Answer: Thanks for the question. From the limited information you have provided I would think that injury to the brachioradialis and/or supinator muscles is a very likely diagnosis. it is also possible that you may have suffered some ligamentous and/or joint injury. I am concerned that other muscle groups are becoming painful. I would like to get you in to see a therapist for an evaluation. We can then direct you to further specialist consult if needed. Please send me your phone details so I can discuss getting you in to see the appropriate resource.
Thanks
John


and Brandon Ellison, PT, DPT, Results – Brentwood

“My knee has been sore since I started running.”

“I have pain in my shins when I run hills.”

“My hamstring is aching after I started running more miles.”

These are examples of questions that are often asked by runners of all ages and experience levels. The answers to these questions are not “cookie cutter” for every person. There are often multiple contributing factors that can lead to running injuries. For example, shoes, weekly mileage, nutrition, cross-training, muscle control and endurance, muscle strength, training terrain, and speed can all contribute to injuries. Of the above factors, some of the more common deficiencies that cause running injuries are lack of core strength and control, and lack of hip muscle strength and control (gluteal muscles primarily). If you do not have a stable core to work from, you will have to work harder in other muscle groups in the legs to make up for the lack of stability. When muscles have to work more and harder, muscle tissue begins to break down and overuse injuries tend to occur. Such overuse injuries include piriformis syndrome, IT band syndrome, shin splints, etc. Once muscle becomes injured, it becomes less efficient and bones, joints, and ligaments tend to be stressed more, contributing to multiple other injuries.

We want to give runners a few good exercises to work on at the first sign of an injury. Commonly, by addressing these deficiencies early, you can avoid aches and pains from becoming a limiting injury.

This video illustrates 3 key exercises that are a good start to improve your core and hip muscle stability and control.

Two of the three wishes have already been granted for children in Middle Tennessee. The first of the three recipients was a wonderful little 4-year-old girl, named Brooklyn, who is battling leukemia.

On the day of the announcement, the staff at our Cool Springs location in Franklin held a surprise party for Brooklyn with a Disney Princess theme. During the party the staff announced that they would be granting her wish of going to Disney World to see all of the princesses in person. It was a real joy seeing her excitement.

“I would like to thank the wonderful people at Results Physiotherapy of Cool Springs, TN for their sponsorship of my daughter Brooklyn’s Make-A-Wish trip to Disney World! She had a wonderful time and we appreciate the memories!”, stated Jake, her father.

The second wish was granted through the staff at our Hendersonville location. It was for another brave little girl fighting leukemia, 3-year-old Lorena. The staff in Hendersonville also held a Disney theme party for Lorena, her family and friends to announce that her wish had been granted. She had an incredible time and it put a smile on everyone’s face.

The third recipient will have their wish granted in the upcoming weeks.

These wishes were granted through the effort of our employees selling Make-A-Wish stars to our patients, family and friends. In addition they participated in our ‘Wear Jeans for a Donation Day’ the last Friday of every month, and then each Friday in December. Employees were allowed to wear jeans on these designated days if they donated an additional $5 to the Make-A-Wish Foundation. “What an incredible success. It makes me so proud to see the involvement and caring hearts of our employees. I want to say a special thanks to our management as well for encouraging and allowing the company to participate in such a wonderful cause,” said Debbie Dabbs, Operations Manager for Results Physiotherapy.

What is trigger point dry needling?

Trigger point dry needling (TDN) is a specific treatment technique that  uses a solid filament needle to treat muscle trigger points (MTrP). A MTrP is a highly localized, hyper-irritable spot in a muscle. It’s commonly what is felt or described as a “knot” in a muscle. These muscle trigger points play a role in producing and maintaining the pain cycle in many musculoskeletal disorders.

These MTrPs develop in muscle for various reasons including referred or local pain, inflammation, tissue injury or other causes. Studies from the United States have shown that MTrPs were the primary source of pain in patients presenting to a primary care setting in anywhere from 30-85% of cases.

How is TDN different from acupuncture?

Trigger point dry needling uses the same tool as acupuncture but with a different theory. Traditional Chinese medicine practitioners view of the human body is based on the holistic treatment of illness and the energy imbalance in the body. Acupuncturists main premise is to direct the Chi or energy in the body to balance and cure different syndromes. Although an acupuncture needle is used in TDN, TDN is based on the traditional reasoning of Western medicine. The sites for needle insertion are located in specific myofascial trigger points in skeletal muscles. Physical therapists trained at Results Physiotherapy in dry needling are not performing acupuncture.

How does TDN work?

The mechanical stimulation of the muscle by the needle produces a local twitch or spontaneous contraction. After this process the muscle activity dramatically reduces resulting in relaxation and decrease in pain and dysfunction. This decrease in pain is related to the removal of muscular compression on the target joint, nerve and vascular tissue. Sometimes the insertion of the needle will also reproduce “referred pain” symptoms. This is often a positive sign confirming the trigger point as being the cause of the pain. It is theorized that dry needling also stimulates release of endogenous opiods, and initiates a “new healing process.”

