This is where physical therapy can play an important role. If you experience difficulties with your balance, we can administer a balance assessment. Then, we can design a personalized program to ensure that you can walk to the best of your ability.

Exercises can be an important tool to improve your balance. Many exercises will help build muscle strength, particularly in your legs. Leg lifts to the side and back, and knee lifts performed two to three times a day at home while holding onto a table or chair can help you maintain strong leg muscles, help you walk comfortably and prevent falls.

Other exercises include the use of parallel bars. Here, we stand behind you while you shift your weight from your right to your left leg in a swaying motion. As you get used to performing the exercise correctly, you can shift your weight forward and backward. Eventually, you will be able to do the exercise without the aid of parallel bars.

Some physical therapists have found that Nintendo Wii games can effectively treat patients who suffer from balance problems, especially those recovering from strokes. In particular, therapists at Bridgeport Hospital’s Rehabilitation Unit in Connecticut report that patients have been able to hold their balance longer after playing tennis using the remote controller and the game on Wii Sports. Other facilities in the United States and Canada have incorporated the machine into their physical therapy programs with great success.

As your treatment progresses, we will add exercises to help you to maintain your level of function. Poor balance can strike from many causes, but with regular physical therapy, you can continue to enjoy walking and living independently once again.

If you have experienced repeated shoulder dislocations—or continue to have pain or problems despite prior shoulder surgery—you might be a good candidate for a Latarjet procedure. This type of surgery stabilizes the shoulder and involves taking a piece of bone from your shoulder blade and attaching it to the joint to fill the indentation caused by recurrent dislocations. It generally requires a one-night hospital stay and carries minimal risk.

However, the recovery from this type of procedure can be somewhat intensive. For the first four to six weeks, you will wear a sling and keep activity to a minimum, engaging in gentle range-of-motion exercises only, to protect the new bone grafts.

A guided physical therapy program is essential to regaining strength, flexibility and comfort. More importantly, we can ensure that you do not impede healing by doing too much too soon or performing the wrong types of exercises.

In the first few weeks, we will give you a gentle movement routine to promote the essential healing and to keep the surrounding tissues mobile and the muscles able to activate. As soon as you are ready to start a more comprehensive rehabilitation program, we will incorporate strengthening exercises that focus on the shoulder.

Latarjet procedures have a very high success rate, and with our help, you should be able to return to your normal physical activities within a few months. We can evaluate your shoulder and help you get started on your rehabilitation. After reviewing your schedule and condition, we can make recommendations to help you avoid overuse.

Depending on how well your overall recovery is progressing, it is best to wait one to four months before picking up a club. Then, ease back into the game. Start by practicing chipping and putting before trying full swings again. At that time, we can advise you about adjustments to your swing that will avoid placing undue stress on the replacement joint. Modifications will depend on whether you are right- or left-handed and which hip has been replaced.

It is also important that you wear rubber-soled athletic shoes, rather than shoes with golf spikes. With spikes, your stance is fixed during your swing, allowing for no accommodation to protect your hip from excessive twisting.

After several weeks, walking the course should not be a problem. Lace up your spikeless shoes, begin with a 9-hole game and later tackle an 18-hole course. On the links,

• use a golf cart, at least at first, so you don’t have to carry your bag
• alternatively, employ a caddy or use a wheeled bag
• avoid damp or rainy weather to lessen the chance of slipping and falling on wet grass

Recovery from hip replacement surgery can be extensive, but you will achieve the best results from your surgery by following our suggestions and committing to our rehabilitation process. Chances are excellent that once you start to play golf again, your hip will feel much better than it has in years. Maybe you will even shave a few strokes o your game!

In 2004 the American College of Sports Medicine noted that physical activity can increase and maintain bone density mass in children and adults, as long as the body gets enough calcium to start with. With decreased bone mineral density, the vertebrae weaken and become vulnerable to collapse. Add poor posture to a weakened spine, and the likelihood of vertebral fracture increases. The weight-bearing exercises of yoga therapy can address this problem.

