FyzicalElPaso: Is Balance Setting Up An Injury?

October, 2019




I have spoken on several occasions on the topic of kids in sports. How much and when? What can we do to avoid overuse injury?Training and overuse we see it commonly inourpractice.Speakingtoparentandcoachinggroups, I sharemymedicalopinionandexperiencethatkidsshould play multiple sports. Stay tuned, I’ll explain where I’m comingfrom.Ihavetwosons,bothofwhomweretalented athletically.Myoldestson,Boomer,seemedtobeanatural at virtually all sports – football, basketball baseball… you name it,hedid it. IstartedBoomeroffwithtennisatavery youngage. Ibelieve it’sagreatsporttoenhancehand-eye coordinationandmagnify learningpathwaysformovement. Especiallywhenthey’reareyoung.That’sthePT inme.He was good at it, getting better, and then – he decided he wantedanothersport.Aaaghright?Theregoestheplan! I saidwhynotboth,hesaidnotmebutthanks. It’scommon with children but sometimes we may not support it, I know I was bothered. Boomer’s buddies decided to play soccer so guess what he did? AYSO every Saturday plus practice. I learned to really love it. Then baseball, I was the kid’s coach there. He got good then 3 leagues and 2 teams. Sound familiar? He got better but here’s where stuff can begin to happen. As they improve that success cancausekidstobecomesiloedtooyoung intoonesport, potentiallyresulting inoveruse injuries.More leaguesmore innings more travel. How can early specialization become problematic? Boomerwentontotrydifferentsportsandexploredmany –but Ididnothavethesameexperiencewithmyyounger son,Mason. Itriedeverythingtogainathleticvariety–but all he wanted to do was play basketball. When kids play the same sport for 12months out of the year without any breaks(which isbecomingmoreandmorecommonwith offseason leagues), it isverycommonforthemtodevelop overuse injuries. I helped Mason through many injuries from youth to college. Kids do get beat up. An example I’ll use is the Tommy John procedure. This is a surgical procedure of the elbow that is necessary for overuse and instability injuries associated with throwing. The Tommy John procedure is growing at an alarming rate. Pitching at a young age and become specialized throwers early in sourcing the growth in this problem. Here’s the number I promisedyou.Overall incidence is4/100,000but inages15- 19 its22/100,000,astaggeringagespecific increasebased onmanyauthor’sopinion. Thisprocedureusedtoberare, butwiththepopularityofoffseason leagues, it isbecoming muchmorecommon.Don’tshootthemessenger! It’s just real numbers. That’s not 100,000 baseball players that’s people. Boomer is also a prime example of how overuse

can affect a child – yes, he hadmany sports but he could bring itfromthemound.Healsoneverhadanybreaks.He was a talented pitcher on 2 teams and 3 leagues by the time he was 12 years old. He developed shoulder laxity at a young age and still has shoulder issues to this day. That’s why inmy view offseason breaks are so important for a child. If something like that can happen to the son of aphysicaltherapist, itcanhappentoanyone’sson–even if you’rebeingcautious. Iwas,andnow Itryandhelpothers. Identifying solutions: Now, I’m not here to try and scare you. I’m here to try and provide some helpful solutions. I getposedthiscounterargumentallthetime:“Ican’tmake my kid stop playing his sport – he’s way too passionate about it.” To this I say – that’s fine! Respect that passion. Encourage that passion. Some kids simply will not want to try something new once they find something that they love–andthat’sokay.However,therehastobesomesort of spacer to limit their amount of overuse of the muscles and joints needed to play that sport. Think about the difference between basketball and baseball. That is exactly what happened with Mason. He found basketballandwas immediatelyhooked.Forkids likethis, it is important to find something different they can do in theiroffseasonthat iscomplementarybutfun.ForMason, itwasparticipating inahigh-leveltrainingprogramfroma youngage.Hecrushed it inhisperformanceprogram.For your child, depending on the sport, it may be something different–perhaps it’sayogaclassorconditioningprogram oranew, lessdemandinghobby intheoffseason.Whatever thecasemaybe, itshouldbesomethingthattheyenjoythat stillhelpsthemstay inshape–withoutover-stressingthe samemuscles.Trainingprogramsaregreatbecausethey help children avoid overuse injuries while simultaneously helpingthemfunctionatahigher level.Thiswillhelpwhen they return to their sport, as it will provide improvements with strength and movement. In addition, it will still allow themtodosomethingthey love intheoffseason.It isreally important to individualize the best offseason spacers for each child and their sport of choice. I have found that by replicating what I have learned with Mason into our own training programs at Fyzical El Paso, kids have grown exponentially in their sports. Everyone needs a break – especially children! An individualized offseason spacer can help them grow and improve in their sports upon returning. What will your child be doing next offseason? - Luis, Fyzical El Paso


