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Concussions and a Safe Return to Sport

Concussions. They can have lasting effects later in adulthood, so prompt treatment is essential to mitigate long-term effects. While the end of summer draws near, and fall sports get underway at the start of a new school year, it’s important for parents, trainers, and coaches to remain vigilant in watching for signs and symptoms of concussion in young athletes.

Here some tips to help you recognize concussions:

  1. Your child isn’t acting quite like themselves: Look for changes in your child’s usual mood, cognition, ability to pay attention, and energy level. When your child isn’t acting like he/she normally does following a game, it’s a safe bet they may have suffered a concussion.
  2. They sustained a jarring hit: Any hit, whether it is to the head or body, has the possibility of causing a concussion. Hits to the head are obviously related to concussions, but hits to the body can also cause concussions through whiplash-like mechanisms.
  3. Nausea or sensitivity to light or sound: These are some very common signs seen following a concussion.
  4. Dizziness while using their phone or watching TV: This can be caused by a sensory issue within the vestibular system. Also watch out for dizziness or imbalance while driving and walking in busy areas.
  5. IF YOU SUSPECT A CONCUSSION SEEK MEDICAL ADVICE: Waiting to seek medical advice can have an impact on the overall time it takes for your child to recover. Seeking medical advise as soon as you suspect your child may have a concussion is key.

One of the best things that you can do for your athlete as a parent or coach is to be sure that they have baseline testing consisting of physical, cognitive, and equilibrium tests prior to participation in practice and games. Should an injury occur, baseline testing allows the coach and trainer to know when it is safe to allow the athlete to return to sport after an injury has occurred. Also be sure that the testing for your athlete is comprehensive, and not performed only using the IMPACT computer-based test that doesn’t take into account the other functions of the body that may be impacted through concussion.

When seeking medical advice, remember that advice can come from a variety of medical practitioners including medical doctors, physical therapists, athletic trainers, etc. Medical examination usually consists of some tests and measures to determine the severity of the injury. Examination is necessary to rule out other serious pathologies, including a brain hemorrhage. Usual care for a concussion is a brief period of rest (1-3 days), followed by a graded return to sport and school, and then rest. Rest is essential for the brain to heal itself in the early stages, although activity should be resumed as quickly as possible while maintaining little to no symptoms. Physical therapists can help by determining a safe level of activity for the athlete and developing a sport specific training plan. Before your child returns to sport, ensure all testing compares to baseline, that physical activity has been progressed, and that your child is symptom-free with sport specific training.

By following these key steps after sustaining a concussion, your athlete can return to sport as quickly and safely as possible.

Note: This blog is not considered medical advice that should be used if you suspect a concussion in your child. If you believe your child may have suffered a concussion or would like to receive baseline testing, contact our clinic at 434-293-3800.

Sleep and School Performance Go Hand-in-Hand

Want to do better in school? Get more, restful sleep! We all know sleep is important but we might think of it more as an “eat your vegetables” important kind of way. In reality, we should be thinking about it more in a “this could impact my life, hopes and dreams” kind of way. That’s exactly what researchers are finding as we learn more and more about sleep and the value it brings.

Sleep is vital for so many functions and processes in the body: memory, cognitive function, blood pressure, hormone regulation (cortisol, insulin, leptin, grehlin, testosterone), healing, muscle recovery, immune system, etc., etc.,. And, it is especially important for children. Sleep deprivation can significantly impact a child’s performance in school.

So, how do you know if your child is getting enough rest? Here’s a good rule of thumb:

  • Children aged 6-13 should be getting 9-11 hours of sleep each night
  • Teens should be getting 8-10 hours

While these are good gauges to check patters in your household, that’s just a starting place. Behavior can be a great clue.

Signs of sleep deprivation are similar to symptoms of ADHD. They include:

  • easily distracted
  • difficulty focusing
  • yawning
  • moodiness
  • irritability
  • fatigue
  • depression
  • difficulty learning new concepts
  • forgetfulness
  • feeling “fuzzy”
  • unmotivated
  • clumsy
  • increased appetite
  • overweight

Most likely, we could all make a few adjustments to get a better night’s sleep.

The best rules work for both children and adults:

  • keep a consistent, daily bedtime
  • avoid eating within three hours of bedtime
  • discontinue screen time at least an hour before bed
  • can the caffeine after noon
  • maintain a set bedtime routine for children

With these simple tips, you and your little ones will be sleeping sounding and reaping the benefits in no time!

Sam Spillman, DC

Backpack Safety Tips

Backpacks. They’re necessary, but they also need to be safe. A child may lug to school more than 10 percent of his or her body weight which can be a serious pain in the back!

