Category: Athletic Performance

GOLF – How to Stay Injury Free

Does you back, shoulder or elbow have you screaming Fore!? You are not the only one whose play is effected as the result of a nagging injury or lack of flexibility. The good news is that FYZICAL Therapy & Balance Center, your local neighborhood private practice, can help you with your injuries.

The best golfers in the world make fitness an integral part of their game and have forever changed Golf. Par 5s are now reachable in 2. Fatigue is not as much of a factor. Ball striking is more consistent, and scores continue to drop. Technological improvements in equipment have helped, but more than ever, Golf Professionals are investing in physical health. Most amateurs, however, have not taken advantage of getting their bodies in the best physical condition to play the game they love. It may be the shortage of proper fitness programs specific to golf. It may be that the information out there just doesn’t seem to fit the individual. Or it may be the fear of injury or the lack of a personal plan based on individual needs. One thing is for sure – investing in your physical health will add to the enjoyment of your game!

Low back pain is the most common injury or complaint among both professional and amateur golfers. Next are upper extremity injuries (elbow and shoulder). Low back problems occur as the result of a powerful rotation and extension motion in the golf swing. They can also occur as the result of inadequate flexibility in the hips and trunk. A 2004 study suggests that increasing extension ROM of the lumbar spine and rotation in the lead hip (left hip in a right handed golfer) may decrease the incidence of low back pain. FYZICAL Therapy & Balance Centers (Bristol and Southington) are the only two Certified McKenzie Spine Care Clinics in New England! There is no better place to get treated for your back pain.

The elbow is the second most common injured area in golfers. The two most common problems are medial epicondylitis (aka golfers elbow) and lateral epicondylitis (aka tennis elbow). Both are thought to occur as the result of poor swing mechanics, as a result these injuries become apparent with an increase in play. These injuries also occur from hitting the ground frequently (taking a divot) or hitting a shot “fat” (taking a very large divot). A good stretching and strengthen program have been shown to decrease these problems, along with improved swing mechanics.

The key to injury prevention is a proper warm up routine before hitting the links. Over 80% of golfers spend less than 10 minutes warming up before a round. Those who do warm up have a 50% less incidence of injury compared to those who do not warm up.

A personalized program can be designed for you by a certified Titleist Performance Institute practitioner at FYZICAL Therapy & Balance Center. This will focus on helping to increase range of motion, improve balance and coordination, increase strength, increase flexibility, and increase stability which can all help with injury prevention and improve your golf game. You might even gain a little extra distance as a bonus!

For more information please contact, Keith Sobkowiak DPT, L/ATC, Physical Therapist/General Manager at 860-585-5800 or keith@fyzicalct.com , to help with all your rehabilitation needs. Keith also has his Level 1 Certification from the Titleist Performance Institute (TPI).

FYZICAL Therapy & Balance Center has offices in both Bristol (860-585-5800) or Southington (203-272-8490) for your convenience. Same day appointments available.

Keith Sobkowiak | Fyzical CT
Keith Sobkowiak – PT, DPT, ATC/L Bristol

PLANTAR FASCIITIS – PREVENTION, SIGNS AND SYMPTOMS

ANATOMY OF PLANTAR FASCIITIS
The plantar fascia is a band of connective tissue that runs along the sole from the heel to the ball of the foot. One of its main roles is to keep the bones and joints in position and enables us to push off from the ground. Bruising or overstretching this ligament can cause inflammation and heel pain. In many cases, plantar fasciitis is associated with a heel spur.

Who is at Risk for Plantar Fasciitis?
– High impact activities: running, jumping, aerobics, etc.
– Flat-footed or high arches. People with flat feet may have reduced shock absorption,  increasing strain on the plantar fascia. High arched feet have tighter plantar tissue, leading to similar effects
– Middle-aged or older. Heel pain tends to be more common with ageing as muscles supporting the arch of the foot become weaker, putting stress on the plantar fascia.
– Overweight. Weight places a greater mechanical load on the plantar fascia. There is evidence that overweight and inactivity lead to chemical damage to the plantar fascia, with a worsening of pain.
– Being on your feet. People with occupations that require a lot of walking or standing on hard surfaces may suffer plantar fascia pain.
– Wearing shoes with poor arch support or stiff soles.

PREVENTION OF PLANTAR FASCIITIS
– Maintaining a healthy weight to minimize the stress on the plantar fascia.
– Choosing supportive shoes. Avoiding stiletto heels and shoes with excessively low heels. Buying shoes with a low to moderate heel, good arch support and absorption.
– Starting activity slowly. Warming up before starting any activity or sport, and starting a new exercise program slowly.
– Allowing adequate recovery time between workouts or training sessions.

SIGNS & SYMPTOMS OF PLANTAR FASCIITIS
You may experience:
– Sharp pain in the inside part of the bottom of the heel, which may feel like a knife sticking into the bottom of the foot.
– Heel pain that tends to be worse with the first few steps after awakening, when climbing stairs or when standing on tiptoe.


