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Martha | Back to tennis after fractured vertebrae!

Christie | Recovering from a sports injury!

Clay | Triathlete overcomes neck fracture!


New York City, Westchester & Connecticut

Providing personalized care for real Results in the Manhattan-NYC, Eastchester, Hartsdale, Katonah, Darien and Norwalk areas.

If you need physical therapy, then you want physical therapy from the most educated, experienced, and specialized physical therapists that offer attentive care for your joint, muscle, or orthopedic condition. Premier Physical Therapy is the leading NYC Tri-State (NY-NJ-CT) orthopedic and sports rehabilitation practice. In addition to physical therapy and rehabilitation for general orthopedic conditions, our licensed physical therapists specialize in hand therapy, sports injuries, pediatrics, neurological conditions, work-related injuries, balance and vestibular rehabilitation. Our caring physical therapists are dedicated to helping every person achieve and maximize his or her physical health and pain relief.

Premier Physical Therapy is a participating member of both the NYU Langone Medical Center Musculoskeletal Rehabilitation Network and the Hospital for Special Surgery (HSS) Rehabilitation Network.

Refer a patient, request an appointment online, or call to schedule your preferred appointment at any one of our physical therapy centers of excellence located in Manhattan-NYC, Eastchester-NY, Hartsdale-NY, Katonah-NY, Darien-CT and Norwalk-CT.

Orthopedic

Physical Therapy

Hand and Wrist

Therapy Centers

Pediatric Physical

Therapy Centers

Spine Centers

 for Back and Neck Rehabilitation

Joint Rehabilitation

(Shoulder, Elbow, Knee, Hip)

Foot and Ankle

Rehabilitation

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    Overstrider? More steps to become a better runner.

    Summer is in full swing – for a runner this means the height of training season is fast approaching. Many runners are stepping it up and increasing their mileage for late summer races or for upcoming fall marathons. This is the good news. The bad news is that over 50% of recreational runners and up to 90% of runners training for a marathon will sustain a running related injury this year. It’s not all bad though – runners have the ability to identify and correct faulty running form in order to embark on a healthy marathon season this fall.

    Overstriding is a faulty running mechanic that deserves our attention. You may not have given much thought to your running stride before, but the length of your stride is a potential power player in your health as a runner. Stride length and step rate are important pieces in both injury recovery and prevention. Like the name says, overstriding simply means that a runner exhibits a long stride length, and therefore takes fewer steps per minute for any given distance. This may sound efficient, but overstriding has been linked to a variety of running injuries including patellofemoral pain syndrome, iliotibial band syndrome, plantar fasciitis, achilles tendonitis and tibial stress fractures. These injuries often result from excessive impact forces at the hip, knee and ankle joints, which accompany overstriding.

    Many studies have linked an increased step rate to a considerable reduction in running-related injuries. Increasing the number of steps you take with running is simple, even for the most habit-oriented runners. There is no magic number for step rate – it simply has to be higher than your originally preferred step rate. Subtle increases in step rate as little as 5-10% have been shown to reduce joint compressive forces andrunners_legs decrease risk of injury. This alteration in running mechanics has proven to be just as, if not more important than a strengthening rehabilitation program. Strength is not the sole indicator of recovery; when returning to running after an injury, it is paramount that rehabilitation principles carry over to your daily runs.

    So how can you change your stride? If you have been a runner for 20+ years, or even 5 years, you are most likely set in your ways. It can feel daunting to change it up. But remember, increases as little as 5% have been shown to make a difference! Your Physical Therapist at Premier Physical Therapy can help you determine step rate with only a video camera and a treadmill. Your PT will have you run on the treadmill at your preferred speed for 5 minutes while he or she counts the number of right foot strikes over a 30 second period and multiplies by 4 to determine steps per minute. This will provide you with a baseline rate from which to increase 5-10%.

    If it seems overwhelming to implement a new running pattern throughout the entire course of your run, you may start by adding incremental time periods at the new step rate. There are also apps that will aid in maintaining step rate, freeing you from the burden of counting the number of steps you take each minute. Metronome apps like Jog Tunes will find music according to beats per minute to match your new step rate. Other metronome resources include Pro Metronome, BestMetronome.com, and RunningPlaylist.net.

    Ask your Physical Therapist at Premier Physical Therapy about ways to combat overstriding and start taking more steps to become a better runner!

    In health,

    Jennifer Jurewicz, PT, DPT

    Lily Mercer, SPT

    References

    Heiderscheit BC, Chumanov ES, Michalski MP, et al. Effects of Step Rate Manipulation on Joint Mechanics during Running. Medicine & Science in Sports & Exercise 2011;43(2):296-302.

