4.) Mix up your footwear. Try to find some summer shoes that have a little more arch support and some that have a strap behind the heel to change the demands on your foot. There are many different options out there, you can look into SuperFeet, FitFlops, Merrell, and Birkenstocks to name a few.
Injury Prevention for Swimmers!
Swimming is one of the best cardiovascular endurance exercises out there that strengthens the whole body! A lot of land based sport athletes resort to swimming and aquatic exercises even when they are injured or for cross training because it is a low impact sport that can in times of injury for a land based athlete provide a pain-free method for exercise. Because of it’s low impact nature, many people also enjoy swimming as a lifelong sport. Now even though swimming is an amazing sport, it has its own host of common injuries seen in competitive athletes and recreational athletes.
The most common injuries we see in swimming are shoulder, low back, neck and knee. A fun fact--the average high school swimmer performs about 1-2 million strokes a year with EACH arm. That is a lot of repetitions of one specific motion! If you haven’t guessed it yet, the most common causes of injuries in swimming are due to overtraining, poor stroke mechanics, and a sudden increase in workload.
Swimmer’s Shoulder, also known as, shoulder impingement is by far the most common swimming injury we see. Impingement syndrome occurs when the supraspinatus and biceps tendons get inflamed and repetitively aggravated or pinched between the acromion and humeral head during active motion. Often times, impingement is associated with poor posture, increased mobility of the shoulder joint capsule, poor motor control and strength imbalances from a structural standpoint. When imbalances in the body then mix with training errors such as overtraining, overloading, or poor technique, then we tend to see these injuries occur! Swimmer’s shoulder tends to affect freestyle, butterfly, and backstrokers the most. The good news is, these injuries respond very well to scapular stabilization programs and improvement of stroke form and efficient technique.
Lower back pain in swimmers is also quite common. Younger athletes are prone to back pain caused by repetitive stress in the lower back from hyperextension, stress from diving, or underwater kicking. These athletes need a strong focus on core stabilization exercises and core strengthening to help maintain their posture during hours of swimming.
Neck pain in swimmers is common since a HUGE part of the sport involves when and how you breathe. Just like how the shoulders undergo repetitive stress, we have to make sure we have proper positioning and alignment of the head and neck during all strokes too. Ideal positioning with all strokes during swimming reflects our ideal regular standing position on land. During freestyle breathing for instance, we often see people over-rotating or over-extending the neck to breathe which disturbs that proper alignment position. Instead, breathing during freestyle should involve a whole body rotation, and a smaller neck movement to place less stress through both neck shoulder joints. Bilateral breathing is also important to help aid in reducing imbalances through the right and left sides.
(Katie Ledecky showing off great breathing mechanics in Rio!)
Knee injuries are more common in breastrokers since the breaststroke kick mechanics places stress along the medial knee structures such as the MCL, the medial retinaculum and patella. Often times, swimmer’s that experience knee pain with breaststroke commonly have reduced internal rotation and extension mobility of their hips which translates to more stress along the medial knee. A second mechanism can be aberrant patellar tracking which can irritate soft tissue structures and cartilage under the kneecap.
(a good view of how much hip internal rotation is needed in efficient breaststroke kick)
(here is also a good view of proper neutral neck alignment during breaststroke)
As with any types of sports injuries, injury prevention is key! Here are some key methods that can help!
Proper Dynamic warm-up: joints and tissues function better when they are properly prepped for the 2 hour practice you have coming up! (Here is Michael Phelp’s doing his signature arm flap warmup pre-race! See? Olympians have to warm up too!!)
2. Dry Land and Strength training: dry land strengthening not only improves your power in the pool, but it helps to stabilize the joints that you repetitively use during practice, promotes good postural awareness and strength so that you don’t end up with repetitive stress injuries!
(Missy Franklin rocking some side planks during dry land practice!)
3. Flexibility and stretching: swimmers tend to have too much mobility in certain joints like the shoulders, and too little mobility in places like the hips and thoracic spine!
4. Stroke technique and mechanics: efficient technique leads to less injury and quicker speed!
If you or your swim team would like some help with swimming injuries, injury prevention, injury screens, or a strength and flexibility workshop, please reach out so we can help (617.618.9290 or email@example.com)!
Violet Chang, PT, DPT, OMT
Graston Technique Certified
Girl Fit Physical Therapy
Thanks to our student Kayla for being our guest blogger this month!
Never Rush the Healing Process!
By: Kayla Caban (Simmons College DPT student)
A few years ago I was lucky enough to travel to Ireland to work with the physiotherapy students of University College Dublin (UCD) regarding Gaelic football players and the injuries that they receive while playing the competitive natured sport.
We quickly learned that the Gaelic Athletic Association (GAA)has seen a high prevalence of soft tissue injuries. The most common soft tissue injury seen are muscle strains, particularly hamstring strains. This type of injury is common due to theextremely fast paced nature of the game, requiring sudden changes in speed to beat or catch the opposing players, which predisposes players to a hamstring injury. Significant muscle fatigue in the second half of matches also increases the risk of hamstring injuries, which is inherent in severe endurance sports like Gaelic football.
Gaelic football players, on average, sustain more than one injury per year and 35% of these injuries are previous injuries that are reoccurring.The elite levels of the GAA of both hurling and football have programs implemented to help prevent and reduce the amount of these injuries; however, the sub-elite levels do not have the same resources and therefore have been seen to have a higher rate of hamstring injuries. For a lot of the younger levels, parents of the players volunteer as coaches, which means there can be a vast difference in the knowledge of the game and the susceptibility of the players to injuries.
Our goal as Simmons College students was to implement a hamstring strain prevention and rehabilitation program to help teach the coaches and payers about preventative training. Along with implementing rehabilitation programs we also wanted to educate the coaches, players, and parents about what exactly a hamstring injury is and the signs and symptoms that can occur with a hamstring injury. We also wanted to make sure that they were aware of how long they need to rest in order to maximize healing and prevent future injury. Lastly, we wanted to educate these populations about how to avoid overtraining in order to make sure that they did not to jump into training that is too vigorous; instead they need to gradually build up their training level in order to avoid spikes in training levels as this is commonly associated with an increase in injury. We also learned that 35% of all injuries occur during training sessions, showing how important it is to warm up before a practice. Gaelic football players tend to get back into the game before their body/injuries are fully healed, which makes re-injury rates increase, showing how injury prevention education is very important!