As in traditional physical therapy, therapists can design an exercise program tailored to your age and flexibility that incorporates yoga poses and breathing exercises. Practiced with awareness and caution under the guidance of a trained professional, this therapy also

• promotes good posture and coordination through weight-bearing poses—including arm balances, inversions and standing poses
• enhances bone strength (weight bearing on a single limb)
• improves muscles’ endurance, elasticity and stamina
• increases blood flow to promote healing, relieve pain and decrease inflammation
• increases flexibility
• improves balance
• restores range of motion and function

Yoga no longer involves just stretching, either; new versions of “power yoga,” derived from ashtanga yoga, can give participants quite a workout. To avoid injury, do not try yoga without professional guidance or push yourself too zealously.

Yoga is a tool used by physical therapists to treat a variety of musculoskeletal conditions. A physical therapist trained in yoga therapy can show you what this ancient form of exercise can do for you.

Several studies, however, have suggested that engaging in exercise such as strength training can significantly improve MS symptoms. It may also delay the degenerative effects of the disease.

Although physical therapy will not cure the symptoms of MS, it can give you the tools to cope with the changes you experience. As soon as possible after your condition has been diagnosed, you should make an appointment to see us. We can teach you how to

• strengthen muscles
• relieve stiffness
• reduce fatigue
• improve independence
• minimize pain
• enhance overall functioning

Although weight-training machines and free weights such as dumbbells can be very helpful, an additional benefit to physical therapy is that you can go beyond weight
training. To provide you with practical ways to improve your functioning at work and in the home, we will also design exercises that do not require specialized equipment. These include modified push-ups and leg squats, both of which you can perform at home. By incorporating strength training into your day, you can improve your balance, coordination and strength.
The ultimate goal of physical therapy is one of empowerment—helping you to manage your MS. Through strength training and other techniques, the result will be long-term management of your symptoms and a better quality of life.

Pain pumps are no longer inserted directly into joints. Some recent well-publicized cases reported that patients who underwent arthroscopic shoulder surgery and subsequently used pain pumps to deliver anesthetics like bupivacaine to the joint developed damage to the cartilage, producing a condition technically called glenohumeral chondrolysis.

Glenohumeral refers to the shoulder joint, and chondrolysis to the death of chondrocytes, the cells that compose cartilage. Normally, cartilage cushions the ends of the bones that form a joint, so if the cartilage cells die and the tissue degenerates, the result is the painful bone-on-bone friction of osteoarthritis. While physical therapy cannot “cure” this condition, we are often the rst to recognize the signs and refer the patient to a surgeon.

Even with a pain pump, a good rehabilitation program will hasten and enhance your recovery. After surgery, we can design a progressive program of physical therapy that will

• increase your range of motion
• build up your strength
• enable you to resume daily activities in a timely manner

To achieve a successful outcome after surgery, let us help you begin an exercise program that will return you to optimal function—pain-free, strong and flexible.

Knee pain and injuries happen when you damage cartilage, muscles, tendons, ligaments and bones in your knee. A blow to the knee, a sudden twist or an unusual landing while running or jumping can all cause significant stress to the knee. These injuries can occur during running, extreme sports, football, basketball, lacrosse and hiking, among other activities.

Twisting or landing hard can sometimes result in a torn anterior cruciate ligament, causing two distinct types of knee pain, chronic pain and acute pain. Acute pain can be more intense in the short term, but chronic pain can last indefinitely.

A knee strap or sleeve impacts the patellar tendon, producing several benefits. The patellar tendon can be overused in certain sports, which can lead to inflammation and a partial tear of the tendon. The knee strap or sleeve

• enhances knee reactions
• speeds healing
• reduces pain
• helps prevent further injury

After an injury, you will probably have to protect your knee for a while, but using a strap or sleeve should get you up and moving more quickly. Best of all, these devices usually fit all sizes and anyone can learn how to properly tighten one.

Whether or not your physician prescribes a knee strap or sleeve after injury, we will gladly design a program of rehabilitation that hastens your recovery in a safe, eeffective manner. A combination of exercise, manual therapy and a positive attitude can assist in healing and put you on the road to recovery.

