True of False? No pain - No gain

While our kids are growing rapidly in their pre-teens and teens, their bodies change in many ways. They grow taller, their hips widen, their feet change, and they gain significant weight. All of these changes place new stresses on their musculoskeletal system which takes time to adapt.

For those who are active and sports oriented, these changes may cause “growing pains” making participation in their activities painful. More stress is added through increased intensity of activity as they begin to compete at higher levels of competition, leading to repetitive stress and overuse injuries. These injuries may include tendonitis, stress fractures, sprains and strains throughout the body. If not addressed, these problems can derail a sports season or become lifelong problems.

What To Look For…

As a parent, the best sign to look for is pain. Some muscle soreness is to be expected, especially at the beginning of a season. Soreness should subside quickly as the body gets used to the new workload. Pain in a specific joint is rare in healthy adolescents therefore, if their soreness increases or becomes painful, your child may have an injury. Local pain in a joint is frequently the sign of an injury. Common injuries in teens are chondromalacia patella (pain under the knee cap), Osgood Schlatters (pain just below the knee on the tibia), shin splints, stress fractures, and ankle sprains.

As a parent it is important to listen to the concerns of your child. “No pain, No gain” is not always true, and can be harmful. It is important to monitor training schedules and have breaks to recover between seasons and large tournaments. If problems do arise, have your child evaluated by a physician or physical therapist. Once a problem is identified solutions such as exercise training, stretching, or bracing can usually solve the problem and get your child back on the field safely.

TOPIC OF THE MONTH - Selective Functional Movement Assessment

Do you ever wonder why you suffer from repetitive or chronic injuries that seem to be unrelated to any injury? Or do you ever wonder why you don’t perform as well athletically as other people? Do you feel like you work out and you don’t progress as well as you feel you should. Then the SFMA could be for you.

SFMA stands for Selective Functional Movement Assessment .This is a test designed to look at movement throughout your entire body to determine any limitations in mobility and stability you may have. These limitations may be underlying factors in any chronic problems or reduced performance you may be experiencing in your life. Frequently a restriction or weakness in one joint or area of your body can lead to limitations in a movement pattern that affects your whole body. The SFMA can help you pinpoint these limitations.

Once the SMFA identifies specific restrictions, your physical therapist can design a program to specifically address them. With a more individualized program you can be sure that you are doing the most effective work out routine and not wasting time and energy exercising areas that don’t need it. This will also allow you to address an area that may be leading to chronic pain and dysfunction and eliminate some unneeded aches and pains.

The SMFA is now available at Ascent Physical Therapy. Call 970.949.9966 to schedule an appointment and get your-self fit for summer.

Ascent Physical Therapy is GROWING

We are excited to announce that we will be opening a second clinic on July 11^th 2011 in Eagle at 341 Broadway. The new facility, in the heart of downtown Eagle will benefit our local patients living or working in the Gypsum/Eagle region. With clinics in Avon and Eagle, we feel we are providing our patients with a greater choice of health care provision. We look forward to having the opportunity to serve our patients in this new location.

Your input is very valuable to us! We welcome any suggestions you may have as to what we should incorporate into our new clinic. Please feel free to leave a post or email us with any information you believe will help us obtain the results for our patients that they deserve.

New PT to the team!

Ashley Dentler received her Doctorate of Physical Therapy from Northeastern University in Boston, Massachusetts. She is certified as a Strength and Conditioning Specialist through the National Strength and Conditioning Association. She has had training in the areas of outpatient orthopedics, neuromuscular rehabilitation and functional movement therapy.

While at Northeastern, she succeeded in enhancing the learning and teaching environments for Physical Therapy curriculum as well as serving as a Teaching Assistant in multiple courses.

A Rhode Island native, Ashley is an avid runner, skier and swimmer and is looking to continue her love of the outdoors in Colorado. “I am thrilled to be a part of a community of people who share my passion and love of an active life style. It is an honor and privilege to join this team of professionals as we work to better the lives of our community.”