Our overall vision was to promote injury prevention throughout the club level GAA sports. We did this by creating a presentation and a pamphlet for the coaches/players. The pamphlet contained general information regarding hamstring strains and included; what is a hamstring strain, signs and symptoms, causes and risk factors, rehabilitation process and criteria to follow to return to play. The pamphlet is displayed below:
One of the most important keys to take away from the information listed above is that before any activity, it is important to warm up properly in order to increase blood flow to the muscles for effective stretching, which can reduce the risk of injury. Another important take away is that it is extremely important to let your body rest after an injury. I wanted to share this information to the patients of GirlFit, not only to inform you about what I learned about hamstring injuries along my trip to Ireland, but to make it known how important it is to listen to your body! A lot of athletes are so concerned about returning to their sport after an injury that they try to rush the healing process, which can actually make the road to recovery a lot longer or even cause secondary injuries. So if you are reading this and you can takeaway one thing, I encourage you to give your body time to heal, you’ll thank me in the long run!
1.) Flynn S. 2 Most Common Gaelic Football Injuries and How to Prevent!. Flynn Medical Exercise. 2017. Available at: https://flynnmedicalexercise.com/2015/10/18/gaelic-football-injuries/. Accessed April 5, 2017.
2.) Valle X, L.Tol J, Hamilton B et al. Hamstring Muscle Injuries, a Rehabilitation Protocol Purpose. Asian Journal of Sports Medicine. 2015; 6 (4). doi:10.5812/asjsm.25411.
3.) Worrell T. Factors associated with hamstring injuries. An approach to treatment and preventative measures. Sports Med. 1994 May; 17(5):338-45.
A guest post from a PT student, Maya, who was a part of our Girl Fit team this summer!
Over the last six weeks, I had the amazing opportunity to work with Kate Hamilton and her unbelievable team at Girl Fit Physical Therapy as part of my DPT education. While I expected to learn infinite amounts about patient management, clinical decision making, and professional development, there was so much I did not expect to learn.
From age 3 to 18, I spent countless hours in dance classes, rehearsals and performances. I attribute the person I am today to not only my amazing parents but also the discipline dance forced me to have inside and outside the studio. While I have nothing but positive memories of the 15 years I danced, these six weeks at Girl Fit helped me remember a lot I had forgotten.
During my first week, Kate had me research common diagnoses seen at Girl Fit so I would better understand the underlying pathology of our patients’ symptoms. Doing this research, I began having flashbacks to 10 year old Maya feeling weird aches and pains— aches and pain which sounded a lot like the diagnoses I was reading about. I started to see a version of myself in some of our patients, however the biggest difference between 10 year old me and the amazing young women who come to Girl Fit is that they have someone advocating for them. During those 15 years of dance, I never had someone talk to me about what was healthy pain and what was not. As a result, I think I pushed through injuries that I could have sought help for.
While all of my aches and pains have resolved themselves today, the PTs at Girl Fit are taking a more proactive approach. The PTs are helping educate young women about how to be the healthiest version of themselves. This knowledge is extremely empowering and can be seen in the determination of all young women who come through the doors at Girl Fit. The Girl Fit team helps their patients recover from injuries, leaving them stronger than when they walked in, but they are also teaching their patients how to prevent future injuries.
While I do not know where my future degree in physical therapy will lead me, I now understand the importance of my role as advocate and educator for my future patients. I will serve to be the person I wish I had when I was growing up, the person Kate and all the PTs at Girl Fit are for their patients so passionately and effortlessly.
Maya Johnson, SPT
Guest post from the owner of one of our favorite dance studios in Newton about the love, joy, AND health benefits of dance!
Why dance? For me, the answer is easy. I just love the way my body feels when it is moving to music. I love the way it feels to soar through the air as I leap. I love finishing a pirouette just perfectly. I love when a particular style just feels “right” on my body. I even love the sensation of sweat dripping down my face after a particularly aerobically challenging recital dance! I just love to dance.
But, you know what I think is so cool? Nobody is going to have the same answer as mine. And, that is what makes dance so amazing. One of our new 3-year-old students at All That Jazz this year told her parents after her first pre-ballet/tap class that “dancing makes me happy in my heart.” I loved hearing this so much! Here is a child who is still learning how to talk and yet she so eloquently summarized why she loved her first dance class so much.
Interestingly, there is actually a more technical and medical answer to the question “Why Dance,” too. There have been several recent studies conducted on the benefits of dance and dementia. One such study was conducted by the journal, Frontiers: "Dancing can reverse the signs of aging in the brain." ScienceDaily in August 2017.
"Exercise has the beneficial effect of slowing down or even counteracting age-related decline in mental and physical capacity," says Dr Kathrin Rehfeld, lead author of the study, based at the German center for Neurodegenerative Diseases, Magdeburg, Germany. "In this study, we show that two different types of physical exercise (dancing and endurance training) both increase the area of the brain that declines with age. In comparison, it was only dancing that lead to noticeable behavioral changes in terms of improved balance... I think dancing is a powerful tool to set new challenges for body and mind, especially in older age."
In other words, dancing on a regular basis can actually keep your body AND your brain healthy, especially as you get older. While exercise of any kind is important and beneficial for your overall well-being, there is clearly growing research to suggest that dancing can actually make you SMARTER and stay this way for as long as you keep dancing.
So, again, I ask, Why Dance? Whether it is because it makes your heart happy, or your brain happy, as long as it makes YOU happy, just do it!
Deb Vogel, Director of All That Jazz Dance Studio in Newton
We are lucky to have another guest blogger...this time Aria sharing her experience with how valuable being part of a team is, especially in time of injury!