    Influence of Stride Frequency and Length on Running Mechanics: A Systematic ReviewSports Health: A Multidisciplinary Approach 2014;6:3 210-217

    RunningUSA.org

    Taunton JE. A retrospective case-control analysis of 2002 running injuries. British Journal of Sports Medicine 2002;36(2):95-101

    van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW.. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41:469-480

    Willy RW, Buchenic L, Rogacki K, et al. The effects of a gait retraining program using mobile biofeedback in high risk runners. Proceedings of the 3rd International Patellofemoral Pain Retreat 2013

    read more
    Joe TattaOverstrider? More steps to become a better runner.
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    Taking an ACTIVE approach to Recovery

    We have all experienced some type of pain in our lives, and how we respond to that pain dictates how well we recover. With immediate acute injuries, the most common response is to stop painful activities, rest the area, possible ice/heat the area and/or take OTC medication. However, if this rest period becomes too prolonged, you can be detrimentally affecting your body and your recovery. So, how much rest is too much rest?

     Understanding Tissue Healing

    To understand healing and your recovery, it’s first important to understand the phases of healing that each tissue goes through after injury. These phases can help dictate when you should return to activities, and what type of activities you should be performing.

    Phase One – “Acute Inflammation”: Within the first 1-7 days post injury, the tissue responds to injury with acute inflammation, causing an increase in pain, temperature, swelling, and/or loss of motion. These responses are the initial steps of healing, and work by bringing repairing mechanisms towards the area of injury. This phase can last from 2-4 day in minor injuries, and can be up to 7 days with more severe trauma. In this acute phase it’s important to rest the injured area, apply ice often, and avoid aggravating activities. This rest allows the repair mechanisms to come into the cell in preparation for the laying down of new tissue. Performing intensive movement and aggravating activities during this time can damage the new forming tissue, and create weaker tissue once healed.

    Phase Two – “Proliferative Phase”: This next phase involves the creation of new cells, and the tissue experiences an increase in collagen formation as damaged tissue is removed. As more tissue is formed to replace injured tissue, it’s important that the tissue heals in the way that the tissue is used, and that motion be initiated to ensure correct tissue structure is created. Aggravating activities should still be avoided, however, beginning to return to daily activities and movement of the injured tissue should begin. This is also the perfect time to begin Physical Therapy, to ensure a controlled and supervised progression of mobility and exercise that is tailored and unique to your injury.

    Phase Three – “ Maturation and Remodelling”: Approximately 3 weeks after the initial injury the maturation phase. This phase consists of the maturation of collagen, and the production of the final scar tissue. Here, it is imperative to begin more intensive movement of the tissues, although still trying to limit aggravating activities. About 6 weeks after injury acute healing is complete, however continued healing happen as you stress/strain the new tissue. As you apply new stress to the area your body detects any inherent weakness in the new scar and tissue, and remodeling and creation of new tissue is constantly occurring to ensure the area is strong enough.

    Benefits of Early Motion

    Now that the phases have been presented, it’s easy to see why initiating early motion has been proven in the literature to produce the best results for recovery. In the early phases after acute inflammation, motion is vital to enhance the production of new tissue, ensuring it forms in the appropriate direction. This will help maintain full motion of that tissue and associated joints, making sure the scar tissue isn’t restricting motion. Early motion is also important to ensure cartilage health, making sure the joints are moving and lubricating the joint and associated cartilage. Early motion will also help begin to strengthen the affected area, decreasing the risk of re-injury and muscle wasting.

    Negative Effects of Immobility

    If activity is not initiated, a myriad of negative effects can follow. Firstly, the new tissues being created is forming in a patchwork pattern, and without stressing that tissue it will not form in the appropriate direction. This disorganized tissue will stiffen the area and restrict the mobility of that tissue, and may even lead to more chronic issues with motion such as joint contractures (a permanent shortening of muscle/joint). Lack of activity and motion will also promote continued and prolonged loss of muscle strength, which has multiple negative effects on the body. Initially, as the injured tissue heals, the other muscles surrounding the injured area will be forced to pick up the slack, causing them to be overworked and possibly lead to another injury as they fatigue. Along with that, the new repaired tissue won’t strengthen either, leaving it more susceptible to re-injury and delaying your recovery.

    Besides the negative physiologic effects, it’s also important for mental health to begin a more active approach to. Studies have shown that immobility and passive approaches to recovery can often create fear and anxiety of movement, teaching the false idea that passive strategies are good for recovery. This will exacerbate fears of re-injury and further decrease activity levels, prolonging recovery. Some studies have even suggested that passive approaches increase the tendency of people to look towards passive strategies such as surgeries or injections, instead of trying to actively control their recovery with physical therapy and exercise.

