Marathon Physical Therapy
and Sports Medicine Fall '07 Newsletter

Articles:

• ACL Injury & the Female Athlete
• Pilates
• What is Pelvic Floor Physical Therapy?

Clinic News:

• Runners and Triathletes!!!  Marathon is now offering Group Pilates Mat Classes!!!
• Postpartum Health For Moms Course

Community News:

• Marathon Physical Therapist, Jody Yoken (Newton), travels to Israel to assist in Charity Bike Ride to raise funds for local physical therapy services.

ACL Injury and the Female Athlete

Since the inception of Title IX in 1972, the involvement of girls and women in athletics has increased at a dramatic rate. Over the past 12 years, participation by women in the Olympics has doubled and as of the 2004-2005 NCAA reports, there are more women than ever participating in collegiate athletics.

This increase in the number of females who compete in athletics is staggering... as is the incidence of ACL injury in the female athlete. It has been well documented that female athletes have a 4-8 fold increase in risk of ACL injury when compared to male counterparts of the same sport. Over 38,000 females injure their ACL’s per year.
           
It is imperative that female athletes are educated at a young age so as to help take the necessary steps in preventing an ACL injury. There are many factors that seem to play a role in ACL injury. Our focus primarily lies with neuromuscular re-education, proper strengthening, and educating about proper nutrition in order to stay healthy and prevent injury.  

Written by Jonathan Banz, Physical Therapist

Pilates

Pilates is a mind-body exercise developed by the late Joseph Pilates in the 1920s. The Pilates method involves stretching and strengthening exercises that work to promote body awareness and symmetry through controlled movement. Pilates is useful in rehabilitation because it strengthens the deep core muscles that help stabilize the spine, pelvis, shoulder girdle and neck. Pilates does not focus on the superficial or global muscles that are often over-emphasized and may be contributing to postural dysfunction. The center of Pilates is based upon a series of mat exercises; however other equipment is used such as the reformer, cadillac, chair and the barrel.

Two exercises that are often used in rehabilitation for low back pain are the toe touch and the single leg circle. The single leg circle begins in the supine position on the mat with the spine and pelvis in neutral. One leg is straight on the mat and the other leg is reaching to the ceiling with the hip flexed to 90° and the knee extended. Inhale and circle your leg towards midline, maintaining a neutral spine, then exhale to complete the circle. Imagine you are drawing a circle on the ceiling with the tip of your foot. Repeat the circles 5 times and then switch directions. Repeat on the opposite leg. This exercises focuses on lumbo-pelvic stabilization and hip mobility.

The second exercise, the toe touch begins in the supine position on the mat with your hips and knees bent to 90° or in a “table top” position. The pelvis is “imprinted” or in a posterior pelvic tilt. Inhale and engage the transversus abdominus by drawing you navel to your spine, maintain the abdominal connection as you exhale and lower one leg to the mat. Inhale as you draw the leg back to table top and repeat on the opposite leg. Complete 10 repetitions and then lower you legs down one at a time. This exercise focuses on strengthening the abdominal muscles that aide in providing support to the lumbar spine.  These are just two examples of how Pilates can be used in rehabilitation. Ask your physical therapist how you can incorporate Pilates into your exercise routine.

Single leg circle	Toe touch

Marathon Physical Therapy now offers private machine and mat training and group mat classes at our Newton Location.  Please call 617-244-1990 for further details.

Written by Kerry Ardleigh, DPT

What is Pelvic Floor Physical Therapy?

 It seems these days that Pelvic Floor Physical Therapists have been popping up throughout the world.  Most of you are probably saying “physical therapy for what?”  The pelvic floor is composed of the musculature and connective tissue which surrounds the pelvis and forms the floor of the pelvis.  The function of these muscles is to support the viscera (organs) in the area, provide sphincter control (important for maintaining continence) and improve sexual activity.

Now you may ask why someone needs to see a physical therapist that specializes in the pelvic floor.  There are many reasons and here are a few:

1. Incontinence
2. Pelvic pain
3. Post partum rehabilitation
4. Post Cesarean-section rehabilitation
5. Post Hysterectomy or other Intra-vaginal surgeries/Post abdominal surgery
6. Dyspareunia (painful intercourse)

Patients are also referred to pelvic floor physical therapy for medical diagnoses such as vulvodynia or vestibulitis, interstitial cystitis, pudendal neuralgia and irritable bowel syndrome.  Pelvic floor therapy is not only appropriate for women, but also men, because both men and women can experience pelvic pain, as well as urinary and bowel dysfunction (frequency, urgency and incontinence).

There are common symptoms about which patients complain when evaluated by their doctor or pelvic floor physical therapist.  Urinary symptoms may include frequency, urgency, incomplete emptying, retention, hesitancy and incontinence.  Bowel symptoms can be similar to urinary symptoms, but can also include constipation, diarrhea, bloating and pain.  Patients with pelvic pain commonly complain of painful intercourse (including painful ejaculation in men), pain with sitting, burning and/or rawness, low back pain, and any of the previously mentioned urinary or bowel symptoms.

Once patients are referred to see a pelvic floor physical therapist (usually from a urologist, urogynecologist, gynecologist or gastrointestinal/colorectal specialist), a thorough evaluation is performed.  The evaluation includes both an external and intra-vaginal or intra-rectal examination looking at tissue mobility and quality, tension in the pelvic girdle and pelvic floor muscles, strength and the ability to relax the muscles, posture and joint mobility.  Treatment usually consists of some combination of myofascial trigger point release, soft tissue and connective tissue manipulation, joint mobilization, neuromuscular re-education, biofeedback and electrical stimulation.  Most patients are seen once or twice a week.  Duration of treatments does depend on the condition and sometimes how long the patient has had symptoms.

Written by Niva Herzig MS PT, BCIA-PMDB

ATTENTION ALL MOMS!!!

Marathon will soon be offering a new educational course entitled “Postpartum Health for Moms: Restoring Form and Function”, with a focus on understanding the way the body changes in response to pregnancy and how women can be proactive to reverse these changes in the post-partum period. This 7-part class will meet Tuesdays at the Norton clinic beginning  February 19, 2008 and is relevant for women at anytime after a pregnancy, be it months ago or years ago. Click here for more information, or you can direct questions to Jessica at jmckinney@marathonphysicaltherapy.com.

Hi everyone,

Now that I'm finally adjusted to daylight savings time, I thought I'd report on my recent trip to Israel. I was participating in a 5-day bike trip across the country (from Tiberias to Jerusalem) in order to raise money for Alyn, Israel's only pediatric and adolescent rehab hospital. Upon arrival, I met with the head physical therapist and some of his patients. He gave me a tour of the facility (state of the art with pool therapy, prosthetic training, and wheelchair fitting) and I got to sit in on some of the treatment sessions. It was sad to see the patients and how involved these kids were, with ventilators and amputations, from car accidents and terrorist attacks. The hospital is not government funded, and treats Israeli and Palestinian children. My team, which included my husband, father, and myself raised over $11,000, and all together the 500 riders raised over $3 million. The ride itself was physically and mentally challenging, covering over 60 miles and 1800 meters of climbing a day. Of the 500 riders, only 80 participated in this 'challenge' route, and I was proud to be one of 4 females to ever finish! However, it was all worth it to see the smiles on the kids' faces, as they cheered us in on the final leg of the ride into the hospital. At the closing ceremony, each child represented all the rider's home-countries, but attaching the flags to their wheelchairs or bicycles. It was a beautiful and emotional experience. I will attach some pictures of the ride.

Enjoy!
Jody Yoken, DPT