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  • The 4th Trimester: Redefining Postpartum Care

    Last May, the American College of Obstetrics and Gynecologists (ACOG), came out with an article about redefining the postpartum visit in order to better serve women. In the article, the ACOG writes about how postpartum care should be an ongoing process and not just a single visit to the doctor’s office. This process can begin right after birth and can last for the duration of the first 12 weeks after birth, which is why these weeks are being dubbed the “4th trimester”: three trimesters before birth and a trimester for the mother to recover and take necessary steps to heal. The ACOG state that the comprehensive postpartum visit should include a full assessment of physical, social and psychological well-being. The ACOG article has a list of components of postpartum care which includes but is not limited to the following: Mood and emotional well being Infant care and feeding Sexuality, contraception, birth spacing Sleep & Fatigue Physical Recovery from birth Chronic disease management Health maintenance Just one important aspect of postpartum care should entail going to see a physical therapist who specializes in women’s health or pelvic floor dysfunction. Working with a physical therapist will incorporate diastasis assessment, pelvic floor assessment, body mechanics to help carry or lift your baby and modalities or manual therapy for pain relief. Pregnant and postpartum women are at risk for abdominal muscles separating, which must be assessed 6 weeks postpartum to determine if the abs are split or not. Exercises should be progressed safely in order not to make the separation worse. Women may also experience bladder control issues, incontinence or pelvic pain, all of which can be addressed with a specialized physical therapist. Although this article was written last May, it is important to spread the word and inform as many women as you know. In France, every woman who has a baby is covered by insurance to go to PT after giving birth just to make sure everything is working as it should be. America should be doing this as well! Pelvic floor physical therapy is just one part that should be incorporated in the 4th trimester. The ACOG took the first necessary steps to start redefining the normal care of pregnant and postpartum women, and now it’s time for us to spread the word. ”Optimizing postpartum care. ACOG Committee Opinion No. 736. American College of Obstetricians and Gynecologists.” Obstet Gynecol 2018;131:e140–50. Accessed March 25, 2019. Request an appointment with Zion Physical Therapy today!

  • What is a “pinched nerve”?

    So commonly I hear patients say something along the lines of “my neck hurts and I have some tingling in my hands. My doctor said I have a pinched nerve”. Ever wondered what this really means? And most importantly, how can physical therapy ease the symptoms and help you get back to what you love doing? The expression “pinched nerve” is a term used to indicate what we know as radiculopathy. It most commonly refers to the clinical description of when a nerve root is irritated, and as a result of this irritation you can experience pain or tingling along the course of nerves coming from that specific nerve root. A radiculopathy can result in numbness, weakness of some muscles or changes in reflexes, and all these symptoms can occur anywhere from the neck into the shoulder, arm, hand, or fingers. Good news is that the majority of patients with cervical radiculopathy get better over time and do not need treatment. However, for some people, pain still persists and a pinched nerve can really get in the way of living your regular life. Pain might stop you from working, from sleeping well, from playing an instrument, playing with your kids or cooking. Because of pain you might move less and the lack of moment can make the neck even more sensitive and less prepared for everyday activities. That’s when physical therapy can help! The main focus of physical therapy for a person experiencing symptoms of cervical radiculopathy is decreasing the pain and disability. Because there are other pathologies that have the same or similar signs and symptoms of radiculopathy, your physical therapist will conduct a thorough examination (assessing range of motion, strength, joint mobility, reflexes and functional movements), ask you about your experience with this pain and also possible past experience with neck pain and create an individual treatment plan based on your symptoms and needs! Treatment can vary greatly and usually entails a combination of hands on techniques to decrease sensitivity of the neck joints and muscles, such as Maitland, mobilization with movement, nerve gliding techniques. Exercises are also a key component of rehab, to improve the range of motion and strength. Every patient and every story is different, so it is important to evaluate your specific situation to understand what the contributing factors might be! If you are experiencing neck pain and you have questions, give us a call at (212) 353-8693!

