom-free. For those who do develop symptoms, about 80% of cases are mild to moderate, while only 14% of patients are severely affected. A wide variety of symptoms—which usually arise between 2-14 days after being exposed to the virus—have been reported, but the most common are fever, fatigue, dry cough, loss of appetite, shortness of breath, and loss of smell.

The course that COVID-19 takes in each patient depends on several factors, particularly their age, weight, and the presence of any other health conditions like heart, lung, or liver disease. Although it’s clear that COVID-19 can be a devastating disease, especially for those who have multiple risk factors, most patients will go on to make a complete recovery. It can take as little as a few days to several weeks, but eventually these patients’ symptoms resolve entirely as their immune systems eradicates the virus.

However, this is not always the outcome with COVID-19. As explained above, a certain group of patients continues to be symptomatic for weeks or months after their original diagnosis. By this point, these individuals are technically free of SARS-CoV-2 and should have already recovered from it. The exact number of patients who become long haulers is unclear because there is no established definition of PACS, but research has suggested that at least 10% to 13% of patients report dealing with symptoms lasting for more than three weeks. According to the Center for Disease Control and Prevention (CDC), the most frequently reported symptoms of PACS are similar to those seen with the initial bout of illness and include the following:

  • Fatigue
  • Shortness of breath
  • Cough
  • Joint pain
  • Chest pain

Other common symptoms include brain fog, anxiety and depression, muscle pain, headache, and general weakness. It’s not entirely understood why these patients are beset by these residual symptoms, but studies suggest that older individuals, those who are overweight or obese, and patients with asthma or extensive symptoms early on are more likely to become long haulers. Please note that these are not prerequisites, however, as some patients with mild-to-moderate illness initially will also develop PACS.

Once they reach this stage, the lasting physical and psychological impairments present can complicate daily life and prevent patients from moving and functioning normally. Long haulers may report difficulties exercising or even in performing basic activities like walking, standing up and sitting down, or doing household chores. These patients are often restricted by fatigue and shortness of breath, and their limitations may be further compounded by joint and muscle pain.

Regaining strength, balance, and function with physical therapy

The practice of physical therapy is uniquely positioned to help these patients who are coping with the residual effects of PACS. Physical therapists are movement experts who work with patients on an individual basis to alleviate their pain and address their impairments through a variety of strategies. While treating patients with other painful conditions throughout the pandemic—often remotely through telehealth—physical therapists have also been closely tracking the discovery of long haulers who require additional care. In the process, physical therapists throughout the country have learned about the most common symptoms and particular needs of these patients, and in response, have designed customized treatment programs to address them.

Dynamic Sports Physical Therapy in New York City has heeded this call as well, by recognizing those with PACS as a group that will benefit from physical therapy and making it clear that our services are available to them. That’s why we have partnered with Mt. Sinai Hospital to develop a comprehensive rehabilitation protocol specifically made for long haulers who are being held back by their lingering illness.

The goal of physical therapy for those with PACS is to enable patients to increase their physical activity levels and exercise capacity. This is primarily accomplished by targeting strength, endurance, balance, and functional abilities with a wide scope of movement-based interventions. In addition, extra concern is given to each patient’s response to activity, particularly their respiration—or breathing—while performing these tasks. Therefore, patients’ oxygen saturation—which measures how well they are breathing—is monitored and regulated before, during, and after physical activity to ensure it does not exceed a certain level.

Our PACS rehabilitation protocol is exercise-based and consistent with evidence-based practices for similar conditions. In addition to monitoring respiration, we assess the following parameters during a patient’s first visit and at each subsequent appointment:

  • Exercise and functional capacity
  • Presence of pre-existing conditions
  • Muscle and joint range of motion
  • Strength
  • Balance
  • Ability to complete normal activities of daily living

Once these baseline assessments are recorded, your physical therapist will design a personalized treatment program based on your specific symptoms, impairments, and goals. Programs vary from patient to patient, but in most cases the following interventions are used:

