Excel PT: Foot and Ankle Pain

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RECOVER MORE QUICKLY AND COMPLETELY FROM A FOOT OR ANKLE SPRAIN

Rolled, twisted, and turned: three words that no one wants to associate with their ankles. All are common descriptions of ankle sprains which are among the most common injuries managed in emergency departments and primary care clinics. Ankle injuries should never be taken lightly and are too often mistreated or not treated at all. The good news is most ankle sprains resolve without the need for surgery. Ankle sprain – what is it? An ankle sprain is a stretch or tear in one or more of the ankle ligaments which are slightly elastic bands of tissue that keep the ankle bones in place. The ankle ligaments are particularly prone to sprain because of the small size of the joint and the forces exerted on the joint with movement. (continued inside)

By Rachel Braman, PT, DPT

INSIDE : • Recover More Quickly and Completely From A Foot Or Ankle Sprain

• Why Does My Foot Hurt? • Exercise Of The Month

www.excelphysicaltherapy.com

THE NEWSLETTER ABOUT YOUR HEALTH AND CARING FOR YOUR BODY Health Tips Newsletter

RECOVER MORE QUICKLY AND COMPLETELY FROM A FOOT OR ANKLE SPRAIN INSIDE : • Why Does My Foot Hurt? • Featured PT (continued from outside)

• Exercise Of The Month • Patient Success Spotlight

How is a sprained ankle diagnosed? A physical therapist can test and screen for ankle sprain as well as other, more serious conditions that could be causing pain and swelling in the region. To provide a definitive diagnosis, a physical therapist may collaborate with an orthopedic physician or other health care provider, who may order further tests, such as an x-ray to rule out other damage to the ankle, including a fracture.

to delayed healing. iv Physical therapists recommend checking with your doctor for information regarding use of medication.

Another traditional form of treatment for ankle sprains has been splinting or rigid bracing for immobilization. The latest research shows that use of a more functional type of support such as a lace-up or semi-rigid brace in conjunction with early exercise therapy is recommended because it provides better outcomes compared to rigid immobilization alone. If immobilization is used, it should be for a maximum of 10 days after which functional treatment should begin. How can physical therapy help? Therapeutic exercise should be started shortly after injury and can speed recovery and reduce the risk of re- injury. iv Ankle therapy includes general range of motion as well as strengthening exercises. This is often combined with something referred to as proprioceptive training. Proprioception is the ability for a person to sense where they are in space. The nerve fibers that give us this sense are impaired with ankle sprains, often requiring retraining to prevent further injury from new falls or awkward positions. Your physical therapist is trained and experienced in choosing the best treatments and exercises to help you safely heal, so you can return to your normal lifestyle and reach your goals faster than if you were unassisted. Let us know how we can help! Sources: DohertyC,DelahuntE,CaulfieldB,HertelJ,RyanJ,BleakleyC.The incidenceandprevalenceofanklesprain injury:asystematic reviewandmeta-analysisofprospectiveepidemiological studies.SportsMed.2014Jan;44(1):123-40. KaminskiTW,Hertel J,AmendolaN,DochertyCL,DolanMG,HopkinsTJ,NussbaumE,PoppyW,RichieD. NationalAthletic Trainers’ Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes. J Athl Tr 2013;48(4):528-545. vandenBekerom,M.P.,Struijs,P.A.,Blankevoort,L.,Welling,L.,vanDijk,N.,&Kerkhoffs,G.M. (2012).What Is theEvidence for Rest, Ice,Compression,andElevationTherapy in theTreatmentofAnkleSprains inAdults?JournalofAthleticTraining,47(4),435-443 VuurbergG, et al.Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline.Br J SportsMed.2018Aug;52(15):956.

By Rachel Braman, PT, DPT

What is the best treatment? No matter the severity of the sprain, the first measures of treatment are typically conservative. Many are familiar with the RICE (rest, ice, compression, and elevation) protocol for use with minor injuries. Although widely used, a recent review found that there is a lack of high quality evidence to determine if this is effective for acute ankle sprains and therefore should be used as part of a multifaceted treatment approach including exercise. Every injury is different, so if icing your sprained ankle provides relief, do it. Use ice every few hours and for no more than 20 minutes at a time. This may not be appropriate for people with diabetes, damage to the peripheral nervous system or vascular disease. More doesn’t equal better in the case of applying ice. Anti-inflammatories, such as Ibuprofen, have also been traditionally used for pain and inflammation control. This has become more controversial in recent years as newer studies suggest that NSAID use may delay healing as inflammation is the body’s natural response to an injury in that it causes chemical signals in the body to recruit nutrients and growth factors to the site of injury. It is theorized that blocking this initial inflammation may lead

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Nic Shuscavage, PT, DPT (LANCASTER CLINIC) FEATURED PT

Why Does My Foot Hurt?