  • Tips for Optimal Posture While Working From Home

    Whether you’re working from home or just spending more time on the couch these days, do you find your neck or back aching from how you’re sitting? Chances are you don’t have the same ergonomic setup at home that you do at work, so here are a few things you can try to avoid pesky neck and back aches! Sit with your weight over your pelvic floor and hips higher than knees. This means not sitting back on your “sit” bones, but slightly forward so that your weight is balanced between your sitting bones in the back and your pubic bone in the front. You can try tucking and tilting your pelvis (anterior and posterior pelvic rocks) in sitting in order to find the middle and what feels like your neutral spine. Your hip/knee angle should be about 100-110 degrees (hips higher than knees). Your rib cage should be balanced right over your abdomen, which should be balanced right over your pelvic floor. Now your core is primed and ready to fire at a moment’s notice! If your back is not already touching the back of the chair or couch that you are sitting on, add some back support. Place a pillow, blanket, sweatshirt, etc. behind your lower back until it feels supported all the way from your upper back to your lower back. 3. Next, make sure your feet are supported. If they are not flat on the ground, place a book, pillow, blanket, etc. under your feet. This will help prevent excess strain to your low back. 4. Lastly, let’s support your arms. If you are sitting at a table or desk and are sitting up high enough that your forearms can be supported on the desk - great! If not though - maybe you are sitting on your couch - you can use pillows or rolled up blankets/towels on your lap to support your forearms while working on your computer. Having support under your arms will help to relax your neck. Experiment with different positions and levels/types of support while sitting on your couch or in different chairs in your home using the above guidance. One size does not fit all. Ideally, you should feel comfortable and able to relax. If something feels off, try adding or taking away support. Do what feels best for your body. And don’t forget to add some movement throughout your day as well - your body and mind will thank you. If you’d like to make a Telehealth or in-person appointment with a skilled PT to evaluate your sitting or standing workstation at home, please call (212) 353-8693 or email schedule@zionpt.com

  • 10 Reasons to See a Pelvic Health Physical Therapist after C-Section

    You are experiencing lower back pain. You are experiencing lower back pain. You are leaking urine upon exertion or when your bladder is full and you have to urinate. You want to get back to your pre-pregnancy exercise routine. You have pubic symphysis pain. You have a separation of your abdominal muscles known as Diastasis Rectus Abdominus. You still “feel 3 months pregnant.” You have pain with transitional movements ie. getting in and out of bed, sit to stand, lifting your baby. Your scar is tender, uneven or lumpy. You experience urinary urgency/frequency, pain with sex, or constipation. You feel fine but want to make sure you are on the right path to recovery!! Did you know that in France, a pelvic health physical therapy evaluation is standard at 6 weeks post-partum? Why don’t we do that in the US? At Zion PT, we are trying to bring awareness about all of the symptoms that could present themselves after a vaginal or C-Section delivery that could impact a woman’s quality of life and that she may think is “normal” or “will go away eventually”. Take charge and schedule an evaluation with one of our highly specialized pelvic health therapists today! If you’d like to make an appointment, please call 212-353-8693!

  • 5 Exercises to Re-establish Core Strength after Vaginal Delivery or C-Section!

    So you just had a baby...congratulations! It’s about 6 weeks post-partum and you’ve been cleared to exercise again by your OB or midwife. Great. But where do you start? Good question! During pregnancy, the body’s hormones allow the abdomen and pelvic girdle to stretch and shift to accommodate the little person growing inside of you. This is all truly amazing and necessary however what happens after you give birth? Does it matter whether you’ve given birth vaginally or whether you’ve had a C-Section? Does everything immediately go back to your pre-pregnancy state? Not necessarily. After having a vaginal delivery, there may be trauma to the pelvic floor in addition to laxity in the abdomen from pregnancy. After a C-Section, all of the abdominal muscles under the umbilicus are cut in order to access the uterus and then are repaired. How do we get these muscles working again? Sit-ups? Planks? Running? NOT YET!!! FIRST, we have to isolate, re-engage and create proper coordination of the deeper core muscles in order to re-establish a solid base to support our spine and extremities during activities of daily living and return to sport. This video offers a 4 step exercise progression for getting back in touch with your deepest core muscle, the transverse. The fifth exercise adds a final layer which is a bridge, shown in this video. It is important to work with a trained pelvic health physical therapist to ensure you are performing these exercises correctly without compensation. Every woman post-partum starts out at level after delivery unique to their body and a full evaluation of the abdomen and lumbar spine/pelvis and hips should be completed to make sure the exercises being done are appropriate for you. An individualized exercise progression can then be prescribed as well to help you meet your goals! If you have questions or would like to schedule an appointment to have one of our pelvic health specialists evaluate you, please call 212-353-8693! It’s never too soon or too late to get the proper help to get your back to doing what you love best! -Dr. Staci Levine, PRPC