Dry Needling at Results

• At Results Physiotherapy, our most experienced manual physical therapists are selected  and trained to perform TDN. We have therapists trained to perform TDN at the majority of our clinics across the state.
• The cost is $35 per session. The average cost for acupuncture is $70-80/session. Insurance does not cover it at the moment, but we expect this to change as patients demand the service.

Results Physiotherapy is committed to maintaining the highest level of training available for its therapy staff. Dry Needling is an adjunct to a highly-skilled therapy intervention-it does not replace it. To be good at dry needling a therapist must have extensive skill in “hands-on” treatment. Results Physiotherapy continues to dedicate itself to having world-class “hands-on” or manual therapists.

Donnie Sharp joined Graeme Keys at our Farragut clinic in 2010. After proving himself to be a quality clinician, Donnie approached Results about opening a clinic in his hometown Oak Ridge: “I knew we had something different to offer the people of Oak Ridge. I am excited to share Results’ unique therapy with my Oak Ridge community.” The Oak Ridge clinic just had its one year anniversary and is growing steadily. Mary Hobbs recently joined Donnie as the clinic’s 2nd therapist and is quickly getting busy. Elizabeth Murphy and Travis Davis are the two support staff that help keep things running smoothly. Things will only get busier for Donnie this year with he and wife Kristen expecting a second child in August.

Name, Clinic, time Frame with Results : Donnie Sharp, Results Physiotherapy Oak Ridge since April 2011

Birthplace: Oak Ridge, TN

University(s) attended: University of Tennessee Knoxville, B.S. in Exercise Science; Doctorate in Physical Therapy from East Tennessee State University

Family Status: Married to Kristin Sharp with 16 month old daughter Reagan.

If I wasn’t a therapist I would be: Pitching for the Atlanta Braves.

Currently reading: Goodnight Moon is read on a nightly basis; It’s a personal favorite (for my daughter).

Last Movie Seen: Undefeated, documentary film about a Memphis High School (Manassas) football team

Favorite Sports Team: MLB: Atlanta Braves, NCAA: Tennessee Vols, ETSU baseball

Favorite Joint to Treat: spine

Favorite Treatment Technique: Glenohumeral MWM with belt followed closely by a Cervical SNAG MWM; PTs reactions are priceless when they see the functional ROM gains with a simple joint mobilization.

Favorite Food to Cook: fried walleye and hush puppies

Best Place Visited: St. Lucia

Favorite Musician or Group: Zac Brown Band

Biggest Influence on Career: I would have to say that my father has been the biggest influence on my career; Growing up with a physician as a father who also has a love for sports lead to the only logical career field of Physical Therapy.

When I’m not at work I’m:  Spending time with my wife and daughter;  wakeboarding, fishing and working out

Goal(s) for next 12 months: finish McKenzie certification, OCS and welcome “baby boy Sharp” into the world (August 2012)

Answer: Thanks for the question. Without knowing a few more details it is hard for me to know exactly what might be going on. Sciatica, bursitis, iliotibial band friction syndrome and piriformis syndrome are all common “injuries” or pain syndromes that often start with the commencement of running and cause pain in the hip region. We treat all these injuries. The best plan would be to get you in for an evaluation so we can work out what is causing your pain. We do not need a physician referral to see you.

Here is a good article on running injuries:
http://www.resultsphysiotherapy.com/running-the-marathon-how-to-avoid-injury

Let me know if you need more information.

John

Answer: Thanks for the question. It sounds like you may have joint stiffness, second to low-grade inflammation. We need to get you in asap. You need to be in top shape for your run this weekend and this is something that should respond quickly. We would prefer to see you immediately rather than wait for the day before the race when we might tend to be more conservative and concerned re post-treatment soreness. Two or three sessions of good manual therapy should have you in good order by Saturday. We have several running specialists in the area, let me know if you would like me to help getting you set-up.

Answer: Thank-you for the question. It would be worthwhile knowing what your daughter’s Orthopedic surgeon has advised regarding running. At the moment I would advise her to remain in the boot at home if it is hurting walking without the boot. You should clarify this with the surgeon. We could get her in now for an assessment to at least start her on the appropriate strengthening and stretching exercises to prevent recurrence and we could also assess her footwear to ensure she has the right running shoes for her foot type. These things are often not addressed in an Orthopedic consult.

Physical therapy treatment will become more relevant once she is starting to return to normal daily activities and is getting out of the boot. She will possibly have some short-term ankle stiffness from the boot that should resolve quickly with physical therapy treatment at Results.
Hope this helps. Let me know if you have any other questions.