– Heel pain after long periods of standing or after getting up from a seated position.
– Heel pain after, but not usually during, exercise.
– Mild swelling in the heel

Helpful Hints on Self Care
– Gentle stretching of the Achilles tendon and plantar fascia, weight loss, taping, arch support and heel lifts
– Night splints
– Ice Massage
– Custom orthotics

What FYZICAL can do for you…
– Decrease initial pain and inflammation.
– Identify biomechanical dysfunction.
– Improve flexibility.
– Strengthen the plantar fascia.
– Return to full fitness.
– Injury prevention.
– Custom Footmaxx orthotics

Physical therapy includes myofascial release and scar tissue breakdown of the plantar fascia, and supervised stretching. A strengthening program for the calf muscles and small muscles of the foot is important. We will also use evidence based manual techniques to get you on the road to recovery. Be aware that this may increase soreness initially, but persistence should be rewarding. Care should be taken to wear supportive and stable shoes. Patients should avoid open-back shoes, sandals, ‘flip-flops’, and any shoes without raised heels.

If you have plantar fasciitis, foot pain or heel pain it is best that you call to schedule an evaluation before doing more serious damage. We have two facilities that are qualified in assessing and treating these types of ailments. You can call Bristol at 860-585-5800 or Southington at 203-272-8490.

Keith Sobkowiak | Fyzical CT
Keith Sobkowiak – PT, DPT, ATC/L Bristol

Athletic Performance & The McKenzie Method

“Sport is a series of repeated movements and/or sustained loads” MDT conference, Miami 2016.

When the best athletes from around the world gather together to compete at the highest level of competition, people pay attention. The Olympics always seem to draw huge numbers of viewers that enjoy watching the best of the best compete. Inevitably, these viewers pay attention to the detail that is displayed on their HD screens. In London, it was the colorful, mesmerizing designs on shoulders and knees that raised awareness about Kinesiotape. In Rio, it was the circular bruises on the bodies of swimmers that have people wondering what “cupping” is. These modalities to musculoskeletal care seem to allow athletes to continue competing for the time being. What people don’t notice because of these distractions, are the repeated motions and sustained positions that these athletes do with their bodies.

The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is a system of musculoskeletal care that uses repeated motions and sustained positions to allow patients to control their own symptoms. It is an ongoing diagnostic process that, when performed by a trained MDT clinician, leads to outstanding results and patient empowerment. It looks at how an individual is moving, and what kind of symptoms are occurring as a result of that movement. A patient-specific repeated motion or sustained load is selected by the clinician and performed by the patient, with a careful monitoring of the change in symptoms. This process occurs until the patient and therapist have found a direction and force of movement that abolishes the patient’s symptoms, and prevents the symptoms from reoccurring by compliance with the patient’s own movement.

Here are some examples of repeated movements that are seen in the Olympics. Think about how many times a swimmer brings his/her arm through extremes of motion in one event. How long does a cyclist spend hunched over the front of their bike? Over the course of a 150 mile bike race, cyclists perform 37,000 revolutions. That’s a lot of the same motion, over and over again. Think about gymnasts, who have more range of motion than most people could dream of, and take advantage of the full available range. Rowers perform the same motion over and over again, with their wrists, elbows, shoulders, and back. Think about how many times the aforementioned motions are performed all year round, day in and day out, preparing for the Olympics.

One member of the United States skeletal team, Alex Ivanov, explains the positions required to compete in Olympic skeleton. “You have to arch your back as much as possible, which isn’t the greatest for being healthy, but it’s really good for going fast.” Alex has experienced a number of injuries from training and competing in this sport, many of which have occurred in the spine. Utilizing MDT, his physical therapist was able to diagnose his back pain, and provide a program that involves extending the spine. This is the opposite motion that Alex spends most of his time in during his sport.

“Having an extension protocol keeps everything moving the way it should and balances the movements I do in training. It’s kept me way healthier for the last couple of seasons”
Alex continues to use these simple McKenzie exercises to prevent the pain from coming back. He has integrated extension exercises in his warm-up and cool down in order to prevent the previously problematic positions from becoming an issue. His teammates have benefitted as well.
“Lower back and thoracic spine problems are pretty rampant in our sport. Having this in our warmup, they’ve all noticed some pretty big differences. It’s simple, it helps out, and it fits in with our routine really well.”

It is at the end range of available motion where most patients experience the most change in their symptoms. By visiting that end range of motion repeatedly, in a direction chosen by the clinician, a reduction in symptoms are often experienced. This reduction can occur after as little as 3-5 therapy sessions.

The bottom line is, athletes should be utilizing the McKenzie method to treat their own pain, because they repeatedly go through these same motions in their sport on a regular basis. Injuries in any sport are inevitable. Olympic athletes are prone to injury because of the nature of their job. When you look at the way the body moves, and treat these athletes according to their preferred movement patterns, amazing results should be expected. After all, when the Olympics are over, will athletes continue to have their skin sucked out by a cup? Will they continue to go to a facility every day to have their shoulders taped? No. But they will continue to move. MDT should be utilized for these athletes, and all athletes with pain, because after all, everyone has to move. It is important to know how to move in the right direction.

Here at Fyzical Therapy and Balance Centers of Southington/Bristol, we are the MDT experts as a certified McKenzie clinic. For questions or concerns please contact us in Bristol at 860-585-5800 or Southington at 203-272-8490. We also specialize in orthopedic and sports therapy, vestibular rehabilitation, balance /falls and health and wellness including BODYQ, a full body fitness assessment and FOOTMAX, customized orthotics designed to address foot pain.

This article was written by Brian Greer, DPT.

Brian Greer | Fyzical CT
Brian Greer – DPT Southington

Brian graduated from the Doctor of Physical Therapy program at Springfield College in 2016. He is currently a staff physical therapist in our Southington location.