  • Running Safely During a Pandemic

    Taking a run outdoors during a pandemic can be a saving grace for your mental health. In fact, research has shown that regular exercise may reduce the risk of developing acute respiratory distress syndrome, a major cause of death in patients with the COVID-19 virus. However, during a time when we’re all supposed to stay inside, it might seem ironic that there are more people now, more than ever, flooding parks and outdoor spaces to run. First off, is it safe to run outside right now? Yes, if the appropriate measures are taken to ensure safety. The best plan for running right now is to go out for a solo run, in non-crowded areas. You should time your run for when you know the route will be less crowded, especially in a place like Manhattan where crowds seem to be impossible to avoid in our favorite parks. While running solo, it’s important to still maintain at least six feet of distance from others. Generally speaking, germs dissipate very quickly outdoors, however, that doesn’t mean you should abandon social distancing orders. How do you prepare yourself to run outdoors? CDC guidelines recommend “wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain.” If you’re running solo in an area where you won’t encounter others, it’s likely not necessary. But, if you’re running in a crowded area which is likely in Manhattan, NY, it’s a precaution you should take. While wearing a formal face mask may be uncomfortable, a secondary option is to wear a Buff gaiter, which is a tube of fabric that runners wear on their necks for extra warmth but might be more comfortable due to its sweat wicking capability. Yes, face masks are annoying when you’re breathing heavy while running. But, you should still wear them to prevent spreading the infection to other people and avoiding inhalation from the infected to yourself. Don’t overtrain! Runners tend to demarcate time by race seasons. So, how do you continue to meet your goals as a runner, regardless of the level you are used to training at? The key is to stay in shape across the physical spectrum! If the fall race season materializes, you can still be ready. It may not be PR ready, however, you can still pick up a race in a healthy manner. Now is NOT the time to push your body to the limit and train like you want to run a PR. Running will create a stress-response, which in normal times is good for your health and longevity, but is a dangerous response right now because it could affect your body's ability to handle infection. Try not to place anxiety or stress around hitting a certain mileage or pace. Ask yourself after you complete a run; are you feeling energized or depleted? Running should feel restorative right now during a time of high stress. So what is the appropriate running prescription right now? The Physical Activity Guidelines for Americans recommend at least 150-300 minutes per week of moderate-intensity aerobic physical activity and 2 sessions per week of strength training on separate days to help your immune system keep viruses at bay. For seasoned runners I recommend: 3-4x/week of running for a maximum duration of 60 minutes/run. 2x/week of strength training, with at least 24 hours in between a run and strength session so that you can run on fresh legs. Remember! Running more than 60 minutes, at an intensity > 75% of your personal max intensity, could in the short term weaken your immune system and make you more susceptible to sickness. So, for right now, it might not be the best decision to go for those long, intense runs. What if you are new to running? I recommend starting with an alternating run/walk combination: 2-3x/week of running, starting with 1:1 ratio of run to walk. Progress one level per week until you reach the goal that you set for yourself. Stay within that 60 minute window, however, if you are only able to go for 10 minutes at first- that’s ok! It’s important to be patient and kind to your body right now and build up in a way that feels right to you. For all levels of runners, while we are battling a pandemic; keep yourself at a conversational pace to avoid overstressing the system. If you’re not sure what that means, it’s simple! You should be able to talk comfortably throughout the duration of your run. Rest days!! Your “rest days” should be restorative and can include alternative exercise such as yoga, pilates, walking, stretching/mobility, OR complete rest if that is what you need. At minimum, I recommend 1-2 rest days. It can be tempting to pick up running 7x/week while there is more free time than usual, however, it’s crucial to avoid acute or overuse injuries to stay healthy right now. Don’t forget sleep! It is important to get at least 7-9 hours of sleep per night for both physical and psychological recovery. If you are sick with any cold or flu symptoms or at-risk of spreading the virus, you shouldn’t go out for a run. Normally, the general rule of thumb is if it is above the neck, run through it. Not in these times! Err on the side of caution. The bigger concern is spreading it to those who are at high risk, such as the elderly or immunocompromised. Now is the time to focus on making yourself a better runner. How? Focus on your limitations as a runner. Not sure what they are? Consult a Physical Therapist! A Physical Therapist can provide a detailed musculoskeletal evaluation which will include a running analysis to identify any biomechanical faults. Common areas that are important to work on to improve quality and longevity as a runner is single leg stability, core strength, hip strength (especially the gluts!), and mobility. A Physical Therapist can provide a creative plan of care addressing your personal limitations to compliment you as a runner. You can make yourself bulletproof toward injury from running by focusing on your limitations right now, especially if you are looking to be fall race season ready or are brand new to running! Phone: 212-353-8693 • Fax: 347-507-5510 • Office Email: frontdesk@zionpt.com