  • Generalized strengthening exercises to build back muscles that may have been weakened by inactivity
  • Progressive aerobic and cardiovascular endurance exercises to increase activity levels and exercise capacity
  • Mobility and stretching exercises to improve flexibility and range of motion
  • Neuromuscular electrical stimulation to assist with muscle strengthening
  • Biofeedback, a technique that teaches patients to voluntarily control certain bodily processes through electrical sensors and audio/visual cues
  • Mindfulness-based techniques, which help patients identify and understand triggers that exacerbate their PACS symptoms; when combined with biofeedback, these two techniques can train patients to downregulate these processes and effectively reduce their symptoms

We will carefully guide you on how to perform these interventions at first, and then monitor you throughout their entire course of care to ensure that the workload and pacing is appropriate. If you respond well to your initial plan and don’t show any signs of an adverse response, the next step will likely be to gradually increase the frequency, intensity, duration, and type of exercises in your program as you progress.

Reach out now if residual COVID-19 symptoms are holding you back

So if you’re currently bothered by symptoms that are related to PACS, we invite you to get in touch with us to find out what we can do for you. You can access our PACS rehabilitation program either in person or virtually through our telehealth services if you prefer to avoid coming into our clinic. For more information or to schedule an appointment, call Dynamic Sports Physical Therapy in New York City at 212-317-8303.

Innovative treatment that restricts blood flow can rapidly build muscle and accelerate recovery from injury in New York City

The best physical therapists have a variety of methods and techniques in their arsenal so they can respond to each unique patient with the most appropriate treatment plan that gives them the strongest chance of recovering. In addition to traditional interventions like manual (hands-on) therapy and stretching and strengthening exercises that often serve as the backbone of most programs, developments in technology and research have opened the door for new ways of delivering treatment to patients. One technique that’s been gaining popularity in recent years is called blood flow restriction training (BFRT), which can produce rapid gains in strength and boost recovery from injury in New York City when integrated into a physical therapy plan.

After suffering an injury or while recovering from a recent surgery, one of the most pressing issues patients face is loss of strength from inactivity. This is often inevitable when pain and disability prevent one from exercising a certain body part, and it’s one of the major obstacles to overcome while working back to full functionality. Building back muscle through targeted strengthening exercises is helpful and typically a necessity of the rehabilitation process, but it can take time, especially after severe injuries.

This is where BFRT comes in. For athletes and patients looking to accelerate their recovery, BFRT alters the flow of blood to specific muscles and takes advantage of the body’s natural response to produce strength gains at lighter weights that are comparable to gains that would normally be obtained with heavier weights. Here’s how it works:

  • After performing careful measurements, the physical therapist will place a specialized elastic belt (or cuff) around the upper portion of either the arm or leg that will be exercised
  • The cuff is inflated to a specific pressure that is individualized for each patient
    • This pressure partially restricts the flow of blood through the veins while allowing blood to flow through arteries normally
  • The patient will then perform a series of strengthening exercises with a resistance band or light weights while the therapist provides guidance

Partially restricting venous blood flow disturbs the homeostasis of the muscles near the location of the cuff because they don’t receive enough blood to contract. This leads to the production of hormones that move throughout the body, and this response will add to the local response in muscles and increase the number of proteins being made. The end result is that doing lots of repetitions with BFRT will strengthen muscles to a similar degree that heavy lifting would produce. The main difference is that the lighter loads don’t stress the muscle and tissue as much as heavy loads, which leads to even more rapid improvements.

Anyone recovering from surgery or injury in New York City can benefit from BFRT

Since BFRT only minimally damages muscles and tissues, it’s ideal for patients of all ages recovering from surgery or injury in New York City. While working with heavy loads can actually slow down rehabilitation, BFRT allows patients to experience similar benefits, but at a rapid rate and without the same risks. BFRT is most commonly used on patients recovering from surgeries of the upper and lower extremities like ACL reconstructions, meniscectomies, hip or knee replacements, and rotator cuff repair, but they are certainly not the only patients that can stand to benefit. BFRT can also be effective for individuals recovering from musculoskeletal injuries like sprains, strains, and fractures, and may be appropriate for some patients with osteoarthritis, rheumatoid arthritis, and osteoporosis, as well as those recovering from a stroke or spinal cord injury.