My name is Aria Moshief and I am a rising senior at Wellesley High School. I have been an athlete since I was 2 years old, and I have gotten many injuries since then. From ages 8-11, I would have injuries that would put me back in physical therapy every 6 months. From those injuries, I’ve learned to know when to stop, especially with the help of teammates. Being on any team, you know how to communicate, confide, and trust each other. My worst injury occurred when it was my first year on a competitive dance team. I was 12 years old dancing on a team with girls who were 16-18 and I felt a ton of pressure to be able to dance the way they do. By pushing myself too hard, I inflamed my hip flexor and tore my labrum in my hip. This injury caused me to have to leave the dance team, and never return to a studio again. However, I was able to join the dance team at school and compete without the same level of intensity there was at my studio. Joining the team as 1 of 3 freshmen, I was nervous as to how the upperclassmen would react to me playing it safe with some things that could potentially re-injure myself. The more bonding and talking we did, the more I felt comfortable with dancing at my own ability. The girls were completely understanding of my injury and never pressured me into trying something that could end up badly. Trusting teammates is a huge deal, especially when you don’t really know anyone on the team. Instead of feeling the need to compete with my teammates, I felt comfortable with identifying my limits rather than trying to ignore them. Being on the team for my entire high school career, I have met tons of girls who have different abilities, and level of talent. The team is always so supportive of my decisions to sit out of a practice if I’m in pain, or if I need to take a break. No matter the injury, you will always have people that will support you throughout your recovery process. And having that support system will make the recovery even better!
Cupping - More than just polka dots!
(though we do love polka dots)
Cupping is an ancient form of alternative medicine that originated in China. It has been around for thousands of years, but has moved into the spotlight after the 2016 Olympics when Michael Phelps was seen sporting the classic purple circles that cupping therapy can leave. What are those marks though and what does cupping do besides leave them? Cupping is a type of instrument assisted soft tissue mobilization that uses glass, silicone, or plastic cups to exert a negative pressure (like a vacuum suction) on the skin and underlying tissues. Typical massage techniques are compressive (think hands pushing into your muscles) whereas cupping is actually decompressive. The suction exerted by the cup lifts layers of tissue and brings blood to the surface of your body which can help improve blood flow, provide a stretch to your fascia, and improve mobility. The purple mark left by cupping therapy is not a bruise and is not painful, it is evidence of the blood that has been pulled to the surface, which has theoretically removed potential blockages from your system and prepped your body to start healing. Cupping therapy in conjunction with strengthening and stretching can help improve your recovery and maximize your flexibility. Ask about cupping at your next physical therapy visit, or schedule a Wellness visit with Christina to check it out! Contact us at 617-618-9290 or firstname.lastname@example.org to schedule an appointment.
Cupping now offered at Girl Fit PT!
Hello Girl Fit community!
My name is Nicole and I really like dancing! If you were to ask anyone who knows me to tell you one thing about me they would tell you that I just really like dancing. I started dancing at the age of 2 and haven’t stopped since. (I am almost 26 now!) I danced competitively in high school, I danced in college, and now I have my own dance company that I run with a close dancing friend. To put it shortly, dance is my life. So the moment I was in too much pain to keep dancing, my life was turned upside down. I lost a part of my identity. But this is a happy story, I promise! So bear with me here. I want to explain to you all why you should never ever give up.
It was May 2016 when my hip pain started. I woke up one morning after an intense workout and I couldn’t lift my left leg. I didn’t have health insurance in the Boston area because I was only 23 and still on my Dad’s health plan and he only had coverage in Buffalo. So after a few weeks of pain, I decided I to fly to Buffalo and get my hip checked out. I had a consult with a hip doctor there and a MRI before coming back to Boston. After a few weeks, the doctor from Buffalo called to tell me that the MRI was normal but I had some strange blood work, so he couldn’t do anything for me until I saw a rheumatologist… Now I couldn’t afford to keep flying back and forth to Buffalo so I had to find a new job in Boston. I needed my own health insurance. It took a few months but I finally got a new job and once the health insurance kicked in I started seeing doctors in the Boston area. I saw 10 different specialists (in both rheumatology and orthopedics) before finally being referred to a physical therapist who actually believed me and the amount of pain I was in. The problem was that I was a dancer, and “normal” people do not put their bodies through the extreme ranges of motion that dancers do. So every doctor I saw was convinced that nothing was wrong because I could touch my toes. After going to physical therapy for a few months, (Girl Fit didn’t even exist at this point in time yet!) my physical therapist suggested I visit the Dance Medicine section at Boston Children’s Hospital. It was there that I met Dr. Stracciolini. She knew what dancers do and she believed me. She could see how much I had gone through and she knew that dancers never fully expresses how much pain they are in. She ordered a new MRI to be done.
The new MRI showed a ganglion cyst and possible labral tear. But the worst part was, the radiologist compared the new MRI to the CD of the old one from Buffalo, and the findings were “consistent”... meaning that the radiologist in Buffalo mis-read the MRI!! I wasn’t crazy. There was something wrong with my hip.
It was around this time that my new health insurance decided that I should be better and that they weren’t going to cover any more PT visits. So, Dr. Stracciolini suggested this new little PT practice that opened up in Newton that had reasonable self-pay options. And that was when I came to Girl Fit and met Kate :). I was going through various rounds of diagnostic cortisone injections and Kate and the Girl Fit crew helped me continue to get stronger. Things were finally looking up, but unfortunately the pain was not getting any better.
So it was around June 2017 that Dr. Stracciolini ordered a new set of x-rays and a new MRI with contrast. They found that I had hip dysplasia and a labral detachment tear. These diagnoses were what my insurance needed in order to cover more physical therapy visits. Then, Dr. Stracciolini referred me to Dr. Yen (the hip scope surgeon at Boston Children’s) and I continued doing PT with Kate.
I called Dr. Yen’s coordinator and the first appointment that he had available wasn’t until the end of August!!! I was bummed. That summer my dance company was putting on our first ever full length production and I wanted nothing more than to dance in it. And I was starting graduate school in the fall… I was really hoping that all my hip troubles would be gone by the time school started, but if I couldn’t even get a consult with the surgeon until the end of August, I wasn’t going to be able to have surgery until school’s winter break… my troubles were not over. But little did I know they were going to get much much worse before they got better. (still a happy story, I promise!)