  • Physical Therapy Telehealth visits: What can be accomplished???

    It’s no secret that COVID-19 has challenged our healthcare system in some negative ways, but what about some of the positive changes it has brought on? Telemedicine was seemingly only performed for mental health consults and visits whereas now it seems as though most healthcare providers have found a way to communicate with and treat their existing patients AND new patients via HIPAA compliant Telehealth platforms! But what about Physical Therapy? What can a Physical Therapist do via a Telehealth session for both current patients AND new patients/referrals? A profession that prides itself on being able to diagnose and treat with the use of our skilled observation and palpation/manual skills in addition to therapeutic exercise, neuromuscular re-education and modalities performed in office? Glad you asked!! Let me assure you there is plenty we can do… 10 Things Telehealth for CURRENT patients can accomplish! Progress your established PT exercise program via real-time PT demonstration and patient observation and trial Ergonomic assessment of your home office space with suggestions to improve as needed! Provide guidance on proper posture and ergonomics on activities performed in your home (bathing your kids, cleaning, cooking etc.) Provide guidance on how to stay active and safe in your home with your current injury Teach a spouse, significant other or roommate how to perform simple manual or muscle energy techniques to perform when necessary Provide flexible scheduling around your commitments to be able to prioritize your health and well-being Communicate with your PT regarding other healthcare professionals you’ve spoken with and test results regarding your current injury Maintain continuity of care to ensure maintenance and improvement on progress thus far Assess and provide guidance and referrals on new issues/injuries that may arise as a result of our temporary “new normal.” Provide breathing techniques, stretches and app recommendations to decrease stress during this trying time. 10 Things Telehealth for NEW patients can accomplish! Provide an opportunity to get care you need NOW vs waiting for social distancing restrictions to be lifted! Take a thorough history of the issue/injury and have a complete dialogue with your PT on how to move forward Enable information exchange and proper communication between referring healthcare providers and your PT Provide guidance on proper posture and ergonomics on activities performed in your home (bathing your kids, cleaning, cooking etc.) Provide potential referral out and recommendations if other healthcare providers need to be involved in your care Perform general posture and range of motion assessment Begin basic exercise program to address impairments via real-time PT demonstration and patient observation and trial of exercises Provide a home exercise program to start with Recommend products which could be useful for a home workstation or support of a joint Recommend self-care management via use of heat/cold/compression/elevation and frequency with which to apply If you’d like to make a Telehealth appointment with a skilled PT to continue your plan of care or schedule an evaluation, please call (212) 353-8693 or email schedule@zionpt.com, or request an appointment online.

  • MomStrong Workout: Baby Edition

    Let’s be realistic. It’s awesome to have childcare available to get to your favorite fitness class, but it’s not always feasible. And we know flexibility and convenience are cornerstones of keeping up with your fitness goals. Here, I share some of my personal explorations of “making it work” with a baby at home. These exercises are what made sense for me, after two months of focused foundational exercises for the core and hips. Feel free to try them, knowing that some moves are more advanced than others. Don’t jump into it if you are having back pain, pelvic pressure, or a diastasis that has not been checked out. Or, we can work on exercises together to build an at-home workout that makes sense for you, as part of our MomStrong program. Suggested Duration: 6-18 minutes (or until baby is over it) 1 min/exercise, 1-3 times through Baby Bird-Dog Side Plank with Rotation Tickle Airplane Abs Baby Sumo Squats Straight Leg Baby Lifts Twisting Baby Lunge Contact Zion Physical Therapy to schedule an appointment online or in person at one of our four convenient locations: Phone: 212-353-8693 Office Email: frontdesk@zionpt.com Online Form: Request Appointment