If you’re currently recovering from surgery or an injury in New York City, a physical therapy program that includes BFRT at Dynamic Sports Physical Therapy could be right for you. Call us at 212-317-8303 to schedule an appointment today, or click here to learn more about BFRT.

Success stories from Dynamic Sports Physical Therapy in New York City: James can exercise once again, without pain or headaches

James visited Dynamic Sports Physical Therapy in New York City complaining of headaches, neck pain, fatigue, and difficulty concentrating and sleeping. He told his therapist that he started noticing this pain after first discovering that he was going to be a father. Increased stress levels seemed to make James’ symptoms worse, and he reported that the pain and lack of sleep—in particular—had become gradually worse over the past four months.

James’ therapist, Ashli, performed a thorough evaluation and asked him a series of questions to investigate the source of his painful issues. The evaluation revealed that he had reduced range of motion in the cervical (neck) portion of his spine, decreased strength in the neck muscles responsible for flexion, decreased stability of the shoulder blade (scapular) muscles, and increased tension in another set of neck muscles. A biofeedback assessment also showed that James had an increased heart rate and breathing rate. Based on these findings, Ashli determined that James was dealing with migraines and chronic neck pain.

Treatment targets neck strength and range of motion

Before beginning treatment, James stated that his primary goals were to decrease his pain levels, experience fewer headaches, and get back into regular exercise. His treatment program consisted of two sessions per week for six weeks, and its central focus was to improve his cervical range of motion and cervical stability, while also boosting his ability to control physiological responses like heart rate and skin conductance with biofeedback. This was accomplished with pain science education, aerobic exercises, exercises to improve cervical and scapular stabilization, use of a manual (hands-on) therapy technique called cervical distraction with suboccipital release, biofeedback with breathing and relaxation exercises, and positive reinforcement.

James also received two sessions of acupuncture, in which a combination of needles were inserted in various areas of the neck and shoulders. This included stimulating the Shen Men point and vagal nerve in the ears, which was intended to activate the parasympathetic nervous system in order to treat James’ insomnia.

After 12 sessions of physical therapy, James told his therapist that he no longer had any headaches or neck pain, and was able to start sleeping for 6-8 hours. He also reported feeling more control over his physiological responses and has continued practicing progressive muscle relaxation and paced breathing exercises at home. On top of that, James has been able to resume exercising regularly, and takes more time to pursue activities to reduce his stress levels.

James had this to say about his outcome after completing treatment: “My experience at Dynamic Sports was amazing! Ashli was always attentive to my situation, listened, and helped me become more optimistic. She gave me control back in my life. I was hooked when she said, ‘I will help you, help yourself get better.’ It worked.”

See for yourself what’s possible with Dynamic Sports Physical Therapy in New York City

Ashli and the rest of the team here couldn’t be happier to hear the kind words from James and see such a marked improvement after only six weeks of treatment. His story shows what’s possible when a treatment program is based on a detailed examination and carried out with commitment by the patient. If you happen to be dealing with any pain or other restrictive symptoms, we invite you to find out for yourself what can be accomplished with a personally customized exercise plan from us. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment today, and get started on your path to recovery.

Our New York City physical therapists speak on the benefits of a treatment approach that addresses psychological as well as physical health

Many people tend to think about pain simply as damage to a joint, muscle, or bone that seems isolated from the rest of the body. The only way to treat it, then, is to target the damaged area with exercises and other interventions that are intended to heal it and alleviate the pain. But research has been showing that pain is far more complex than this, and that there are many other factors at play. In particular, it’s been found that our psychological state and perception of pain or injury often have a significant impact on how pain is experienced. This understanding has led to the development of psychologically-informed physical therapy (PIPT), which puts a slightly different spin on the traditional model of care. Below, our New York City physical therapists explain how PIPT works and why it may lead to even better outcomes for you.

The bedrock of physical therapy has always been the use of movement-based strategies that are individualized to each patient and designed to reduce their pain levels and improve functional abilities. PIPT completely retains these core values, but it takes a much broader approach than the traditional methods used to manage pain. In addition to concentrating on the physical issue responsible for a patient’s pain, a major focus of PIPT is to also address the behavioral aspects of pain—which is essentially how each person responds to their pain. This is primarily accomplished by identifying each patient’s individual expectations, beliefs, and feelings, and using them as factors that will help predict their chances of having a successful outcome.