On August 1st, 2017 I was rushed to the ER from work for what we found out to be a kidney stone. It turned out that I was going to need surgery to get the stone removed. I was not expecting that one… So we waited a week to see if the stone would pass on its own (it didn’t) and I went into surgery. When I came out, the doctor did not have the good news that I was hoping for. They weren’t able to get the stone because my ureter was too small for their surgical equipment. They had to put a stent in to stretch out my ureter and they were going to have to leave it in for two weeks before going back for ANOTHER surgery!! My consult with Dr. Yen AND my dance company’s show were that week! I was going to be in surgery two days before putting on my first ever professional production. I was terrified.
The day before the second kidney surgery, I met with Dr. Yen. When he walked in the room, I knew something was not right. He looked at me and said “I can’t do the scope on you, you’re going to need a PAO.” I immediately started crying. A PAO was not a small surgery. The scope surgery would have been a 6 week recovery with some PT and I knew I would have bounced back in no time. But the PAO (Periacetabular Osteotomy) had a much much longer recovery time... But I wanted nothing more than to dance again, so I agreed to meet with the next surgeon.
I met with Dr. Matheney on the morning of Friday August 25th, 2017. It was opening night of our show and I had to be at a tech rehearsal in a few hours. But Dr. Matheney was amazing. He explained the procedure to me and reassured me that the end was in sight. They were going to cut my pelvis in three places so that the acetabulum (the socket of the hip joint) could be rotated around the femoral head (the ball). My hip had basically been coming out of the socket by 1 cm for the past year. That was why I was in so much pain! And that was why it hurt to dance!
We scheduled the surgery for my winter break and I continued seeing Kate at Girl fit to try to keep my hip as strong as possible before going into surgery. But I was happy because I got to go see Kate and the rest of the girl fit team at least once a week. :)
In order to get the PAO done and recover enough to be able to go to class on crutches in January, I had to push up my December finals by 2 weeks. (Anyone who knows anything about architecture master programs knows that this is NOT an easy feat.) I spent my entire thanksgiving break doing homework at my desk in my apartment all alone. My super awesome friend Lisa did came over with a few study snacks and study breaks, but for the most part all I did was homework. Then the day finally came and it was time for me to get a new hip! I was terrified but incredibly excited at the same time.
After my surgery, I spent two weeks in bed before flying to Buffalo to spend a very emotional holiday with my family. My father was diagnosed with an aggressive brain cancer (the same week I found out I needed the PAO) and we weren’t sure if this holiday would be the last. (update as of June 2018: no new tumor growth in my Dad’s brain!)
One month following the surgery, I was back at Girl Fit and this time we were actually building strength instead of just maintaining. I was SO ready to get back to the dance floor. I also started to see Kelsey Griffith through The Micheli Center. She helped me A LOT with all the mental challenges that came with the PAO. She even visited me while I was still recovering in the hospital!
PT was not easy. There were days where I would end up crying on the floor in my room at home, but I was making more progress over the course of 1 week than I previously had over the course of 1 year. I was doing my exercises everyday while trying to keep up with all my graduate school coursework. I was exhausted. But everytime I came into Girl Fit, I couldn't help but smile. Everyone in there was always happy to see me. They always asked about school and they always made me laugh. Anytime Kate was out of the office, Christina would treat me and she always made me feel so confident with her positive comments on my progress. Once my range of motion restrictions were lifted, I started taking mindful movement classes with Jen and I always felt so grounded, centered, and strong. I cried after my first mindful movement class with her because I surprised myself so much with how strong I had become. They were tears of joy and relief. It finally felt like my body was my own again and that I had control over it.
My hip journey has taught me a lot about life. First, it taught me to never doubt myself. I am the owner of my body, and I know it best. Never let someone tell you what you are or are not feeling. You know yourself the best. Second, it taught me that the people who you surround yourself with are incredibly important. I built myself a team of incredible, strong-willed, and inspiring women who believed in me from day 1. I can honestly say that I would not be where I am today if it were not for the wonderful support team that I have: my dance partner and best friend Lisa, Kelsey from the Michali center, the Girl Fit team, and most importantly Kate. They are all incredibly knowledgeable at what they do and most importantly, they are always positive and smiling. Finally, I learned that no matter what you are going through, you should never ever give up. You are ALWAYS strong enough to follow your dreams.
It has been a long two years, but I am finally dancing again! I have Persevered And Overcome many obstacles on my way to healthier hips.And I owe a lot of that to Girl Fit. I am so happy and incredibly proud to be a girl fit girl.
Thanks to Nicole for contributing to our blog!! We are super proud of her!
I want to share with you a story that embodies what I always hoped Girl Fit would be. Meet Hannah… the girl who decided to go for it! Hannah saw our Girl Fit (@girlfitrocks) Instagram post on January 22…
Feeling a little nudge of inspiration, Hannah went to her mom that day and told her that she had decided to try out for a rowing team. She wanted to go for it. The next week, Hannah came to Girl Fit for a Wellness Visit and gait evaluation. We checked her strength, flexibility, balance, body mechanics, and gait and Hannah told us all of the fitness requirements on which she would be tested for her tryout. Instead of trying to crank out sit ups and push ups each night and risking getting injured while prepping for her tryout, we developed a well rounded and safe strength and flexibility program for Hannah. She came to work out at the Girl Fit Studio 3 days a week and performed her home exercise program another 3 days a week for 6 weeks to prepare for the tryouts. She went in feeling confident and prepared… and she crushed her tryout! Hannah was the YOUNGEST GIRL to make the rowing team and she is LOVING her new sport.
The Girl Who Decided to GO FOR IT
We’re so proud of her and feel really lucky that we got to help her follow her dreams.
A blog post by Girl Fit PT's co-op student Madeleine
Madeleine is a 5th year student in the Doctorate of Physical Therapy program at Northeastern University. She grew up as a competitive synchronized swimmer on the North Shore of Boston. She joined the Girl Fit team in January 2018 as a 6-month co-operative education student. If you called the office or came into the clinic recently, you have probably seen her smiling face!
I like to joke that my feminist awakening started when I was 9 and watched “Legally Blonde” for the first time. As a 9-year-old, I was under the impression that you could either be a girly-girl or a tom-boy. Girly-girls were pretty, popular, and conformed to societal expectations of women. Tom-boys were sporty, smart and had the monopoly on empowerment. Legally Blonde taught me that you could be both pretty and smart. At an elementary school age, this was revolutionary to my world view. Ever since my Elle-Woods-feminist-awakening, I have been on a life long journey to understand how I define feminism, and how best to use my power as a woman to help other women.