    How PT Can Help

    Recovery-TimeIf you didn’t seek Physical Therapy after your initial injury, it’s never too late to begin. In the initial phases PT can help if you are unable to move your muscles, such as after surgery, by passively moving the area to avoid joint contractures and maintaining the health of your cartilage. Some studies suggest this passive movement can even help maintain your body’s ability to sense it’s position (balance). Along with early movement, manual breaking up of scar tissue can be helpful early in recovery, as well as with more chronic type injuries. Dense scar tissue forming can actually prevent muscle fibre regeneration from happening, prolonging injury and recovery. This scar tissue can restrict motion of the area which can predispose the area to another injury. PT also helps ensure correct progression of your activity level, ensuring proper timing based on your individual injury. Your therapist can help alleviate the pain, and advise you on how much is too much, as well as help alleviate fear and anxiety about returning to potentially injurious activities.

    Multiple studies have shown more optimal recovery with early movement in ligament, tendon, muscle and bone injuries. More recent literature reviews have even promoted early movement and walking in hospital based PT settings such as the Intensive Care Unit (ICU) for critically ill patients, as well as immediately post-operatively with many other Orthopaedic surgeries such as knee and hip replacements. All these studies have proven multiple times that early motion leads a quicker recovery time, and a quicker and fuller return to full activities. If these people can be up and walking around, so can you!

    Take an active approach to your recovery! Balance is the key, knowing how much is too much, but not being fearful of movement. The initial protection and immobility is good for healing, however the earlier you can get back to usual activities, the better the injury responds physiologically and the better you heal mentally.

    In health,

    Lauren Carleton, PT, DPT

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    Joe TattaTaking an ACTIVE approach to Recovery
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    Summer Running: Heat Related Injury and How to Avoid It

    Heat Exhaustion: What is it?

    It is a heat related injury that occurs when the body fails to cool itself in response to increased temperature, humidity or situations involving strenuous activity.

    Symptoms

    • Cool moist skin with goose bumps when hot
    • Faintness
    • Dizziness
    • Weak rapid pulse
    • Muscle cramps
    • Nausea and vomiting
    • Headaches

     Heat Stroke: What is it?

    It is a heat related injury more serious than heat exhaustion. Heat stroke may result in more dangerous outcomes such as organ damage or death.

    Symptoms:

    • Elevated body temperature (>104 F)
    • Altered mental status (slurred speech, confusion, agitation, irritability, delirium)
    • Nausea and vomiting
    • Flushed skin
    • Increased breathing rate
    • Increased heart rate
    • Headache

    Causes and Risk factors:

    • Dehydration Running-Hard-On-Road-Sport-Fashion-iPhone-6-plus-wallpaper-ilikewallpaper_com
    • Overdressing
    • Alcohol use
    • Underlying health condition (ie. chronic lung, heart disease)
    • Obesity
    • Sudden change in temperature
    • Older age
    • Higher heat index
    • Medications: Heart medications (beta blockers and diuretics), Allergy medications (antihistamines) and antipsychotics/tranquilizers

    What to do if you or someone who know experiences heat injury?

    If heat stroke is suspected 911 should be called Immediately.

    Immediate stop exercise or strenuous activity and REST.

    Find a cooler resting place/ remove exposure to heat.

    GET COOL – (get in a cold water, spraying down with hose, sponging areas such as head, neck, armpits and groin).

    If symptoms don’t resolve in an hour OR body temp is greater than 104 call 911.

    Educating yourself is the first step. Now that you know the risks, symptoms and treatment of heat injury. Lets look at some tips to avoid them. After all we did wait patiently (or not so patiently) through those grueling winter months to hit the scenic paths along the river – did we not?

    HYDRATE!

    You knew this one was coming, but lets talk specifics.

    How much water should I drink while I’m running?

    Hydrating during exercise in hot weather actually doesn’t do much to combat your rising core temperature. It/s how much you drink BEFORE that makes the difference. With that being said longer (>4 miles) runs may require you to take in fluids while running.

    Ok. So then when am I supposed to hydrate?

    Rule of thumb is 2-3 hours prior to going for your run – consume 16 oz of water.

    What about sports drinks? Or is water enough?

    The first 45-60 min water is just fine. Typically, running longer than 60 min in the heat will require supplementing something to replenish electrolytes. If you don’t like sports drinks – goo or sports gel works as well.

    Scale it back…temporarily

    We’re not suggesting a brisk walk vs. running. But scaling back intensity 65-75% the first time you run in high temperature (above 90 F) is suggested, initially. Over the next 10 days ramping up to your previous level of intensity. This allows your body to acclimate to the higher summer temperatures.

    Early bid catches the worm

    …and the cooler temperatures. You might want to re-think those after work runs. Evidence shows the hottest time of the day is often around 5pm. If you aren’t a morning person, you’ll want to wait till the evening hours (think after 8pm).