The overall goal of PIPT is to prevent disability in each patient by helping them to better understand the complex nature of their pain, making treatment plans extremely personalized, and stressing adherence to treatment plans in order to improve outcomes and reduce associated costs. It involves a range of specific techniques, some of which are slight variations on traditional physical therapy methods, while others are completely unique to PIPT. Below are five of the fundamental principles of PIPT:

5 fundamental principles of PIPT from our New York City physical therapists

  • Biopsychosocial approach: this means that the physical therapist will be looking at your pain as the result of biological, psychological, and social factors, and they will educate you regarding this concept so you can better understand how things like your mood, perception, and history with pain all contribute to your overall experience
  • Behavioral aspects of pain: this relates to the above principle and focuses exclusively on how your behaviors directly influence your perception of pain; by better understanding this connection and working to change your behaviors, you’ll be able to take more control over pain’s impact on your daily life
  • Strong emphasis on interviewing: the initial interview has always been one of the most important steps of physical therapy, and there’s an even stronger emphasis on it in PIPT; the main difference with traditional physical therapy is that you’ll be asked detailed questions about your mental state and daily interactions—for example—in addition to your physical condition
  • Therapist reinforcement: this is another standard component of all physical therapy programs that receives even more attention in PIPT; your physical therapist will provide you with ongoing support as you follow your treatment plan and as you display signs of improvement, which has been found to yield better outcomes for patients
  • Individual techniques or protocols: in addition to the pain-relieving treatments (like ice, heat, and ultrasound) and movement-based interventions (like various exercises and manual [hands-on] therapy) typically used in physical therapy, other individual techniques like relaxation training, guided imagery, problem solving, and cognitive and behavioral training strategies
    • Another commonly used intervention is biofeedback, which teaches patients how to control certain functions of their involuntary nervous system (like heart rate, temperature, muscle tension, and blood pressure); this is done through a device that measures one of these bodily functions as the patient modifies their response accordingly

PIPT has technically been around for about 30-40 years, but a strong interest in it has been developing over the past decade or so. A growing number of physical therapists are now using PIPT as a part of their approach to care in order to screen and better target treatments for many patients, especially those who are at a high risk for pain-related disability. Research has also shown that it’s effective for a number of common painful conditions, as several studies have found PIPT to be more effective than traditional physical therapy for neck pain, low back pain, knee osteoarthritis, chronic knee pain, and degenerative disc disease.  If you’re interested in learning more about PIPT or are currently dealing with pain of any sort, our New York City physical therapists are happy to assist you. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment today.

Success stories from Dynamic Sports Physical Therapy in New York City: Charlton bounces back after just eight weeks of treatment to complete an Ironman

Charlton first came in to visit Dynamic Sports Physical Therapy in New York City after experiencing pain in the middle of his knee. He first noticed the pain while on a training run about eight weeks before his first Ironman Triathlon in Cambridge, MD, and said that he had never dealt with any knee issues up to that point.

To determine what was causing these symptoms, Charlton’s therapist put him through an SFMA screen, a diagnostic system that assesses movement to pinpoint the problem. Results showed that Charlton had dysfunctional movement patterns in his ability to touch his toes (multisegmental flexion) and rotate to the right and left (multisegmental rotation). He also demonstrated a reduced ability to stretch his hamstring and calf muscles, decreased stability of his core, and reduced hip strength. Based on this assessment, the most likely source of his knee pain was found to be patellofemoral irritation due to valgus collapse in his running form. This essentially means that the lack of hip strength and core stability resulted in poor alignment of his hip and ankle, which led to irritation of the knee.

Overcoming a tight timeline for treatment

The main challenge in prescribing Charlton’s physical therapy was the proximity of his race and the need to balance strength training with training volume. His treatment plan consisted of a manual (hands-on) therapy technique called soft-tissue mobilization combined with the Active Release Technique, which was applied to his calves, iliotibial band in the knee, hamstrings, and other thigh muscles called the adductors and tensor fascia lata. The strength program focused on achieving optimal alignment of his lower extremity while squatting and running. A variety of exercises were also utilized to increase the strength of various muscles that supported his hip and core muscles.