An important stop on that journey was a class I took for my minor in “Global social entrepreneurship”. I traveled to India for a 6-week study abroad program that focused on women’s empowerment and development in rural and suburban India. I learned an immense amount about social entrepreneurship, Indian culture, and the best way to empower women.
We visited many different organizations running different programs to address the needs of the women in their community. We visited a taxi service for women that also taught women how to drive. We visited a school that used theater to help women process and speak about the injustices they had experienced in the world, such as sexual assault, a rampant issue in rural, northeastern India. We worked with a company that taught women how to sew and then provided them with tailor jobs. The lesson I took from the successful organizations we interacted with, was that women don’t need to be “empowered”. What women need is to be given knowledge and skills that they do not already have.
Research agrees. Most research in the development space is focused on resources and women’s access to those resources. Deepa Narayan of the World Bank, writes, “we see resources, however, not as a feature of empowerment per se but as… catalysts for empowerment, as enabling factors that can foster an empowerment process.”1 Empowerment, or increasing access to resources, has a positive effect on economic development, according to the American Economic Association.2 Empowerment is not necessarily telling girls they can be anything, but rather giving them better access to resources they need to succeed.
Though underprivileged women in rural Ragistan, India may seem very different than the adolescent female athletes we see at Girl Fit Physical Therapy, I believe what I learned applies to the empowerment happening every day in the clinic. In middle and high school sports, girls are not given proper education on injury prevention. They are told they need to train more to be better: “everything needs to be strong!”. Research has shown that due to many barriers, children and adolescents are not given proper injury prevention education.3 Without this information, girls are at very high risk of injury from training too hard and putting stresses on their body which are unnatural.
I have seen first-hand what the Girl Fit model has done for some of our patients and clients. A girl comes in with an injury from her sport and is weak in certain muscle groups, despite training 6 days a week. She has poor body mechanics, as well as low body awareness, which may have led to her current injury and also puts her at higher risk for a second injury. When she graduates from physical therapy, she has a tool box full of exercises that she can do to work the areas she needs to keep strong, knowledge of how strengthening and stretching keeps her from putting herself at risk for another injury, and understanding when her body is telling her to slow down or stop.
Each week, the Girl Fit team meets to talk about research in physical therapy so we can use the best exercises, best techniques, and give the best evidence-based practice to our patients. While I do not think the physical therapists even realize it, they are empowering their patients and clients based on research in development. I am proud to have been part of the Girl Fit team and to have helped improve the lives of many strong girls and women by giving them the skills and knowledge they need to take care of their bodies.
The road to Girl Fit PT
Over the last 10 weeks, I have been fortunate enough to complete my third and final clinical education experience as part of my doctorate of physical therapy coursework here at Girl Fit Physical Therapy. Apart from getting to work with an incredible staff and learn an immense volume of knowledge in my field, I have had the distinct privilege to treat a unique and exuberant patient population. This population, a collective of strong and talented women and girls, has taught me as much, if not more, than I have been able to pass on to them.
Let me provide a brief history of myself and my role at Girl Fit PT before we get to the last bit of information I would like to impart. I am in my last year of physical therapy school at Massachusetts College of Pharmacy and Health Sciences, to graduate in May. This is an amazing realization for me, as I have known I wanted to be a physical therapist since my senior year in high school.
I grew up as a dancer in Scranton, Pennsylvania, studying ballet, tap, jazz, modern, hip-hop, character/cultural dance, and musical theater. I continued dancing throughout college, attending West Chester University of Pennsylvania, where I majored in Exercise Science and minored in dance, while earning my yoga teaching certification through my school’s partnership with Yoga Alliance. At WCU, I performed with and choreographed for University Theatre and University Dance Company, traveling with the latter to Ladek-Zdroj, Poland, to present original choreographic works as part of gala concerts in an international dance festival. That year, I realized that as I proceeded in my academic career, I wanted to wed my love of movement science with my love of dance and the arts; in short, I wanted to be a physical therapist who specialized in a performing arts population. While completing my undergraduate exercise science internships, I channeled this aspiration into being able to work with the resident PT for the Pennsylvania Ballet, as well as with a local outpatient clinic whose director taught an injury prevention course at WCU for music majors – a course for which I was chosen to serve as a teaching assistant.
Physical therapy seemed to be the perfect vessel to make both these passions my career. As a dancer, I fortunately never sustained any derailing injuries; however, my fellow company members surely did. I watched the recuperation process for these injuries, learning that physical therapists were the wizards at work getting these injured dancers back on stage in what seemed like no time. From the opposite end of the spectrum, my mother had always taught me, “if you don’t use it, you lose it”. This she learned from watching my grandmother’s physical health decline until she finally passed away in 2001, in part due to the fact that as her health issues increased, she led an increasingly sedentary life that at one point was no longer voluntary. My mother was the driving force behind my knowledge of health and fitness, and the importance it should hold – not just for one’s sport, but for one’s basic livelihood.
MCPHS’s DPT program consists of two years of didactic work, followed by a final year of three 10-week clinical education experiences. One clinical must be of a complex medical/inpatient nature, along the lines of hospitals, nursing homes, and rehabilitation facilities, and another must be an outpatient setting, which is the most widely known area of PT. Our third clinical is more flexible, wherein we are allowed to choose a specialty within either of the aforementioned disciplines. When it came time to work with our professors in voicing our interests for this specialty, I was sure to vocalize my passion for working with a sports medicine population that specifically served dancers and performing artists. I was delighted when my professors informed me that they had found a site that seemed to be my perfect match, a site to which they had not yet sent a student – Girl Fit PT.
My first clinical was at a skilled nursing facility/continuing care retirement community in Seattle, WA. My second was at an outpatient orthopedic site that specialized in sports medicine in the geographic center of New York City. Both experiences were incredible and I enjoyed them thoroughly. At Girl Fit PT, I became well versed in diagnoses and treatment techniques specific to dancers, as well as gymnasts, skaters, and other young female athletes. These athletes, to my surprise, were not only eager to return to full performance of their beloved sports, but also to learn about their bodies and the multidimensional importance of wellness along the way.