    Get cool clothes

    Literally.

    Check out what they’re made of.

    There are plenty of companies now that offer more moisture-wicking clothing that’s better than those standard cotton biker shorts from 1982.

    Skip the dryer.

    Dryer sheets and fabric softeners actually lessen the moisture-wicking properties of most exercise clothing material. Hang drying your clothes not only prevents this, but makes the clothes last longer.

    Fail to Plan. Plan to fail.

    As mom always says – have a plan. Stick to the buddy system. Run with a friend who can easily identify any signs of heat injury. Or at a minimum let your significant others, roommates or family members know you’re going out for a run and when to expect you back.

    Run cool,

    Natalie Lovitz, PT, DPT

    References

    http://www.dartmouthsports.com/pdf9/2319785.pdf?DB_OEM_ID=11600

    http://www.mayoclinic.org/diseases-conditions/heat-stroke/basics/definition/con-20032814

    http://www.mayoclinic.org/diseases-conditions/heat-exhaustion/basics/definition/con-20033366

     

    read more
    Joe TattaSummer Running: Heat Related Injury and How to Avoid It
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    Safe Lifting Techniques To Prevent Injury

    Low back pain is one of the leading causes of disability. Chronic low back pain is a multifactorial phenomenon and it affects 70 to 80 percent of adults at some point during their life. Further, low back injuries account for 30 to 40 percent of workers’ compensation payments and the majority are a result of strains and sprains, most of which are due to overexertion associated with lifting and handling. It is, therefore, worth teaching safe lifting and handling techniques to prevent back injury or re-injury. Having more efficient ways of performing certain day to day activities such as lifting and carrying heavy objects, combined with the use of good body mechanics may be essential in the prevention of potential injuries.

    Watch the Video Below for Safe Instruction and Proper Lifting Technique.

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    Joe TattaSafe Lifting Techniques To Prevent Injury

Sports Physical Therapy

Sports Medicine and Rehabilitation

Balance and Vestibular

Rehabilitation (Vertigo)

Ergonomics and Work Injuries

(Corporate Physical Therapy)

Locations

New York City
(Manhattan)

Upper East Side @ 77th
170 E 77th St – Prof Ste 2
New York, NY 10075
Hours: Mon-Fri 7:00am – 8:00pm; Sat 7:00am – 2:00pm
Phone: (212) 249-5332
Fax: (212) 249-9539

Murray Hill/Midtown South
461 Park Ave S Rm 802
New York, NY 10016
Hours: 7:00am – 8:00pm
Phone: (212) 696-2727
Fax: (212) 696-4499

Upper East Side @87th 177 E 87th, Suite 303, New York, NY 10128 Hours: 7:00am – 8:00pm Phone: (212) 249-2758 Fax: (212) 249-2506

Financial District
7 Dey Street, Suite 601
New York,  NY  10007
Hours:  7:00am – 8:00pm
Phone:  (212) 249-2451
Fax:  (212) 861-2653

Upper West Side @ 72nd
162 W 72nd St Fl 4
New York, NY 10023
Hours: Mon – Fri 7:00am – 8:00pm; Sat 7:00am – 2:00pm
Phone: (212) 362-3595
Fax: (212) 362-3587

Upper West Side @ 96th
132 W 96th St Ste 1A
New York, NY 10025
Hours: 7:00am – 8:00pm
Phone: (212) 249-2758
Fax: (212) 249-2506

MidtownE./ Sutton Pl.
226 E 54th St Ste 304
New York, NY 10022
Hours: 7:00am – 8:00pm
Phone: (212) 371-7001
Fax: (212) 371-7011

Midtown
22 E 49th St Fl 6
New York, NY 10017
Hours: 7:00am – 8:00pm
Phone: (212) 753-1175
Fax: (212) 753-1719

Westchester

Katonah
223 Katonah Ave
Ste C
Katonah, NY 10536
Hours: 7:00am – 8:00pm
Phone: (914) 232-1480
Fax: (914) 232-3341

Eastchester
575 White Plains Rd
Eastchester, NY 10709
Hours: 7:00am – 8:00pm
Phone: (914) 771-6200
Fax: (914) 771-6202

Hartsdale
141 S Central Ave
Ste 205
Hartsdale, NY 10530
Hours: 7:30am – 8:00pm
Phone: (914) 946-5685
Fax: (914) 946-0304

Connecticut

Darien
36 Old Kings Hwy S
Ste 110
Darien, CT 06820
Hours: 7:00am – 8:00pm
Phone: (203) 202-9889
Fax: (203) 202-9975

Norwalk
346 Main Ave
Norwalk, CT 06851
Hours: 7:00am – 8:00pm
Phone: (203) 847-4400
Fax: (203) 847-4442


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