1. How did you decide to become a physical therapist and what motivates you to work with patients? I’ve always been intrigued by human movement and anatomy so a career in the medical field was always something I was interested in. I decided that a career in physical therapy would be perfect for me after a great PT experience I had myself, following an ACL tear that occurred when I was playing football in High School. I was able to see firsthand how positive an impact a PT can have in a patient’s life and how hands-on treatment and exercise can help people return to the activities they enjoy. 2. In your words, what makes Excel Physical Therapy different from other physical therapy clinics? Excel is very different from most other PT clinics simply because of the way we schedule patients and put our patients’ needs first. Excel’s treatment model allows for more one-on-one time and therefore more hands-on treatment, leading to better, faster outcomes. 3. What was your most memorable patient experience? My most memorable patient experience occurred when working with a patient post-surgical with delayed healing. Our sessions were lengthy and grueling but over the course of several months she was able to transition from a wheelchair, to a walker, to a cane and eventually back to walking normally without an assistive device and return to exercise. It was a great testament to both her and my determination and hard work. 4. If you could be any animal, what would it be and why? I think I would have to choose to be a dog. On a good day you play fetch, go for hikes and walks in the park, and on a bad day you mostly take naps. 5. If you could describe yourself in one word what would it be and why? Loyal - Personally I believe in showing firm and constant support to my family and friends, as well as professionally to my patients. 6. What do you like to do in your off time, outside the clinic? Outside the clinic I like to travel, hike, visit the Jersey Shore and spend quality time with my daughter and family.

Plantar fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot. Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult. Physical therapy is an effective treatment for plantar fasciitis by using stretches and manual therapy to restore mobility to the foot. Foot and shin pain can arise from many different causes. The most common causes develop from changes in the way you walk, unsupportive footwear, long term standing, walking, or running. The key to recovery is an early evaluation and treatment plan developed by a physical therapist. The therapists at Excel Physical Therapy will work to determine the cause of your problem and quickly decrease your pain. They will also help you find the correct balance between strength and flexibility, which allows you to experience pain free walking or running and return to activity as soon as possible. Help To Relieve Your Foot Pain Physical therapy is the natural way of helping your body recover from ankle/ foot pain. At Excel Physical Therapy, your pain is extensively evaluated by an expert physical therapist who has years of training in medical evaluation of musculoskeletal and ankle/foot conditions.   Your physical therapist then addresses the root cause of your pain. The treatment plan may include modalities to relieve pain, specialized gentle manual therapy to increase soft tissue and joint mobility, and specific ankle/foot exercises to rebuild your strength.

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CALL US TODAY IF YOU ARE IN PAIN

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“I am finally able to resume full duty at work, stand and walk for longer periods of time...” “After badly spraining my ankle my doctor sent me to physical therapy (not Excel). After a few months of not making much progress, I was switched over to Excel’s Blue Bell location for my therapy. I began working with Danielle and both my Doctor and I noticed improvement almost immediately. We started slowly but she gradually increased my stretching and exercise as she saw my ability to move my foot and ankle increase. It has been a long recovery since I was first injured, but thanks to Danielle and Excel I am finally able to resume full duty at work, stand and walk for longer periods of time, and have full motion and strength in my foot and ankle. I would definitely recommend Excel to anyone needing physical therapy. Thank you for everything!” - J.T. (Blue Bell Clinic) Try this exercise if you are experiencing leg pain EXERCISE OF THE MONTH

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Coupon Corner!

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COMPLIMENTARY PAIN ASSESSMENT

CALF STRETCH - ON WALL

Stand close to a wall and place your toes up on the wall with your heel on the floor. Slowly lean forward until you feel a stretch in your calf. Hold for 10 seconds. Repeat 3 times each on each leg.

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Your complimentary pain assessment may be conducted via telephone

THIS EXERCISE IS DESIGNED FOR PAIN PREVENTION CALL YOUR THERAPIST IF YOU ARE EXPERIENCING ANY PAIN!

Call to schedule. Expires 4-30-19

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