My time at Girl Fit PT
This is a fantastic segue into where the rest of the Girl Fit PT team and myself come in. The most valuable tenet I learned during my time here has been the emphasis on independence and empowerment to our patients of all ages. This includes educating them in every step of their treatment, so that by the time they are strong enough to spread their wings and fly the Girl Fit PT nest, they are knowledgeable in the anatomy of their injury, what exercises constitute a solid home program, and why it is so important that they stick to performing it. I have been only too grateful to help them on that journey.
Speaking of journeys, now that we have discussed the journey that brought me to Girl Fit PT, let’s talk about how my journey as a student physical therapist at Girl Fit PT can maintain relevance for all our awesome patients after I leave. Throughout my time here, one of my projects was staying up to date with current research in the physical therapy field – research that specifically addresses our patient population at Girl Fit PT. Kate was kind enough to loan me a particularly relevant issue of the Journal of Orthopaedic & Sports Physical Therapy, known more simply as JOSPT, from October 2017. On a biweekly basis, I synthesized 1-2 articles pertinent to our patient population to present during team meetings. This was a fantastic way to keep me on my toes as a student and clinician, as well as impart important discoveries on diagnoses and treatment techniques to the rest of the staff that could only serve to better our plans of care for our valued patients. As the weeks progressed at Girl Fit and I developed relationships with these awesome patients, I began to choose articles for my presentations that addressed diagnoses of specific patients, to further augment the treatment we were providing in real time.
Low back pain and joint hypermobility syndrome
For the second part of this post, I would like to focus on the passage of this information onto our patients and parents. My emphasis will be on the diagnoses of low back pain and joint hypermobility syndrome, since these were significant cases that I saw throughout my time at Girl Fit Physical Therapy. I hope that this presentation will demonstrate that you contribute as much to our cycle of knowledge and growth as we hopefully do to yours during your time with us!
Is 2018 the year you want to start running? Or maybe improve your PR for a 5 or 10k? Or maybe just be able to run a short distance without pain? Or is it the year you're going to qualify for the Boston Marathon?
Whatever your goals may be, it's important to know take care of your body when you run! In our October blog we shared some tips and techniques on running form, so once you've read that, check out a few common stretches and exercises that you should be doing if you're not already! The repetitive motion of running can cause for some imbalances in muscle strength and flexibility so try to combat them with these:
Stretching for Runners
You calf muscles can get very tight due to running. Make sure you spend time stretching, at least 2x30 seconds on each side, as well as doing some self-massage with a foam roller for 1 minute per side after runs.
The hip flexors and quad muscles are another area that are commonly tight in runners. When performing the above stretch, make sure you are keeping your belly button pulling back towards your spine and your pelvis tucked underneath your body to feel a stretch in the front of your hip. Hold the stretch 2x30 sec on each side. For foam rolling the quads, get into the plank position with your stomach tight and roll yourself along the foam roller using your arms.
Strengthening for Runners
The gluteus medius is a muscle on the side of your hip that helps keep your pelvis level and your knee straight when standing on one leg. The clamshell exercise (above left) is a great way to isolate that muscle. Lie on your side, rolled slightly forward, keep your feet together, and lift your top knee. Be careful not to lift so far that you roll your hips back! Work up to performing 3 sets of 10. When that gets easy, perform side stepping with a band at your ankles to work the same muscle in a more functional position.
The gluteus maximus is your buttocks muscle. This muscle is also very important for proper form with running. To strengthen this area, perform a bridge exercise. Lying on back with knees bent, engage your stomach muscles to keep your back flat and push through your heels as you squeeze your buttocks to lift up your hips. You should not feel this exercise in your back! Work up to 3 sets of 10 and when that gets easy, try performing the same exercise on one leg at a time.
Need More Help?
If you are experiencing pain with running, are thinking about getting into running, or even want to improve your running performance, the physical therapists at Girl Fit are here to help!
- Schedule an 1 on 1 appointment and we can video your running form and perform an evaluation to find any areas of weakness or tightness that might lead to injury or impair your performance. Watching the way that you run allows the physical therapist to target potential pitfalls in your form and prescribe specific exercises, stretches, and drills to correct your technique in order to resolve pain and improve efficiency.
- Join our walking or running club for women to build up your endurance under the supervision of our awesome PTs!
- Contact us today to find out more about these opportunities!
One of our very own physical therapist’s, Jen Wardyga, PT, DPT, is currently getting physical therapy while recovering from ACL reconstruction surgery. While Jen spends most of her time providing physical therapy services to her patients, she now finds herself on the receiving end. See below for her perspective!
As a lifelong athlete with a long list of my own injuries that have put me onto a physical therapy
treatment table, I have lots of personal experience being a patient. While recovering from my second ACL reconstruction surgery, I was a first-year student in PT school and was conveniently learning about the musculoskeletal system, which helped me to learn a lot more about my injury—why it happened, why my physical therapist was choosing certain exercises for my exercise program, and why she was working on some parts of my body more than others. Now I’m recovering from my 3 rd ACL reconstruction surgery as a full-time physical therapist, and I feel like this is the best recovery I’ve had so far.
Some people might say “The third time’s a charm,” but I have put a lot of work in behind the scenes that has certainly helped me to see good progress in my recovery. As a patient, I realized that doing my home exercise program three times a day feels a lot like a full-time job, especially when I’m already so tired from my body working in overdrive as it recovers from such an aggressive surgery. Full disclosure: this is the first time that I have been consistently compliant with my home exercises. Let me tell you, there is indeed real truth when your physical therapist says, “The more you do your exercises at home, the better off you’ll be.” Some of these exercises help me with my strength, others with my flexibility, and still others that help my scar tissue to heal as optimally as possible. To be quite honest, sideways bandwalks and foam rolling my quads, IT bands, and adductors are some of the most—hmm, how should I put this—brutal exercises! BUT knowing what I have learned as a physical therapist, I know they are so important for injury prevention and treatment, which is why I prescribe them to almost every one of my
patients with a lower body injury.