  • All Things ACL (Anterior Cruciate Ligament)

    With school sports seasons starting up, it’s time to discuss all things ACL. The ACL (Anterior Cruciate Ligament) connects the upper leg bone (femur) to the lower leg bone (tibia), and is a crucial structure for preventing too much straightening (hyperextension) and/or twisting of the knee. An ACL injury can be overwhelming to the athlete. Not only is it painful, but it leads to missing out on playing your sport and sharing moments with friends and teammates. For some cases of ACL injuries, surgery is necessary to get back to the playing field, track, or gym. But what should you do in the time between your injury and surgery? And how quickly should surgery be scheduled? **Disclaimer!! This process should be discussed with your doctor/surgeon and physical** **therapist as everybody’s injury is unique** The first barrier is swelling: operating on a swollen knee is not advisable, so inflammation needs to be reduced before surgery can take place. However, it is now shown that attending 4-6 weeks of physical rehabilitation before surgery leads to better outcomes after surgery. This includes more than just decreasing swelling, but also improving active range of motion, improving movement efficiency and body mechanics, and improving strength in the injured leg as well as the non-injured leg. One study shows that those who participate in preoperative rehab showed improved postoperative outcomes at 2 years after the operation. This is a huge deal! With approx 175,000 ACL surgeries performed each year in the United States alone, we need to make sure patients aren’t at risk to re-injure themselves once they return to sports, running, or the gym. Don’t go it alone! Zion Physical Therapy’s Doctors of Physical Therapy have years of experience treating preoperative and postoperative ACL injuries, and will help you achieve your goals through a structured rehab and return to sport program. Have a different injury keeping you out of the game? Schedule an evaluation today and get on track to feel better, faster!! Ask about an injury screen to assess your movement to keep you on the playing field this season! Call (212) 353-8693 or email schedule@zionpt.com to schedule! Josh Jordan, DPT

  • How to Stretch at Your Desk!

    During the time COVID-19 pandemic, you may be sitting more on your couch or having to figure out working from a home desk, and your neck, hips, back and wrists may be sore, tight or painful. Following are eight stretches that are easy to incorporate into your day to manage symptoms or to simply feel a little less creaky throughout your day. You can do them as often as feels good to your body, but we recommend holding each stretch for 20-30 seconds and performing them 2-3 times, 2-4 times a day. Prayer hands: palms together, pushing in Reverse prayer hands: backs of hands together, pushing in Chair pigeon: outside of leg hip height or lower, engage core, lengthen spine Cat cow desk: arch back while looking up, then tuck chin to chest, pulling shoulders forward Neck stretch holding chair: bring ear to shoulder, opposite arm holds on to seat of chair Seated spinal twist: keeping hips and legs forward, twist from the back, looking over shoulder Standing quadriceps stretch with overhead reach: grab onto foot and kick back into hand as opposite hand reaches for the ceiling Forward fold: reach for toes, alternating bending and straightening knees Happy stretching!