Even with the short timeline, Charlton was able to complete his treatment and finished the Ironman Maryland in a time of 10:40:17, which put him in 108th place overall, 99th in his gender, and 16th in his age group. He had this to say about his experience at Dynamic Sports Physical Therapy: “I felt supported and confident going into the race making sure the sharp pains were not a season-ending injury. My experience with everyone at Dynamic Sports was hassle-free and the team made me feel welcome and ultimately excited going into the race!”

Experience similar results at Dynamic Sports Physical Therapy in New York City

His case highlights the importance not only of a proper evaluation—as his knee pain was due to hip weakness and core stability issues—but also how strength training can create an environment that can tolerate load. As noted earlier, the challenging part of Charlton’s rehab was that his race was only a few weeks away when he first came in to see us. Proper strength gained during the offseason would have helped to create normal alignment, which helps the body disperse force optimally as the miles of training needed for an Ironman gradually add up. If your training regimen has been thrown off by injury or you’re dealing with any other new pain, we can create a treatment program that works, regardless of your schedule. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment today.

The Importance of Strength Training for Triathletes

We are nearing the end of the offseason…Have you been hitting the gym?

Strength training is an essential part of a successful triathlon training program.  It helps to improve muscular endurance and power output, it prepares the body for the demands of training and racing, and it helps to prevent injury.

An athlete with well-balanced strength will have the ability to efficiently transfer power from his or her body into each swim stroke, pedal stroke, and run stride.  Conversely, an athlete with insufficient strength can experience power leaks from poor postural control that reduce the amount of force he or she is able to produce.

Postural strength is also very important for injury prevention.  As your workouts get harder, you need the proper support from your muscles to maintain good biking, running and swimming form.  When form fails, we are susceptible to injury.  We all know (should know!) we need good core strength to create a stable base for all the activities we do.

It is especially important to work on the lateral and rotational musculature of the hips and core. These muscles are what help you to move side to side and make cutting motions, and most importantly for running and biking, they also help prevent any unwanted side-to-side or twisting motions of the pelvis, trunk, or legs.  When these muscles are strong, you will be less prone to injury and also more efficient.  Running and biking is a straight-forward motion, so in these sports you are predominantly working the muscles in the front and back of the hips and legs.  Therefore, a strength program that includes strengthening the lateral muscles to improve your stability is very important.

Break your training into phases

Just like running and triathlon training, strength training should be periodized throughout the year.  It starts with the general strengthening/preparation phase, which lines up with the offseason and build phase of triathlon training. This is when you work on increasing your overall base strength.  The offseason, in particular, is also when you get to take a break from focusing extensively on swimming, biking, and running.  So hitting the weights is a nice change of pace!  You can go a little harder with the resistance in this phase because you don’t have to worry about fatigue or soreness for your next run, bike, or swim workout.  Heavy-resistance training in particular has been shown to enhance both short and long duration endurance capacity in high-level endurance athletes as well as well-trained recreational athletes.  Therefore, it can be helpful for races ranging from sprints and 5Ks to marathons and full-distance triathlons.  In addition, the stronger you are, the better you will be able to handle increases in workout intensity and duration as the season progresses.

After the offseason and build phases, you enter the pre-racing phase.  Here your strength training becomes more sport-specific and more focused on explosive movements in order to build power.  You are using the strength gained in the previous phase to build power and speed.  Plyometrics are also added at this point.

Once in the competitive phase, the idea is to maintain strength through the rest of the season.  Resistance and overall volume of strength exercises is reduced, as you focus more on training for your races.

When the season is over, take some time off to rest and recover.  This is important!  During this time, strength training at low loads can be kept up a couple times a week so that you don’t lose too much fitness before the next cycle starts.

If you are new to strength training and unsure of proper technique, sign up for a session with a coach or physical therapist to help guide you.  Even if you are experienced with strength training, it is beneficial to have a functional assessment, so you can focus your strength sessions specifically on your needs.  In most states you can see a physical therapist without a doctor’s prescription, so it’s easy to get evaluated and learn what you need to work on to ensure an injury-free and successful season!