Here are some backpack tips to lighten the load:

  1. Choose a backpack that has two wide straps with good padding to distribute the load evenly.
  2. Adjust the height. Tighten straps so the bag is centered on the back, ideally above the lower curve of the spine.
  3. Use both straps. The one-shoulder method may be cool, but it adds serious pressure and throws body alignment out of whack.
  4. Weigh the bag. It should weigh no more than 10% of the child’s weight. If your child regularly has to carry more than that then you should get them one of those rolling backpacks that they can pull.
  5. Have your child checked. If your kid complains of back pain-even if it seems minor-talk to your doc. No amount of achiness is normal, and a physician can recommend strengthening exercises to help ease it.

Happy backpacking!

Cornell Chicken from the Heart

My grandfather was a farmer in the heart of Cornell chicken country. He raised dairy cows, chickens, and corn in upstate New York and when he retired, he continued farming the most delicious corn – and even became adept at growing brussels sprouts – on the few acres behind his house.

Back in the day, Cornell chicken was widely popularized by Cornell University’s poultry science and agricultural program as an inexpensive protein alternative to beef. And Cornell’s very own Robert C. Baker actually invented the barbecue recipe now famous in Cornell chicken recipes – like the one my grandfather perfected. However, Baker’s real claim to fame was his invention of the chicken nugget, which he actually invented while at Penn State but only gained appreciation after he joined the faculty at Cornell. He would travel all over the country sharing his love of poultry and demonstrations of his recipes.

At one point, Cornell had approached my grandfather inviting him to be one of their instructors at the agricultural school but his love of farming kept his focus. I must say I’m glad it did because my grandfather’s Cornell chicken recipe is a summer classic, and brings back some of my fondest childhood memories.

This Fourth of July I’ll be grilling up a batch of my grandfather’s signature summer fare, complete with corn-on-the-cob for the side – though I’ll be getting my corn from the local farmer’s market. Give it try!

 

What you’ll need: 

  • 1 egg
  • 2 cups of apple cider vinegar
  • 1 cup of vegetable oil
  • 3 tbsps salt
  • 1 tablespoon of black pepper
  • 1 tablespoon of poultry seasoning

What to do:

  • In a bowl, beat the egg and whisk in oil followed by the vinegar and then the seasonings.
  • Marinate whole chicken, or chicken pieces, for 24 hours.
  • Throw it on grill and cook to an internal temperature of 165 F.

Enjoy!

Research Leads to a Better Practice

Research. It’s the core of success. In our clinic, we pride ourselves on evidence based practice.  But what does that really mean to the patient? Evidence based practice combines three things: clinical experience; research; and patient preference or values.  So how do the articles we read from the research that’s done in universities filter down to affect our actual patient care?

One way we use research is to apply what we read to inform our thinking.

For an example, the Journal of Orthopaedic and Sports Therapy published this article that looks at using the drop vertical jump task as a way to predict an ACL injury.  What we learn is that this task isn’t a good indicator of predicting a possible injury. So many variables are involved in athletic injuries that it is very difficult to predict an injury from just one factor.

However, we also learn that increasing the cognitive demand on an athlete when performing the vertical drop jump task, makes the activity more difficult – and therefore, likely increases an athlete’s risk of injury. While this isn’t a perfect simulation of what might be happening on a soccer field or basketball court, it can help guide our rehabilitation of patients.

The result? We’re adding increased cognitive demands in the rehab process for our athlete patients before returning to sport.

Just another example of how research informs on how we care for our patients, through evidence based practice, in the “real world.”

 

Spring Vegetable Challenge: What’s New to You?

While there have been several mornings that have felt like winter instead of spring, spring is indeed upon us! What comes to your mind when you think of spring? Mine is sunshine, being outdoors without a coat and my of course seasonal spring vegetables! Now is the time we will find a variety of vegetables at the farmers market. Having an abundance of fresh and local vegetables is a great time to play around and experiment in the kitchen. Having a variety of vegetables in the diet is very important for health! Your GI tract will be healthier as it will have more diverse and beneficial gut bacteria and you will also be providing your body with more micronutrients that are critical for good function. Challenge yourself this spring to try several new vegetables, or using the vegetables in a different way.

Below I have highlighted some of my favorite spring vegetables.