  • Running Strong through the Trimesters: A Therapist’s Perspective

    I run to feel good, both physically and mentally; therefore, I needed running even more during pregnancy. But running while my body was (and still is) constantly changing presents some new challenges. Here’s a guide of some helpful tips to avoid running into any problems. SAFETY FIRST Take it Slow Let’s start with the usual disclaimer: make sure you are cleared by your doctor (obstetrician/midwife/gynecologist) before beginning an exercise program. There are a number of medical and obstetric conditions that may make exercise unsafe during pregnancy. With that out of the way, the current guideline for exercise during pregnancy calls for about 30 minutes of moderate intensity exercise, most days of the week (as per the American College of Obstetricians and Gynecologists). Fortunately, running is an activity that allows you to moderate the effort you put forth. You may be a seasoned runner, aware of how hard you feel you’re working and able to regulate on your own. Or, your doctor might want you to wear a heart rate monitor and stay within a certain range. As for me and my slightly competitive nature, I needed additional external factors to slow me down. I ran with my dog so that his incessant need to stop and smell the roses would force me to take rest breaks, or I chose a running partner who was slower than my current pace (shown below at 34 weeks gestation, with my 60 year old dad). Staying out of the red zone is important because your blood volume is increasing tremendously (from 30-50% as early as 16 weeks gestation), causing your heart rate to be higher than normal even at rest. And if you’re like me, your iron stores haven’t necessarily caught up with the increased red blood cells, so your risk of anemia is increased. Add to that your difficulty breathing now that your rib cage has expanded and your diaphragm is less efficient (it’s stretched out and contracting against more resistance), and you’re likely to find yourself short of breath way earlier than usual. So, go for your run, but be prepared to slow down and incorporate intervals of walking. Don’t Overheat If you’re in warmer climates or it’s summertime in the city, be especially cautious to not overheat, which could be harmful for your developing baby. I usually like to get a tan while I run, but soon I found more comfort in taking routes that were shady instead of sunny. The thought of carrying a water bottle with the weight I had already gained seemed preposterous, so I memorized all the water fountains along the route as well. If you have retained fluid during your pregnancy, and have found that your hands or feet are swollen on the regular, keep this in mind. Dehydration will come on sooner (especially if you skipped your normal glass of water pre-run so that you could last a little longer without a bathroom break.) By my third trimester, during the heat of the summer, I kept all my runs close to home, sometimes just circling the park next to my apartment, just in case. PREVENTION Do Your Kegels It was early on in the second trimester that pressure built on the pelvic floor and the pelvis started to stretch and change, which meant leakage, first with sneezing and then with running. I had to up my kegel game immediately. I ran with a liner at first, but I caution you that you must change out of your running clothes pretty immediately after your workout, as UTI risk is higher during pregnancy. I recommend a pretty solid kegel routine as soon as you become pregnant (some apps even let you track your sets and reps), but make sure that you’re holding the kegel for 5-10 seconds at a time for improved endurance. I would try to focus on my pelvic floor contraction during the first half mile for good strengthening practice under running conditions and was able to get rid of my leakage in about one month. If you need more help on this front or aren’t sure you’re doing them correctly, check in with us. Strengthening Rules Still Apply Logically, it’s fair to say that your joints now think that you’re going out for your usual jog while wearing a weighted vest. This is not something most people do voluntarily to enhance their training, and for good reason. An increase in one pound of body weight multiples by 3-4 times that amount when you are running, and it will take its toll on your joints. So strengthening is even more important now than it was even before. Keep up your squats and lunges throughout the pregnancy to ensure support for the knees and hips as you gain weight. I chose to stick with my usual HIIT classes (high intensity interval training) with the support of some solid teachers (check out the great team below) and a number of modifications to make it a MIIT class (moderate intensity interval training). Recover Well, Stretch With Caution Recovery is more important for the same reason, mostly by means of rest and refueling. If you were an avid stretcher or just love to feel flexible, this is where you might need to hold back. With your ligaments being looser than ever, stretch with caution as it’s easier now to “over-stretch.” Keep it gentle with a minimal intensity stretch instead of moderate. I had to change my usual runner’s lunge stretch for my hip flexors to more conservative quad stretches, since it started to make me feel a little unstable (more on that later). GEAR Invest in a New Sports Bra First trimester feels a bit like all the other runs you’ve done while at peak-PMS. Mostly your boobs hurt and you feel bloated. Over the course of the pregnancy, you may need to invest in a new sports bra, the same as you will with your other bras to accommodate the change in size. Mostly, my bras made it feel hard to breathe because they were too tight against my expanding rib cage (which can widen up to 3-4 inches over the pregnancy). I ended up doubling up on some older, looser sports bras to stay supported and comfortable at the same time. Consider an SI Belt If you have a history of sacroiliac (SI) joint pain or low back pain, are feeling excessive movement in your pelvis while running, or are dealing with some SI joint, or sciatica symptoms now that you’re pregnant, consider wearing an SI belt (with extender strap) while running to decrease shear forces on your pelvis. I love the Serola belt and keep one in my office in case you want to do a trial run before you purchase. Just make sure to read the instructions to make sure you’re wearing it at just the right level. Check Your Shoes My old posterior tibialis tendonitis (an inflammation of the tendon that runs along the inside of the ankle) said hello during second trimester. Since the ligaments of your feet are also stretching, your lower leg muscles will be working overtime to stabilize your ankle as your foot hits the ground. If you notice your feet are expanding or you start to feel pain in the arches of your feet, considering switching out your neutral or minimal shoe to a stability shoe for some more extrinsic support. I threw my old orthotics into my running sneakers and it remedied the situation immediately. Couple that with a shortened stride to reduce joint loading and you should be on your way to safely running in trimester three. Suffice it to say that being a good body-listener becomes more important than ever, especially since you’re listening for two. If you’ve been cleared to exercise but just want a little more guidance, if you are struggling with feelings of heaviness or incontinence, or if you are having any pain, don’t hesitate to reach out. Zion’s physical therapists specialize in treating both prenatal clients AND orthopedic cases, so rest assured that we can put the pieces together in a way that works for you and helps you keep exercising safely throughout your pregnancy. Request an Appointment!