Ashley will be working at our Avon office Tuesdays and Fridays and the new Eagle office on Monday and Thursdays. To schedule appointments with her call 970.949.9966

TOPIC OF THE MONTH - Exercise for a Better Golf Game

The golf season is here and many of us are ready to hit the links and start golfing. We all want to stay healthy and play the best that we can. Five areas determine how well a golfer can play:

1. Natural talent - the athletic ability and talent we are born with
2. Skill - which can be improved through working with a pro and practicing
3. Equipment - which can add accuracy and distance
4. Mental game - such as course management and maintaining composure while playing
5. Physical preparation - addressing your body’s physical characteristics through exercise and stretching to improve your game

Many golfers spend considerable time and effort on practicing, taking lessons, and buying the best equipment. But, many golfers never address their most important piece of equipment, their body. Golf requires specific physical conditioning like any other sport.

The ideal golf swing requires flexibility, strength, balance and endurance. Many golfers neglect some of these critical components when attempting to improve their game. If a golfer has weaknesses in any of these areas they may make compensations in their swing, causing inconsistency or increased physical stresses on their body. These stresses can lead to pain and injury if they continue.

A regular exercise routine can address most of these strength, balance, and flexibility issues. Strength is important to control the club, maintain proper postures, and generate power. The key areas of strength to work on are core strength including lower abdominals and back muscles, scapular muscle strength, rotator cuff strength, and wrist and grip strength. Flexibility is important to allow proper set up posture and to maximize your ability to turn. Areas that frequently cause problems are hip rotation, thoracic spine extension and rotation, neck rotation, and shoulder flexibility. Balance is important to allow a full transition of weight throughout the swing. With poor balance power is lost or severe swing compensations are made. Endurance is important to allow a golfer to play a full round. Golfers with poor endurance will notice their play deteriorating toward the end of their round.

A physical therapist trained in proper golf technique can evaluate your body for the physical components of a proper golf swing. From this evaluation an individualized program can be developed to improve your game and keep you healthier.

Featured Physician of the Month - Dr. John Paul Elton

Meet an Associate of Ascent Physical Therapy, and this month's featured Physician:

Vail-Summit Orthopaedics

Dr. John Paul Elton

Specialty: Foot and Ankle

After completing his Orthopaedic surgery residency in San Antonio, Texas, and his fellowship training in Boston, Massachusetts, Dr. Elton is delighted to be back in Colorado where he completed his under-graduate and medical school education.


Dr. Elton's fellowship training has given him the expertise to handle the full spectrum of foot and ankle disorders: from sports injuries and fractures, to nerve and tendon disorders, deformities and chronic pain. He emphasizes that most non-traumatic injuries can be resolved with non-operative treatment.

Dr. Elton is an avid cyclist and enjoys skiing and snowboarding, as well as camping and hiking with his wife and two children.

Do you have pain?

Take the first step in dealing with your pain, by calling for a FREE physical therapy evaluation!

Ascent Physical Therapy can help RELIEVE your pain, RETRAIN your movement, and RESTORE your function!

A FREE evaluation includes:
• One-on-one consultation with one of our experienced Physical Therapists.
• Evaluation of the problem, which involves testing your movement, strength and function.
• Discussion of the problem, evaluation findings and your treatment options.
• An opportunity to ask questions regarding your pain and learn about the benefits of Physical Therapy.

Call us today on 970.949.9966 to set up your free evaluation.