October, 2019



Reduces Fall Risk • Improve Balance In Minutes • Patient Success Spotlight • Healthy Recipe

Whether you have poor balance or have been suffering for a long time, seeing a physical therapist at Fyzical Therapy & Balance Centers can help you return to a more active and pain-free life. Give us a call at (915) 330-8854 today!

Did you know that 1/3 of the population over 65 falls each year? Every 11 seconds, an olderadult isrushed to theemergencyroomfora fall.Every19minutes,anolderadultdies fromafall.AccordingtotheCentersforDiseaseControl(CDC),over2.5millionadultswere treatedfornonfatal injuries inemergencydepartments in2013. Inolderadults,fallsare the leading cause of fatal and nonfatal injuries. Most people don’t think about keeping their balance inshapeuntil it is too lateand theysufferaharsh fall.Thegoodnews is thatmost fallscaneasilybeprevented,simplybytheregularexercisingofyourbalancesystem. Ifyou haverecentlysustainedabalance-related injury, it is importanttoseekthehelpofaphysical therapist immediately, inordertoavoidadditional injuries inthefuture. It is importanttonote thatyoushouldalsocontactaphysicaltherapist ifyouhaveanyofthefollowingsymptoms: •Dizzinessorvertigo (“spinning”sensations,evenwhen remainingstill) • Inability to focusor remainalert •Doublevisionor tunnelvision •Nauseaorvomiting •Armor legweakness •Abnormaleyemovements •Difficultystandingup fromaseatedpositionorstanding forprolongedperiodsof time Do you frequently notice an imbalance, dizziness, or unsteadiness that makes you feel as if you may fall over at any given time? Have you suffered from a fall in the past? Are you worried that you may be at risk of sustaining a fall-related injury? If so, contact Fyzical Therapy & Balance Centers today so we can help you figure out the root of your problem and treat itaccordingly.

Am I at risk of falling? Somepeoplehaveahigher riskof falling thanothers. Certain risk factors include:

•Advancedage •Being female

•Livingasedentary life •Previoushistoryof falls •Vertigoordizziness •Parkinson’sdisease •Alzheimer’sdisease •Heartdisease •Diabetes

•Previousstrokeorheartattack •Arthritisoralternative jointpain •Problemswithvision •Problemswithwalkingorstayingbalanced •Fatigue •Overallpoorhealth

Yourphysicaltherapistwillassessyourmedicalhistorytodeterminehowmanyrisk factors toward falling you may have. They will educate you on what these factors mean,aswellasstepsyoucantaketodecreaseyourrisk.Afterthis,theywillperforma thoroughphysicalevaluationtofigureoutwhatthebesttreatmentplanforyouwillbe.