Because your feet are subjected to nearly a million pounds of pressure during an hour of strenuous exercise, proper footwear is important to cushion these loads. For this reason, shoe companies and medical professionals have recommended wearing specific types of footwear to prevent injuries.

It would be nice if the right shoe could really protect you from injury, but research conducted by the U.S. Marine Corps and published in the September 2010 issue of the American Journal of Sports Medicine found no significant difference between shoe types when it came to injury prevention. So what does this mean for you?

Proper physical training— weight-bearing exercises to strengthen bones, stretching to avoid muscle tears, avoiding overtraining, etc.—is a proven, effective way to reduce injury and a safer bet than investing in an expensive pair of shoes. We can design a program targeted to your physical health, your tness and sports goals, and your body type.

As for selecting footwear, stick to the basics:

• Ensure a good fit.
• Choose shoes specific to your type of exercise (e.g., running shoes for runners; basketball shoes for basketball players).
• Go shoe shopping with the type of socks you typically wear while exercising.
• Make sure to walk around the store for a while before deciding on a pair.
• The best shoe for you will be the shoe that feels the best.

To ensure that your body is in the best condition possible while avoiding mishaps on the field, on the court or on the street, our team of experts can help you with training form and instruct you in appropriate and proper stretching and recovery techniques. We can provide you with tools that will help maximize your performance as a healthy and happy athlete.

Pubalgia most often affects high-level male athletes. The pain results from a stretching and weakening of the internal inguinal ring, a triangular anatomical structure in the groin area through which the ilioinguinal nerve and spermatic cord pass. Tears or strains in the lower abdominal muscles, in tendons or ligaments in the groin area, or in the pelvic lining may also contribute to the pain.

The surgery to repair the inguinal canal wall is performed either through a small traditional incision or through several very tiny incisions. Because lower abdominal muscles are shifted during traditional surgery and need to heal first, some time must pass before you can engage in physical therapy.

However, if your physician wants to manage your sports hernia conservatively to avoid surgery, we can design a program that fosters core stability and carefully balances the interactions between the muscles of the hips, thighs and pelvis. Strengthening the inner thigh and abdominal muscles, and balancing the way they are used in sports can minimize the chance of future injury. In addition, we will teach you the best way to heat and/or ice the affected area and oer deep-tissue massage if appropriate. Similarly, a postsurgical physical therapy program that focuses on increasing your endurance and strength will enhance your recovery.

Whether or not you undergo surgery for athletic pubalgia, we can design a program of physical therapy to alleviate pain and strengthen the muscles, making you more
comfortable and preventing re-injury. By following our program, you will once again be able to participate in the sports you love—pain-free.

As we age, the natural loss of muscle makes it harder for our bodies to handle daily activities, such as bending, walking and picking up heavy objects. This loss of muscle tone contributes to back problems, knee injuries and a myriad of other body ailments. No matter how limber you may be, the cardinal rule for muscle is “use it or lose it.” Strength training not only helps maintain muscle but it can also

• reduce the risk of osteoporosis by increasing bone density
• help you maintain a healthy weight—lean muscle mass burns more calories than fat
• protect your joints and ligaments, helping you to avoid future injuries
• improve balance and overall well-being

It is important to engage in the right kind of stretching, as well. Some studies have suggested that the traditional static stretching (stretching a muscle or muscle group to its farthest point and then holding that position)—often a part of stretch and tone classes—is not ideal when used alone before exercise. Instead, the dynamic stretching (slow, controlled leg and arm swings or torso twists) often used by athletic teams to warm-up or a combination of the two (gentle general exercise to warm up and gentle dynamic stretching after exercise) may be more helpful. A 2008 study by the U.S. Centers for Disease Control and Prevention found that engaging in both static and dynamic workouts reduced the risk of knee injury in female soccer players by half.

To truly improve your physical health, heal from injury and prevent future chronic ailments, a good overall fitness plan is needed. We can design an individualized plan that incorporates the right kind of stretching, strength training and aerobic exercise to turn your body into a well-oiled machine.