  • E-Sports: Preventing Orthopedic Injuries and Improving Performance in Video Games

    Orthopedic Conditions in Gaming There are many benefits that video gaming can provide: decreasing stress and anxiety, providing hours of entertainment, and even paying out financially for those who compete professionally in ‘E-Sports’--the top ‘pro-gamers’ in the world take home millions in single tournament prize money, and U.S. colleges are now offering their students thousands in scholarships to recruit for e-sport teams. Whether you play video games for fun or for competition, it is important to be aware of the orthopedic conditions that can arise with prolonged game-play. Overuse Injuries in Gamers Just as with other activities and sports, overuse injuries are common amongst the gaming community; these injuries are uniquely different from those of a basketball player or a marathon runner, but the mechanism of injury is the same: the participant is performing an activity or movement too much, too fast, for too long, and the body can't handle the physical demands of the task. Orthopedic injuries of the hands, fingers, and wrists are prevalent amongst players due to increased APMS (actions per minute) on keyboards and forceful ‘button-mashing’ of controllers; this can lead to players developing upper extremity conditions such as: Gamer’s Thumb, Mouse Elbow, and Carpal Tunnel. Spinal conditions in the neck and lower back are familiar to the casual and professional gamer alike due to poor ergonomic positioning, and a lack of core and postural stability. How to Prevent Injuries and Improve Performance with Gaming In order to prevent these injuries, players need to be able to adapt to the stresses placed upon their bodies, and require progressive loading of the involved joints and muscles and purposeful rest breaks. E-Sport athletes can keep their bodies at the top of their game by increasing their endurance capacity, incorporating strength and conditioning into their training routines, and practicing proper nutrition and sleep habits--this can be the difference between longevity in your hobby or sport, and a life-altering or career-ending injury! Tips to Promote Longevity with Gaming and Decrease Injury Risk Monitor your time spent playing video games, limiting it to 2 hours a day for the casual gamer- Place an alarm on your phone, or set ‘parental controls’ on your console or device: Listen to your body for when it is time to rest, especially if you begin to feel pain and discomfort! Take 5 minute rest breaks every 30 minutes: walk around, stretch your legs, and mobilize your hands, shoulders, and wrists. Avoid slouching too far in your seat to decrease pressure onto your spine: use a small pillow to support your lower back, and keep your feet planted on the floor or a step. Find the ideal posture of your shoulders, elbows, and wrists while holding the controller, keyboard, or mouse: a good posture involves neutral wrist alignment, the shoulder blades retracted and slightly lowered, and the shoulders, elbows, and wrists approximately at a 90 degree angle. Be aware of the positioning of your screen or monitor: The top one-third of the screen should be level with your eyes, and it should be at least 20 inches away from your face. Schedule out at least 30 minutes of daily moderate exercise: prioritize cardiovascular activity, and strength and resistance training. How Physical Therapy can help with Overuse Injuries related to Gaming: Get a Diagnosis and a ‘Game Plan’ to Help Recover from an Injury. Ergonomic Assessments for Postural Alignment and Stress Reduction. Manual Therapy to Improve Blood Flow and Reduce Tissue Restrictions (soft tissue and joint mobilization, stretching, and muscle energy techniques) Therapeutic Exercises for Upper Body and Core Strengthening. Self Care and Mobility for Pain Management. If you’d like to make an appointment to be evaluated by one of our skilled Orthopedic Physical Therapists for postural-related injuries, please call (212) 353-8693, email schedule@zionpt.com, or request an appointment online.

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