Recovery after a Concussion…A True Story

In the fall of 2016, our son sustained a concussion on the football field as the result of a direct hit. While he had been well-coached in how to hit and block properly to avoid injury, there was little that could be done to avoid sustaining a bad hit.

Thankfully, he never lost consciousness, but immediately experienced significant headache, dizziness and extreme sensitivity to light. He was checked out by the on-site EMT and was recommended to see a doctor the following Monday. Over the weekend, his symptoms increased significantly, to the point where he was wearing sunglasses indoors and experience general confusion. Riding in a car was painful, as was listening to music and any type of reading or viewing on a screen.

Our family doctor recommended the standard concussion protocol at that time: no school, no sports or physical activity, no reading, and no screens until he was symptom-free. He was 14 at the time and might as well have been told not to breathe, but we committed to following the protocol in hopes of his quick recovery.  Within a few days of this recommendation, he became restless, frustrated and discouraged. His football season was over, basketball was uncertain, he would miss a total of 18 days of school, and worst of all, symptoms were not changing and he had no outlet for his angst.

At that point, we pursued additional input at Hartz Physical Therapy and were introduced to Drew Nesbitt. The first thing that impressed us was Drew’s ability to interact with a teenager. He treated our son with respect, communicating directly with him and not through us, and he knew the culture of local sports and was easily able to talk recent scores, player highlights and top teams. He instantly put our son at ease.

Up to that time, we felt that we basically had to wait in a dark tunnel for symptoms to disappear until there could be any return to normalcy, and it was maddening to feel so helpless in the recovery process. We quickly learned that Drew was highly educated and well-researched in the concussion arena, and several studies were just beginning to reflect that some physical activity might increase the pace of recovery and strengthen brain function. He developed a multi-faceted plan that allowed our son to re-introduce activity (cognitive, vestibular, physical) that slowly re-strengthened what had been damaged. More importantly, the opportunity to DO something to work toward recovery created motivation and hope!

While Drew initiated the plan, many on the team at Hartz walked it out with our son and their commitment to his success was evident. We were truly impressed with their research and constant willingness to push our son to, but not beyond, his limit. As they worked with him, they were educating him about the injury itself, what each exercise or activity was aimed to strengthen and how he could protect himself from re-injury. In all of this, they maintained realistic goals with a hopeful perspective. It was an experience that created a deeper level of maturity and personal responsibility in our son for his own health and well-being.

We are truly grateful for Drew and the entire team at Hartz PT. Looking back, our one regret is that we didn’t go directly to their office the morning after the injury. We believe our son’s overall recovery would have been shorter with the application of current research and strategy.

~ Testimonial written by Kelly M. whose son was seen by Drew Nesbitt, DPT

What is Causing your Elbow Pain?

A common form of elbow pain occurs when the muscles on the inside of the elbow (Medial Epicondylitis) or outside of the elbow (Lateral Epicondylitis) become inflamed and irritated.  You may have heard of “Tennis Elbow” or “Golfer’s Elbow”, as these names typically describe elbow pain based on its location.  However, despite the names, these symptoms can be brought on by a variety of different motions or activities that involve the elbow.  Both forms of elbow pain are typically caused by overuse from a repetitive activity.

Tennis Elbow (Lateral Epicondylitis) occurs when the extensor muscles of the forearm become inflamed.  Many of the muscles on the outside of the forearm attach to the outside of the elbow on the humerus bone at a spot called the “lateral epicondyle”. Symptoms may include sharp pain, swelling, and tenderness when the spot is touched or bumped.  In addition, repetitive motions of wrist extension, which is used when performing a backhand tennis shot, can aggravate symptoms.

Golfer’s Elbow (Medial Epicondylitis), on the other hand, occurs when the flexor muscles on the inside of the forearm become irritated.  Just like in Tennis Elbow, the flexor muscles on the inside of the forearm attach to a common bony spot on the humerus called the medial epicondyle and may become irritated and painful after overuse or repetitive motion.  A common motion is the gripping of a golf club, hence the name “Golfer’s Elbow”.

So, what can you do if you have this pain? The best approach is to rest and ice the affected muscles.  Since these symptoms are caused by overuse, taking a break from the aggravating activity is important.  Along with resting, decreasing the inflammation in the elbow is very important. Icing the elbow for 10-15 minutes every 3-4 hours can be an effective way to help decrease pain levels.  In addition, some gentle stretching may help to alleviate tightness in the muscles.  Finally, as symptoms decrease, strengthening exercises are important to help prepare the muscles for returning to the stressful activities.  In addition to these treatment plans, people may find relief from wearing a brace just below the elbow to help reduce the amount of strain placed on the affected tendons.

  

 

 

 

In more severe cases, NSAIDS may be needed to help reduce pain and inflammation in the elbow.   As the symptoms decrease, it is important to begin a stretching and strengthening program to help restore full strength and range of motion in the affected elbow.  A gradual return to activities is encouraged, however any increase in pain or soreness could indicate that the elbow is not ready to return to full activity levels.

If you have are having difficulty treating the pain and soreness in your elbow on your own, physical therapy can be very helpful in guiding you with appropriate stretches and strengthening exercises for either Tennis Elbow or Golfer’s Elbow.   In addition, PT can assist you in returning to the activities you love, including golf or tennis.

Does your Growing Athlete have Knee Pain?

Patellar Femoral Pain Syndrome, otherwise known as PFPS, is common in adolescent athletes especially those who participate in sports year-round. This diagnosis presents itself with generic soreness in and around the front of the knee and/or kneecap. Since most athletes in their teens have growth spurts, their bones grow faster than their muscles. This causes an imbalance with the forces around the knee causing abnormal motion of the kneecap. Typically, this will cause pain with prolonged standing, negotiating stairs and athletic activity in general.

Physical therapy is one of the few avenues available to reduce the pain and accelerate a return to sports with full function. The typical plan of care is as follows:

  1. REDUCE SWELLING: Modalities, such as ice, heat or electric stim can help
  2. INCREASE FLEXIBILITY:  Chances are good that the ligaments surrounding the knee (IT Band, lateral retinaculum) haven’t kept up with the bone growth and are therefore very tight.  As a result, the patella moves laterally (to the outside) when running or walking, creating extra friction, and often pain.  Stretching the tight ligaments allows the knee cap to return to its normal tracking pattern and will reduce pain.
  3. STRENGTHEN WEAK MUSCLES:  As the therapist works to stretch tight ligaments, the patient must also strengthen key muscle groups, such as quadriceps, hamstrings, gluteus medius, gluteus maximus. These muscles help to stabilize the joint which provide increased endurance with sport-related activities and also help to keep the patella moving smoothly.
  4. ADD PLYOMETRICS:  As pain and swelling is alleviated, it is time to introduce a plyometric program, such as agility or sport-specific training.  This is the final step with therapy to help the athlete ease their transition back to his/her sport. This last step challenges the athlete with higher functional tasks in order to simulate game or field conditions. Quick steps, lateral jumps, and ladder drills are just a few of the techniques that a therapist may use to help move a young adult toward reentry to their sport or activity.

Don’t wait and deal with pain! Come in and see a physical therapist today.