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A recently published systematic review by Cochrane, comprised of over 100 randomized controlled trials, supports exercise interventions as an effective treatment method for patients with an increased risk of falling.The average age of patients in this review was 76, and 77% of the patients were women. Results concluded that those who participated in exercise interventions had a 23% decrease in falls as compared to the control group. Fall risk was also reduced at 21-24%, depending on if treatments were done in individual or group settings.The risk of fall-related fractures was decreased by 27% and the number of falls that required medical attention was decreased by 39%. Concludingstatements from theauthorsdemonstratedhowoverall, “Exercise reduces both the rate of falls…and the number of people experiencing falls.” At Fyzical Therapy & Balance Centers, your initial physical evaluation may consist of several parts to better determine what your most problematic factors are. These may include vision tests, thinking tests, resting heart rate checks, active heart rate checks, and evaluations of your gait, balance, range of motion, and strength. Based on the results of this evaluation, your physical therapist will design a treatment plan around your specific needs. These plans are aimed first and foremost at reducing your risk of falling, but they will also aid you in improving balance, strength, flexibility, endurance, and overall movement. Some common forms of treatment include: • Pain management. If you are feeling painful anywhere, it will be one of the first things addressed in your treatment plan. Your physical therapist will want to make sure that your treatment is as comfortable as possible, so you will work together on relieving pain first, before continuing into any other forms of physical activity that may bring you discomfort. • Walking and moving programs. This part of your treatment plan is aimed at getting you back to your normal physical function when walking and/or moving. Your physical therapist may ask you to perform certain activities, such as walking in a circle or completing an obstacle course. • Balance training. Balance isa largepartof fallprevention,as lackofstability is one of the main reasons why falls occur. Your physical therapist will

design a balance training plan for you as part of your treatment, and may ask you to perform certain balance-based activities, such as standing on one leg or holding your balance while performing a mentally-stimulating task (such as reciting the alphabet or reading a page from a book.) • Strength training. Strength training is typically paired with your balance training. Your physical therapist will design a strength training plan for you, which will focus on specific muscle groups in need of improvement. The goal of this will be to improve your standing and walking balance, as well as your ability to recover from a loss of balance. • Endurance training. Endurance training is all about working up to more advanced levels of the same form of treatment. Your physical therapist will provide you with an aerobic exercise program and will slowly add on time to those exercises as your endurance improves. For example, your endurance training may begin at 10-minute sessions and then may progress to 30-minute sessions. Are you ready to get back on your feet by improving your balance and decreasing your risk of sustaining a fall-related injury? Contact Fyzical Therapy & Balance Centers to schedule a consultation and get started today!

Call us today at (915) 330-8854 to schedule an appointment!


INGREDIENTS • 1 (14.5 ounce) can crushed tomatoes

• 1 small red bell pepper, chopped • 1 tbsp fresh thyme leaves

• ½ tsp garlic powder • ½ tsp ground pepper • ½ cup grated Parmesan • 8 oz pita chips

• 1 small eggplant, cubed • 1 small zucchini, cubed • 1 small yellow squash, cubed

DIRECTIONS Stir together tomatoes, eggplant, zucchini, summer squash, and bell pepper in a 4-quart slow cooker. Cover and cook on High for 1 hour. Stir in thyme, garlic powder, and ground pepper. Turn toLowandcook for30minutesmore.Usingapotatomasher,crush thevegetablemixture to a chunky consistency. Stir in Parmesan. Stir occasionally while serving with pita chips.


Patient Success Spotlight


Did You Know…


of people over 65 fall annually.

The #1 reason for a MD visit for people


of hip fractures are caused by falls.

over 75 is IMBALANCE.

of adults discharged for fall related hip fractures will fall again within six months.

Every 11 seconds ,an older adult is treated in the emergency room for a fall.


1 out of 5 patients with a

Fall accounts for 40% of all nursing home admissions.

hip fracture die within ONE year after a fall.

Every 19 minutes , an older adult dies due to a fall.

2.3 million fall related injuries are treated in the emergency room annually.

“I am very thankful to everyone!” “My experience was amazing here at Fyzical. I am very thankful to everyone, all the staff was always very happy and cheerful.They make time pass very quickly, and distract you during the session to make it almost painless. My therapist Sean is awesome, he made this horrible ACL injury recovery so much fun.” - Karen G.