Outside of my hard physical work in this recovery journey, the most important thing that has helped me to be so successful thus far is the wonderful support system I have that helps me to keep my spirits and my motivation high. My family has been amazingly loving and supportive throughout my recovery journey, which has helped me to feel like I’m not going through this alone. I am also working with a personal life coach, who frequently helps me to work through the rougher parts of this journey. One of the most important strategies I have learned through this recovery process is becoming comfortable in sitting and pushing through the difficult, frustrating, and uncomfortable situations that often cause me to feel emotions that I cannot always identify right away. Sometimes I cry, and I’m not sure why. Other times I feel frustrated or angry, and I’m also not sure why. Is it the injury that’s causing me to feel this way? Or is it other circumstances or maybe even my perspective that might be the culprit? Through my own research targeting the relationship between emotional and physical components of injury, I’ve learned that inability to appropriately process and manage emotions during the recovery process can cause a delay in physical progress. Sometimes suppressed emotions can manifest in physical forms, causing the body to catastrophize the pain response. As a result, the patient may experience limited physical progress and less successful rehabilitation outcomes.
Now being back in the clinic and treating patients again, I find myself drawing from my personal physical therapy experiences to identify and empathize with my patients even more so than I did before this surgery. One of my goals as a physical therapist has always been to help my patients feel like they are never flying solo through their own injury and recovery journey. I want them to feel like I’m here for them, and we will work through the difficult parts together. Now being on the flip side of surgery, I feel like I can do this even better!
Don’t like foam rolling, doing bandwalks, or performing single leg squats when rehabbing your own injury? Do you find yourself unmotivated to complete your exercises at home because they are difficult and they make you sore? Come to Girl Fit and do them with me! At Girl Fit Physical Therapy, regardless of the physical therapist you’re working with, you are never alone in your journey. We are all a team and we want our patients to have the best success!
Tips on Running Form
Keep your stomach muscles engaged to protect your back. Think about pulling your belly button towards your spine to keep a neutral position and avoid allowing your pelvis to roll forward or back to arch
Think about leaning slightly forward, but ensure the lean is from your ankles not hips
Focus on soft landings
If you can feel the insides of your knees touching when you run, squeeze your buttocks muscles and envision your knees pointing straight ahead as you run
Keep your shoulders relaxed and avoid swinging your arms across the front of your body, that’s a waste of energy! Pump arms straight forward and backward
Don’t forget to stretch, foam roll, and strengthen your legs to keep yourself healthy and strong enough to run
A large majority of recreational runners demonstrate a fault in running form called overstriding, demonstrated in the above picture (left). Overstriding means your foot is hitting ground far in front of your center of mass. This position leads to a “braking force” where the ground is matching your forward impact with a backwards impact. The braking force makes your running less efficient and can lead to pain with running.
Think leaning slightly forward while running (as in the picture above on the right) with your foot hitting the ground more underneath your body to decrease that braking force, improve the efficiency of your stride, and take a significant amount of stress off your knee joints.
When your foot is hitting the ground very far out in front of your body, it leads to a rapid impact force at foot contact. Because the knee is typically straighter, the force travels quickly up the skeleton causing more impact to be felt in the ankle, knee, hip, and even all the way up to the back.
When you land with your foot closer to your center of mass, you will have more bend in your knee which allows the muscles of your leg to help absorb the force. This position will decrease the force of impact at the knee and hip joints and also improves the push off phase as you unload the “spring” of the muscles in your leg.
If you feel like you need some help with your running techniques, posture, or form, please reach out for a session and we can help give you even more individualized assessment and recommendations to improve your running!
Our next blog will go over some common stretches and exercises that are great for runners - stay tuned!
Written by Christina Beachy, PT, DPT, CSCS
We are so excited to be celebrating 1 year of Girl Fit Physical Therapy!
What a year it has been!
Here are some highlights from our fun and busy first year!
- Girl Fit PT had two new PTs join Kate this year to make an even stronger team! Jen joined us in May and Christina joined us in August - both bringing with them a wealth of knowledge and experience, both as athletes and therapists!
- Girl Fit PT has been able to offer a variety of services in our Newton Studio to address the physical and mental needs of our girls.
- Girl Fit, Girl Fit Cardio, Girl Fit Flexibility & Balance
- Yoga with Amy
- Mental Skills Workshops with Kelsey
- Nutrition consultation and support with Laura
- Girl Fit PT had 42 figure skaters take part of the Summer Skate Fit program at the Skating Club of Boston! We also continue to offer off ice training during the school year.
- Girl Fit PT has been lucky to be a part of community activities too!
- We have offered education and classes at local Athletas, the JL Dance Center Un.Convention, Newton North Dance Team, and of course the Skating Club of Boston
- Kate educated other professionals at the Female Athlete Conference on how to individualize an injury prevention program for the female athlete
- We sponsored the Newton Girls Softball League
- We collaborated with Artists for Humanity, an organization that supports Boston youth, in helping us with our great t-shirts
- And beyond our Boston area, last year Kate went to China as part of US Figure Skating to provide physical therapy to athletes during the Cup of China and in a few months will be heading to Japan for the NHK Trophy!
- Girl Fit PT is growing its social butterfly skills thanks to our followers on Facebook, Twitter, and Instagram (638 and counting!). We love sharing Girl Fit PT news as well as inspiration and education with you.
- Girl Fit PT provided internship opportunities for local youth through the Newton Summer Mayor's Internship Program, as well as students from Newton North High School, Nobles High School, and Dean College, and a cooperative position with Northeastern University. We look forward to offering clinical education opportunities to PT students in the coming year!
- Girl Fit PT has been able to work with girls from all sorts of sports: figure skating, dancing, gymnastics, lacrosse, golf, swimming, basketball, softball, volleyball, track, soccer, and more.
- And of course our biggest accomplishment: being privileged enough to be a part of YOUR journey - toward you getting stronger, more flexible, and more confident to help you get back on your way to following your dreams!
We hope to see you THIS Saturday, September 9th, to celebrate our first year and to thank you for being a part of it! Drop in from 10 am to 12 pm for some fitness challenges and some yummy snacks and you may leave with some sweet Girl Fit PT swag!
Thanks again to all of our Girl Fit Girls, our incredible referring medical team, and our support in Newton and beyond! Thanks to you all, this dream has come a reality! We cannot wait for what the next year brings!