Radishes – Radishes have a slight spicy flavor and make a great addition to salads. Simply cut then thinly and add then to a large salad with your favorite dressings. My favorite dressing is a mix of olive oil, red wine vinegar, salt, pepper and a little bit of honey.  Radishes can also be roasted! Simply cut them in half, drizzle with olive oil salt and pepper and roast in the oven for about 20 – 25 minutes. Then just pair them with your favorite protein dish.
Rhubarb – I’m sure we have all tried a strawberry rhubarb pie, but have you ever tried making a savory rhubarb sauce?!

This delicious sauce can be used for chicken, fish and pork either as a marinade or just on top after cooking.

Ingredients: 1 onion, finely chopped; 2 cups rhubarb, chopped into 1cm lengths; 1 cup white wine; 2 tbsp grated fresh ginger; 1 tbsp honey; olive oil; salt and pepper
Directions:
1. In a medium saucepan, gently fry the onion in a little olive oil until softened.
2. Add chopped rhubarb, wine, ginger and honey.
3. Season and cook over low heat for 8 to 10 minutes until the rhubarb is cooked and the sauce is reduced.
I’ve got some leftover rhubarb from the crumble this month.
Asparagus – Asparagus are in season for a very short time, so got to catch them quickly! Asparagus are a very versatile vegetable and pairs well with most dishes. Some of the ways I like to cook with them is to cut them in small pieces and add them to a risotto, they also taste great added to a quiche, or of course you can just simply roast them and sprinkle some Parmesan cheese on top!
Beets – Beets are my favorite! I find that you either love beets or hate them. I’m hoping to convert you to LOVE them! If you find the taste too ‘Earthy’ try grating them with a cheese grater and mixing it in a salad. You won’t be overwhelmed with their flavor because they are cut so thin and will be mixed with a bunch of other veggies from a salad. Don’t forget to eat the beet greens! They are totally edible and gives any salad a great kick!
Happy vegetable shopping (or growing)!
Guest BCPT Blogger

Home is Where Charlottesville Is

Charlottesville is where my heart, and home, is… now. But it wasn’t always the case. As a native of Pittsburgh, I enjoyed opportunity to gain my education on the east coast – earning my bachelor of science in biology with a minor in nutrition from the Indiana University of Pennsylvania, before ultimately graduating from Lynchburg College with a clinical doctorate in Physical Therapy.

Lynchburg boasted far greater weather than Indiana, PA, and I found myself taking up more outdoor activities – hiking, biking, exploring Virginia and all that it has to offer. I knew then, Virginia was for me. As I wrapped up my time in Lynchburg, I took an internship at UVA’s hospital for the summer. My fiance, then girlfriend, was living in Charlottesville at the time and as we took in the sights of Charlottesville – hitting up the shops, restaurants, and events around town – I quickly realized this was where I wanted to make my home.

A few years later, and we find ourselves residents of one of the most charming towns I’ve ever been in.

From the events constantly going on; the character of the people around us; the nature trails; outdoor sports; wineries; and breweries – I couldn’t imagine living anywhere else.

– Bryan Esherick PT, DPT

Benefits of Strength Training for Runners

It has almost become cliché to say that runners should strength train. So then I ask are you a runner who is strength training consistently (2-3 times a week)? If the answer is “hmmm, no,” you might not fully understand all of the amazing benefits we get from strength training. Let me break it down for you.

Benefit #1: It Makes You Faster

Proper strength training has been shown to improve running economy, or the ability to run faster while using less energy. Let me put it this way, if you could run a 7-minute mile with the same amount of effort it takes you to run an 8-minute mile right now, you would take that deal right? Of course you would. Faster runners spend less time on the ground and produce more force when they strike the ground. You can improve your force production and ground contact time through various exercises, drills, speedwork and plyometrics that can actually train the neuromuscular system to fire faster. Make sure you are complementing your runs with all of this ancillary work. Take that deal!

Benefit #2: It Reduces Injury Risk

A strong body is crucial to tolerate the repetitive load of running. Many overuse injuries can be avoided with the addition of strength training and a variety of functional, rotational, and multi-directional movements to your regimen.  I like to explain it this way: if you have an overuse injury like plantar fasciitis, you know the plantar is working too hard. Rest is an answer, sure. But come on, you and I both know you aren’t taking more than a day off without losing sanity! If you are able to strengthen the posterior chain (glutes, hamstrings, calves) to carry more of the load that your plantar is currently taking, you will reduce the use of your plantar and improve its function.

Benefit #3: It Enhances Recovery

This is probably my favorite fun fact that many runners don’t realize. When done correctly, lifting heavier loads produces a positive hormonal response that can rev-up the recovery process AND significantly reduce the risk of over-training. Lifting heavy will improve your overall strength, and metabolism; but what’s more I guarantee you will sleep really, really well at night.   