The medical cost of falls is estimated at

A non-injury ER fall visit averages

$17,463 .

$28.2 billion

Fall victims released from the ER rarely receive fall prevention training or treatment to prevent future falls.

Please speak to a member of our team about scheduling your FALL RISK ASSESSMENT

Improve Balance In Minutes Try this movement if you are experiencing poor balance.

(915) 330-8854


Improves balance


TANDEM WALK - WALL Stand with the fingertips of one, or both, hands resting on a wall. Place the feet ‘heel to toe’ with the left foot forward. Steady yourself in this posi- tion. Step forward with the right foot, placing the heel directly in front of, and touching, the toes of the left foot. Step forward with the left foot, placing the heel directly in front of, and touching, the toes of the right foot. Repeat this sequence, moving forward down the hallway. Reverse direction, moving backward down the hallway.

Contact Us: xxx-xxx-xxx | fill in address Call us at (915) 330-8854 today to schedule you FREE Fall Risk Assessment!


Hi Fyzical PT member, in last month’s newsletter I had information about back pain and I had lots of responses so I thought I’d offer some additional information and maybe some help. If you missed it pop in and we have a few copies left over! Do you have back pain when you sit? Roll over in bed? Get in or out of the car? Drive long periods? If you have pain with these normal daily activities… there is a simple exercise you can do for relief…and get back to feeling normal again….

3 Common causes are: 1. Herniated or slipped disc 2. Stenosis, arthritis, and disc degeneration

Now the 3rd cause… SI joint and Pelvic Pain, is a super tricky one.

3. SI joint and Pelvic pain

It’s frequently not picked up on MRI or X-ray. And we’ve seen a lot of people suffering with back pain and sciatica who’ve tried everything else (including chiropractic, medications, hot packs, inversion tables, injections, smelly blue lotions, failed surgery… and even other PT)… Yet still suffering.

Many times, these people have hidden cause of their pain… a problem in the SI Joint or Pelvis.

So the person might have had treatment for a disc problem or arthritis… but they never had treatment to address the real cause of their problem… the SI joint. SI joint sufferers usually have pain with changing positions such as getting in or out of a car…or rolling over in bed… or getting in or out of bed.

Sitting or driving is usually a problem…and one leg can feel “heavier” than the other.

Sufferers with this cause can even experience groin pain and trouble controlling their bladder (even at a young age).

Most people we see with SI joint and pelvic problems will have pain on either side of the tail bone or in their groin (as shown here…)

WHEN YOU KNOW THE CAUSE OF YOUR BACK PAIN AND SCIATICA, THEN IT’S MUCH EASIER TO DO THE RIGHT TREATMENT TO GET BACK TO NORMAL….. AND HEAL NATURALLY. At Fyzical, we specialize in helping people find out the exact CAUSE of their back pain and sciatica (this can be tricky… because some back pain and sciatica suffers can have more than 1 CAUSE). WhyKnowing theCauseof Your BackPainor Sciatica is so Important...

To schedule an appointment with one of our Back Pain and Sciatica Specialists and find out the exact cause of your back pain and sciatica, call us at (915) 330-8854 and schedule.

Hope this helps you, Luis Zuniga PT, DPT

PS – During the month of October we are giving away 11 Back Pain and Sciatica Screenings...to past clients of Fyzical...who have suffered with back pain or sciatica in the past 30 days… to schedule call (915) 330-8854. Expires October 20th. PPS – Do you know someone you care about who is suffering with back pain and sciatica? If so, there are 2 ways you can help them. First you can have them call us… (915) 330-8854 and schedule an appointment. OR if they’re not ready to schedule yet, have them call our office and request a copy of our Report: “The Top 10 Burning Questions for Sciatica”… and we’ll mail them a report absolutely free. We’ll include a copy of this sheet in addition to some other information that will help them out.