At a physical therapy clinic like Girl Fit PT where sports medicine and injury prevention is our passion, we love to work with athletes! That being said, we see a lot of sports-related injuries. With great appreciation for all of the research that has been done in the world of physical therapy (PT) to help us formulate treatment plans for each unique injury, physical therapists are really confident in treating the physical component of injury. This includes the body aches and pains associated with an injury. In the majority of PT clinics, treatment stops here. However, at Girl Fit we recognize that sports injuries go far beyond their physical component and can also include emotional distress. What does this mean?
Sports injuries are more than just physical -
they're EMOTIONAL too!
I have been an athlete all my life, sprinting up and down soccer fields as a varsity soccer collegiate athlete, running in circles around a track through high school, and have most recently become a yogi as I practice finding my physical edge in conjunction with my mental edge. I have a laundry list of injuries underneath my belt—some as serious as multiple ACL tears and others a little less serious,* like ankle sprains and tendinitis. I am one of the most competitive athletes I know, and I love being able to participate. So when I’m trying my very best to be a good patient while I rest and rehab my injuries, I often come across this one thought: “I know my body hurts, but I’m also having all of these feelings that make me feel like I’m just not myself right now.” Chances are that if you’ve been injured or are currently working through an injury, this same thought might have or may currently be running through your mind too. Why?
Research suggests that a sports injury doesn’t only affect muscles, bones, and other tissues in your body. It affects your brain too! As athletes, just about all of us have some level of an athletic identity—the extent to which we identify ourselves based on our athletic endeavors and the extent to which we value ourselves based on athletic success. So when we are working through an injury that limits our ability to participate in our typical athletic routine or impacts our sports performance, our athletic identities are threatened. For me, this makes me feel less worthy, less competent, less confident, more of an outsider, and less like me. Sometimes these thoughts and feelings can become the forefront of an individual’s emotional state. When this happens, the individual may feel like they’ve lost their sense of self, essentially experiencing an identity crisis.
As a patient, I’ve been here—more than once. I know what it is like to not know who I am anymore because I feel like my injury has taken away my sport—the love of my life and the thing that makes me who I am. It is scary, it is saddening, it is overwhelming, and it is emotionally exhausting. Additionally, evolving research suggests that being in a state of emotional distress like this limits physical rehab success and increases the risk of re-injury when returning to sport.
Even further, research suggests that emotional/psychological recovery can take longer than physical recovery, and only when both components are successfully recovered can an individual return to sport with the lowest risk for re-injury.
Woah—this is scary on all accounts. However, take courage! There is good news!
As physical therapists, it is within our scope of practice to address BOTH components of injury. As mentioned before, we are experts in addressing the physical impairments and fortunately we are learning more and more each day about how to address the emotional component just as effectively. What’s more, at Girl Fit we believe in providing interdisciplinary and collaborative care, meaning we work as a team with other healthcare providers to make sure our patients get the best care possible. As such, we will lend you our greatest support and our biggest hearts when we work through your injury with you at Girl Fit. And when that seems like it’s not quite enough, we’ll team up with a sports psychologist who can make our care team even better. In short, you’ll always be in good hands that will help you to manage your injury and return to your sport with the best and strongest version of yourself!
If you are interested in learning more information about the various factors that can impact athletic identity and emotional state when coping with a sports injury, be on the lookout for future blog posts at https://headinthegameweb.wordpress.com. Topics include but are not limited to the following:
- Athletic Identity
- Mental Toughness
- Social Support
- Coping Strategies
- Rehab Adherence
*Note: ankle sprains and tendinitis are still serious injuries that should be treated with as much attention as an ACL injury. Although these injuries might be small in comparison, they have the potential to affect other muscles and joints in the body, which can increase injury risk in other places.
Written by: Jen Wardyga, PT, DPT
A concussion is not just getting your 'bell rung' it is actually a mild brain injury. It can occur as a result of a hit, jolt, contact, or jarring force to the head. Because it doesn't usually come with a bruise or gashing open wound, it can actually be more dangerous because the athlete may keep playing and not get treated. An athlete that feels bad, but keeps playing, is at risk for another concussion and potentially worse damage.
Signs and symptoms of concussions vary and can include:
- Blurry vision
- Sensitivity to light or noise
- Difficulty concentrating
- Difficulty remembering
- Difficulty sleeping or more sleepy than usual
- Poor balance
- More emotional or irritable than usual
Imagine how hard it would be to play or perform well when you're having any of those symptoms above!! A confused Britney is safer off the field or rink or court & resting instead!
Concussions have been getting more and more headlines lately, but most often with men's football. So, as a female athlete, do you need to be worried about concussions?
The quick answer is YES! For the long answer, keep reading.
Concussions affect girls and women, just as often, if not more often than men. Because there is less awareness in the area of concussions in females, athletes may have one without realizing it. Instead of resting and getting examined, the athlete may keep on playing despite the signs or symptoms.
- Researchers aren't really sure why girls are at a higher risk for concussions - it could be hormones or less neck muscle strength or less training and protection or that girls are just reporting their symptoms...the problem is we don't really know! More reporting & research is needed to help learn more and prevent them from happening!
- Girl report more symptoms like poor concentration, lightheadedness, increased fatigue, headache, and visual hallucinations
- Girl show greater cognitive decline and slowed reaction time relative
- Girl perform worse on balance tests following concussion
- Read below about how you could be at risk - and what you need to look out for!
So, if you think you have a concussion, you need to tell someone & get the proper treatment! You want to make sure your 'head is in the game' so you can practice, perform, and play your absolute best! Remember your brain works just as hard as your body does, so it needs just as much care & protection & attention!
For more reading & research
Being a girl can be tough. Every day you are faced with images and expectations of what a girl should be. And as an athlete, while you love how much fun you have, you probably feel extra pressures and expectations. The best thing for you is to know YOUR body and then learn how to make it work for YOU, in the safest, healthiest, and strongest way.Read More
In our corner of the world here in Newton, we are about helping girls get fit, so they can be strong and follow their dreams. Our commitment to girls goes beyond just this, though. We are committed to girls feeling strong in all aspects of their lives and we want to support and promote causes that help make the world fit for girls too!Read More