Swimmers - Do you want to stay strong & injury free?

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.

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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.

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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.

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(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.

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(a good view of how much hip internal rotation is needed in efficient breaststroke kick)

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(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!

  1. 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!)

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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 office@girlfitrocks.com)!  




Violet Chang, PT, DPT, OMT

Graston Technique Certified

Girl Fit Physical Therapy

violet@girlfitrocks.com

617.618.9290










Never Rush the Healing Process

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. 

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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.

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 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: 

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 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!

Resources:

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.

Picture resources:

1.)   https://www.thesun.ie/wp-content/uploads/sites/3/2017/01/dubdonegal-e1483474903518.jpg?strip=all&w=960

2.)   http://clareherald.com/wp-content/uploads/2015/05/gaelic-football-gaa.jpg

3.)   http://sism.ie/wp-content/uploads/2015/07/973910.jpg

4.)   https://www.howtorelief.com/wp-content/uploads/2018/05/Hamstring-Muscles-1024x853.png

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A promise to my future patients

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.

 

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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.

 

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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

Why dance?

Guest post from the owner of one of our favorite dance studios in Newton about the love, joy, AND health benefits of dance!

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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

www.allthatjazznewton.com

missdeb@allthatjazznewton.com

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The advantages of being part of a team!

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! 

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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!

Cupping - More than just polka dots!

(though we do love polka dots)

The circular marks often left by cupping

The circular marks often left by cupping

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 office@girlfitrocks.com to schedule an appointment.

Cups in place on the skin

Cups in place on the skin

Cupping now offered at Girl Fit PT!





PeriAcetabular Osteotomy = Persevere And Overcome

Hello Girl Fit community!

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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.  

 

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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!)

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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!

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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.  

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Thanks to Nicole for contributing to our blog!! We are super proud of her! 

The Girl Who Decided to GO FOR IT!

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…

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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

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We’re so proud of her and feel really lucky that we got to help her follow her dreams. 

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Feminism in Action at Girl Fit

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.

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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.

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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.

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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.

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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.

Citations:

  1. https://books.google.com/books?hl=en&lr=&id=BzXyApyTGOYC&oi=fnd&pg=PA71&dq=women%27s+empowerment+and+development&ots=HPQ_ghOUy4&sig=t0EXPkdyc6-gPXpU_zUdmMDMRXs#v=onepage&q=women's%20empowerment%20and%20development&f=false

  2. https://www.aeaweb.org/articles?id=10.1257/jel.50.4.1051

  3. http://injuryprevention.bmj.com/content/5/1/36.short

A guest post by our PT student, Gia!

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!

The Physical Therapist’s Perspective of Physical Therapy—But as a Patient!

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!

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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.

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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!