Thanks,
John

“This is a very important and exciting opportunity for us. This will be our first opportunity to test the quality of our therapy in a new and slightly different marketplace. We are confident in our staff, their training and most importantly their enthusiasm and commitment to deliver a therapy option different to what’s available,” says John Nelson, Vice-President of Marketing for Results. “We want to create the same opportunity for the people of Alabama that our patients have come to know in Tennessee. Unfortunately physical therapy is often looked on as a commodity, and that all therapy is seen as being the same. This is not the case. Quality physical therapy can save patients and insurance companies time and money by getting faster, more effective outcomes.”

The new Results clinic will be located in the heart of Huntsville, in the Bellewood Office Center, located on Whitesburg Drive. It sits amongst a busy medical community that is growing as Huntsville booms from the growth stimulated by the aerospace and defense industries. Chad Hobbs will be the lead therapist at the new Results clinic. Chad has worked in Results’ Tennessee clinics for the last 2 years since graduating from Belmont University, in preparation for an opportunity to bring Results to his hometown. “I knew in college that Results was the place I wanted to work. I had the chance to intern with several different therapy establishments. Results commitment to training and improving their staff ensure that their patients get the best quality therapy available.”

Joining Chad will be Jonathan Zecher who is an experienced local therapist having worked for Nesin Physical Therapy for the last 4 years. When asked about his decision to join Results, Jonathan said, “This is a big change for me-what excited me about Results is that I get to treat my patients at every visit. Many therapy companies have the therapist evaluate the patient and then the patient is transitioned to other staff for treatment. This is not the case at Results, and I believe that this is the best model for the patients.”

More information is available on Results and Chad Hobbs here on our Therapist in the Spotlight feature.

The game of golf has become a sport of increasing popularity among Individuals of all ages and skill level. Golf can be a sport of great enjoyment as well as a game of tremendous frustration due to inconsistencies with a player’s swing. Amateur golfers spend countless hours and money on ways to improve their swing. Golfers go through changes in clubs and take multiple lessons from golf pros to improve swing technique, decrease frequency of miss hits, and increase driving distances off the tee. Many times the problem with a golfer’s swing is due to physical limitations that cannot be corrected through changing clubs or swing mechanics. There are specific mechanical swing faults that are created by these physical limitations within the body that can lead to inconsistencies in a golfer’s swing or even cause pain and injury. These physical limitations can be identified by a functional movement screen from a professional who understands golf performance.

Most amateur golfers that participate in the game of golf on a frequent basis will at some point experience some type of pain or injury. Low back pain is one of the most common injuries among golfers due to the dynamic forces on the spine during the golf swing. A study in the American Journal of Sports Medicine in 2007 found low back pain to be the most prevalent injury among 588 amateur golfers followed over a one year period. Results Physiotherapy performs Specific functional movement screens to assess for physical limitations that will predispose a golfer to certain swing faults or possible injuries while playing golf. The golf swing involves rotational forces through the body and those forces must be transferred throughout the body and into the club head in a sequential order to allow for proper force during impact and to prevent abnormal stress on the spine or body. Two of the most common swing faults amateur golfers demonstrate is a reverse spine angle and early extension. A reverse spine angle is when a golfer demonstrates excessive backward or lateral bending of the spine during the backswing. This swing fault makes it difficult to develop the appropriate sequence and force on their downswing. A reverse spine angle swing fault is the most common cause of low back pain in golfers. Many times this swing fault is due to limited hip or spinal rotation and can put increased compressive forces on the vertebrae of the lower spine. A study by Lindsay et al. found that professional golfers with a history of low back pain had less spinal rotation and increased lateral flexion force of their spine during the backswing than golfers without a history of low back pain. Early extension is another common swing fault that occurs on a golfer’s downswing. It occurs when the golfer’s body will thrust or shift forward toward the golf ball on the downswing and can cause the arms to get stuck behind the body. The golfer will typically stand up with their body in their downswing. Many times this will cause the ball to block to the right or hook to the left. The golfer will typically complain of feeling trapped on their downswing. Physical causes of this swing fault can include limited lead hip rotation and decreased stability of the trunk.

Physical therapists at Results Physiotherapy are able to address these limitations through a variety of manual physical therapy techniques such as joint mobilizations of the hip or spine to increase rotation or soft tissue techniques such as myofascial release or trigger point dry needling to decrease myofascial restrictions within muscles. Manual therapy along with a golf-specific exercise program to address a golfer’s physical limitations can lead to significant improvement in a golfer’s handicap and alleviate a golfer’s pain on or off the course which will allow for more enjoyment and longevity with playing golf. Results therapists are trained in performing golf specific movement screens to assess for these physical limitations and they can work directly with your club pro to correct your swing faults. For further information on setting up a golf specific functional movement screen or exercise program contact us at 615-373-1350.