PPPS – Need extra copies of this news letter to share with friends and family? Just drop by the office and we’ll get you what you need.

October is National Physical Therapy Month October is fast approaching, and with it comes its share of official “national day” designations, including whimsical days like “National Pumpkin Seed Day.” But did you know that the entire month has been dedicated to National Physical Therapy Month? So, as the leaves are turning and you’re working on your jack-o-lanterns, take the time to learn more about the many benefits of physical therapy.

What Is National Physical Therapy Month All About? For almost 40 years, physical therapy has been celebrated by official proclamation. And since 1992, October is the month for honoring physical therapists and the important role they play in healing people in pain. In the modern era of social media, hashtags like #UsePhysicalTherapy and #ChoosePT have helped spread the word. Physical Therapy Month allows patients to share their stories about how PT has changed their lives for the better. It also gives physical therapists a forum for spreading the word about the different kinds of treatment patients can receive. Many members of the general public don’t realize that aside from specialized exercises that build strength and flexibility, PT also offers pain management through massage, heat and cold applications, and specialized electronic-pulse devices. What Symptoms and Conditions Does PT Help? Physical therapy tends to be associated with sports injuries, along with chronic problems such as back pain, surgery recovery, and balance issues. Yet, you may not realize the range of problems which physical therapy can help -- both for pain management and to help ease other symptoms. Do you have hand pain and stiffness? Physical therapists treat hand and wrist conditions ranging from carpal tunnel to “trigger finger.” Tennis elbow and rotator cuff injuries can also be aided through PT. Among other conditions the general public may not associate with physical therapy are pelvic floor dysfunction, TMJ, cardiopulmonary disease, Parkinson’s, and traumatic brain injuries. Why #ChoosePT? In recent years, National Physical Therapy Month has also focused on the alternative PT offers over opioids. With opioid abuse at an all-time high -- and tragic overdoses on the rise -- alternatives to this class of prescription medication are even more important. The National Centers for Disease Control (CDC) estimates that opioid prescriptions have quadrupled in recent years. Yet, the number of people reporting chronic pain has not gone down. Of course, many people who have conditions like back injuries or arthritis already understand that physical therapy can increase their range-of- motion. But aside from adding flexibility, physical therapy is a viable way to reduce acute and chronic pain. Prescriptions certainly have a valid place in pain management, and it’s true that physical therapy isn’t right for every patient. So how can you tell if physical therapy is a better choice than prescription opioids? The CDC suggests that if you fall into any of these categories, physical therapy can be beneficial: • Pain comes from fibromyalgia, low back pain, knee arthritis or hip arthritis. These conditions in particular are known for responding well to

physical therapy when it comes to pain management. • The pain has lasted more than 90 days, meaning that it has gone from “acute” to “chronic.” • The benefits of prescription opioids don’t outweigh their risks. In the early days after an injury or an operation, painkillers help patients function without crippling pain. But with each day that passes, the risks opioids pose outweigh the rewards. • If you’ve become afraid of the pain. Obviously, nobody welcomes physical discomfort. But some people become overly dependent on a pill’s ability to remove all aches and twinges. In physical therapy, pain is a way to determine exactly what needs to be worked on, in order to reduce discomfort down the road. Does an official month really matter, given that physical therapists are out there making a difference every day? In many ways, yes! If you or a loved one has been on the fence about giving PT a chance, the many stories you’re likely to hear during this month of public awareness may help you to decide. If you have any questions about whether you should #UsePhysicalTherapy, call our office today to discuss your condition and to set up an evaluation. Sources: https://www.moveforwardpt.com/ChoosePT/Toolkit https://www.moveforwardpt.com/choose-physical-therapy-over-opioids-for-pain- management-choosept https://www.moveforwardpt.com/Resources/Detail/physical- therapy-vs-opioids-when-to- choose-physica https://www.medicalnewstoday.com/articles/160645.php https://nationaldaycalendar.com/national-physical-therapy-month-october/


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