TOPIC OF THE MONTH - Common Biking Injuries and Causes

It’s almost that time of year again. People are starting to dust off their bikes, the snow down valley is melting away, and trips to Moab are being organized. Bike season is upon us. Hopefully we’ll all make it through the Spring and Summer injury free. However you could be one of the unlucky one’s that end up with a bike related injury. Here are some of the most common injuries, and their causes:

• Knee pain (ITB syndrome, patellofemoral pain syndrome) is usually associated with a seat position that is too high or low or forward or back. Improper bike shoe or cleat position can also lead to this, along with muscle imbalances or even poor ankle mobility.
• Neck pain is a common cycling complaint. Often the result of riding a bike that is too long or having handlebars that are too low. Body mechanics that could also contribute to neck pain include poor thoracic mobility or tight hamstrings and hip flexor muscles – these postures all lead to the neck being placed in a hyper-extended posture.
• Foot pain or numbness (sesamoiditis, Achilles tendonitis) is often a result of wearing soft-soled shoes, or using too high a gear, which results in more pressure where the foot meets the pedal. Custom orthotics, can often resolve such problems.
• Hand pain or numbness (ulnar nerve compression, carpal tunnel syndrome, blisters) can be prevented by wearing padded cycling gloves that provide cushioning. Riding with your elbows slightly bent, not straight or locked will help act as shock absorbers and help absorb the bumps in the road. Having poor scapular stability could also lead to upper extremity and hand symptoms.

If you are unfortunate enough to experience any of these problems, the experienced Physical Therapists at Ascent Physical Therapy would love to help. We can analyze your bike posture and bike set-up, identify any muscle imbalances which could be contributing to your symptoms, and provide a custom treatment plan to get you back on your bike as quickly as possible. For more information on bike injuries and solutions, or questions about custom orthotics, please call Ascent Physical Therapy at 970.949.9966.

Featured Physician of the Month - Dr. John E Gottlieb

Meet an associate of Ascent Physical Therapy, and this month's featured physician:

Vail-Summit Orthopaedics
Dr. John E Gottlieb, MD - Specialty: Knee injuries, Sports Medicine

Dr. Gottlieb graduated from Temple University in 1974 and then completed his Orthopaedic Residency in 1979 at the same institution.

Dr. Gottlieb was the first Orthopaedic surgeon in Vail and Summit counties, and has been serving an athletic sports population since 1979, the year he founded Vail-Summit Orthopaedics. He is one of the most active and innovative knee surgeons in the country, recently contributing to a national study.

Dr. Gottlieb and his wife Lynn, a local psychologist, raised three children in the Vail Valley. In his free time, he enjoys playing golf, hiking and trekking in the woods with his two golden retrievers.

TOPIC OF THE MONTH - Reduce the risk of a Snowshoeing Injury

Snowshoeing is an excellent way to exercise and enjoy the outdoors at the same time during the winter months. At intense levels, snowshoe training can improve your fitness even more than running. Even snowshoeing slowly, at about 2 miles per hour, caloric expenditure will be about 480 calories per hour. Pick up the pace to 3 miles per hour and you can burn up to 1000 calories in an hour.

In general, snowshoeing is a relatively safe sport with regard to repetitive overuse injuries. It is a low-impact activity so there is much less potential for muscle/tendon damage. Still, there are steps to make snowshoeing even safer.

• Start your workout with a gentle cardiovascular warm-up and take time to stretch
• Focus on the large muscle groups in the legs and hips
• Worn out, ill-fitting or deformed snowshoe boots can be the culprit of various soft-tissue and joint injuries
• Check the shape and fit of your shoes before the season starts.
  
• Beginners should start slow and build up ability, strength and endurance gradually.

TOPIC OF THE MONTH - How to avoid snowboard injuries

Snowboarding carries a slightly higher risk of injury than alpine skiing - between 3-6 injuries per thousand boarder days (compared to 2-3 injuries per thousand days for alpine skiing). The risk varies with experience as well - the highest risk group being beginner snowboarders (especially those on their very first day). The risk becomes lower for those intermediate riders but then climbs again amongst experienced boarders - presumably because they are boarding faster and attempting jumps and tricks. The most common type of injuries seen with snowboarders are upper extremity injuries, specifically, wrist fractures, shoulder dislocations and AC joint separations. Here are some practical tips to help reduce the risk of an upper extremity snowboarding injury:

· Take a lesson: Most snowboarders don't take professional lessons, but learn from friends or are self- taught. Poor technique and bad habits increase your chances of falls and injury. Play it safe and pay for a few lessons before hitting the slope.