All In All…

When done correctly and consistently, strength training and other ancillary work like drills and faster running can make you more efficient, reduce risk of injury, and enhance recovery.  You will feel stronger on your runs and in races, and you will be able to tolerate higher training loads and have more energy.

Make strength training a priority and your body and mind will thank you!

Ann Dunn, M.S., CPT
BCPT Guest Blogger

 

Cardio: 30 Minutes A Day for a Healthy Life

Cardio. Personally, I am not the biggest fan of cardio workouts. The equipment at the gym is typically crowded, running isn’t comfortable to me, and it’s hard to find the time that fits into my schedule. But, I know it’s important for my health, so I’ve found ways to incorporate it. Enjoying your cardio workouts is half the battle in making the time to stay fit and healthy.

I love hockey. I play two to three times a week, and supplement my cardio workouts with the stationary bike. The bike is great for me – I can write notes, read articles, and it helps me unwind from a long day – all while getting my workout in. I also take the dogs for longer hikes when I have a little extra free time.

Cardio gets a bad rap for being repetitive, boring, and time consuming. But, cardio doesn’t only have to be a run on the treadmill, or spin on the bike, or an hour on the elliptical.

Find a physical activity you enjoy doing, and turn it into a hobby – outdoor activities are excellent for your lungs and your heart. Here are a few ideas for activities convenient for us here in the Central VA area:

  1. Hiking. There are lots of hiking trails here with various levels of difficulty. Get out there, and make your way the top for a great view of the blue ridge mountains.
  2. Kayaking. The Rivanna river offers a great opportunity for a workout with kayak or canoe on a warm summer day.
  3. Walking. The downtown mall right here in Charlottesville is a fantastic location for a brisk walk while you check out all of the sidewalk sales.
  4. Clubs. Find a sport club through the city website or Cville social. There are a variety of sports you can try, so find one you like and stick to it!
  5. Kids. They love to play, so join them outside and get active – you’ll be surprised at the workout you get just by joining your kids for play.
  6. Dog. Grab Fido and head out for a few spins around the block. The next time your dog stands by the door and stares at you to go out, get your running shoes and extend that walk. Don’t have a dog? Did you know, people who have them generally get about 30-minutes more exercise per day than those who don’t. So, maybe head to your local shelter and adopt one today!
The possibilities for a good cardio workout are endless.

All it takes is 30-minutes a day of moderate (50-60% of your max heart rate) activity to reap the benefits (improved immunity, healthier heart, healthier blood vessels, healthier lungs).  So, find something you love and make the change to promote a longer, healthier life!

Bryan Esherick PT, DPT

Four Ways to a Healthier Heart

Did you know heart disease and stroke cause 1 in 3 deaths among women each year – more than all cancers combined. The good news is that 80 percent of those deaths may be prevented. Your heart is the engine that keeps you going – supplying the ‘oil’ for your full body machine – so it’s important to take care of your heart.

February is heart health month, and we’re celebrating by sharing tips to help you keep your ticker ticking!

  1. Exercise daily. You should get 30-minutes of moderate exercise each day – and 1-hour per day for children. Moderate exercise includes things like a brisk walk, biking, weight lifting, or recreational sports. Exercise is important to keep your heart strong, much like you would for other muscles in your body. Check out our other recent blog posts about different types of aerobic exercises and heart rate zones.
  1. Eat Right. This may be the best, but also the hardest, thing to do to keep your heart healthy. Check the labels at your grocery store and choose foods high in fiber as well as vegetables – try to pass on foods high in fat, simple sugars, salt, and cholesterol. This will help ensure arteries stay open and your ticker stays healthy.
  1. Lessen the stress in your life. Stress can create a large burden on your heart by increasing blood pressure and releasing cortisol, and other stress chemicals. This can all have a negative effect on both the heart itself and the arteries it uses to transport blood. When you can’t eliminate the stress, try to manage it with a few breathing techniques; meditation; and even exercise! Find what works for you and try to work it into your daily routine.
  1. Stay positive with friends and family. Want to live a longer life? Positive relationships with those closest to you has been linked to be the #1 factor in living a longer life – ahead of quitting smoking and drinking; exercising; and eating right. As humans, we are meant to be social animals and look for opportunities to build relationships. So when you are done reading this, pick-up the phone and call a friend or family member and set up a time to get together and reconnect.
Some of the best indicators of a healthy cardiovascular system include a normal heart rate, low blood pressure, low cholesterol and A1c levels.

So, remember to take care of yourself, and keep your heart in check!

Bryan Esherick PT, DPT