· Wear protective gear: It is a natural response to put out your hand to break a fall and as a result the wrist can be broken. Wearing wrist guards can help reduce possible wrist injuries in a fall.

· Take a break: The vast majority of injuries happen at specific times of day; just before lunch or the last run of the day when fatigue kicks in. When you are tired, mistakes happen – edges get caught and injuries occur. Pacing your-self, taking a break and not attempting the hardest run at the end of the day all help reduce the risk of injury.

· Get the right equipment: Damaged or inappropriate equipment may contribute directly to an injury or to the severity of one. Make sure the board is the right size and ability level for you. A beginner using an advanced level board which they are not yet competent to control could lead to trouble!

· Learn how to fall: When you are a beginner, falling is an unfortunate part of the learning process. Forward falls commonly result in shoulder-girdle injuries; falls backward more commonly produce wrist fractures, spinal injuries and head injuries. Common guidelines which may help minimize injury risk are to make a fist - this prevents fingers splaying and wrists hyperextending; roll onto your forearms and knees if you fall forwards, and roll onto your bottom – not your hands if you fall backwards.

· Pre-hab: It is a good idea to make sure you are physically fit before you hit the slopes. One of the main reasons people get injured while snowboarding is that they don't have the physical ability for the sport. Focusing on endurance, core strength and flexibility are all important aspects of prehabilitation. Strengthening the forearm and shoulder muscles may allow these joints to within greater force, preventing injuries from occurring.

· Ride Goofy: One study looking at almost 2000 injured riders discovered over 90% of those injured were in a regular stance when they injured themselves.

Featured Physician of the Month - Dr. Jonathan Feeney

Meet an associate of Ascent Physical Therapy, and this month's featured Physician:
Dr. Jonathan Feeney, MD
Specialty: Family Medicine
Colorado Mountain Medical

After graduating from the Case Western Reserve University School of Medicine, Dr. Feeney completed his residency at the St. Paul Ramsey Hospital in Minnesota. In 1980 he joined Colorado Mountain Medical and has worked there ever since.

Dr. Feeney has extensive experience in a constellation of health issues, from the very young to the mature adult, including Women's Health issues and sports related injuries. He is dedicated to wellness and comprehensive health care for the whole family. He has a special interest in multiple sclerosis and served as the Medical Director of the Heuga Center for the Physically Challenged now named 'Can Do M.S'. He has a further interest and experience in concussions in athletes.

During his free time, Dr. Feeney, his wife, and their two children enjoy scuba diving, skiing and travel.

TOPIC OF THE MONTH - Avoid Injury this Winter

Winter has descended on the Vail Valley and many people have been hitting the slopes, lacing up skates, strapping on snowshoes and otherwise enjoying winter. It is important to take the following steps to avoid injury:

• Move outside cautiously: Just as you drive a car with greater caution when roads are icy, take extra care when walking outside on icy and snowed packed surfaces. Take an extra pair of shoes to work or to the mountain so you can wear shoes with good traction in parking lots. Remember to walk slowly and pay attention so you can adjust to a slippery surface.
• Ensure a proper warm up: Spend about 10 minutes at the start of any activity at a lower than normal exertion level. Your warm up should mimic the activity in which you are about to engage: if you are snowshoeing, start of at a slower pace; if your are skiing, hit easier trails for your first few runs.
  
• Avoid 'too much, too soon': Many months have passed between the end of last winter and now. Take steps to properly condition your body before engaging in a physical activity you have not done in a while. This can mean doing off season conditioning and cross-training as well as seeing a physical therapist to learn about any weaknesses or instability you may have, that can put you at risk of injury.
• Remember to cool down: Take some time at the end of physical activity to cool your body down. Return to a lower exertion level so you can signal to your body that you are ending activity.