Bunion (Hallux Valgus)

A bunion is a bump on the medial side of the foot at the base of the big toe. This is a condition often characterized by spreading of the metatarsals and drifting of the big toe toward the other toes. Bunions are more common in women, with the most common causes being hereditary and poor footwear. Symptoms include pain along the medial side of the foot over the bunion, most notably when there is pressure on the bump due to tight shoes. Some individuals develop a callus on the ball of the foot as a result of the weight being transferred to the second toe.

Non-surgical treatment options include medication, altering footwear, and physical therapy. It is recommended to choose wider footwear to alleviate the pressure on the bunion that could further increase the angle at the first MTP joint. Toe spacers may help with mild deformities to decrease the angulation of the toes or the progression of the bunion. Your physician may prescribe NSAIDs to decrease inflammation. Physical therapy interventions include stretches to maintain flexibility of the great toe and foot, strengthening of the great toe, and gait activities to maintain the proper mechanics of the foot.

When non-surgical options have been exhausted, surgery may be indicated to correct the alignment of the first metatarsal and big toe. Depending on the severity of the bunion, your surgeon will choose the proper technique to correct the deformity. Post- operatively, it is important to return to wearing properly fitting footwear. Physical therapy may be prescribed post-surgically to restore range of motion and flexibility of the great toe and foot.

Caitlin Niemeier, MPT

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Balance Rehabilitation

Balance dysfunction is a common cause of falls in an aging population, which makes physical therapy intervention vital to prevent injury. Understanding the true cause of disequilibrium, or imbalance, is important for treatment.

There are three different systems that control balance: vision, proprioception, and the vestibular system. Visual feedback provides an image of one’s environment; decreased visual feedback can disrupt balance due to a lack of awareness of the environment. Proprioception is the perception of spacial orientation, or where one’s body is in space. A decrease in proprioceptive feedback can distort an individual’s ability to negotiate changing surfaces. The vestibular system provides a perception of motion and orientation in relation to gravity, as well as controls eye movement to permit a clear visual image of surroundings (Walter). Vestibular dysfunction from various causes can elicit a variety of symptoms including vertigo (dizziness), nausea, headache, imbalance, tinnitus (ringing in the ears), and visual disturbances.

The good news: physical therapy can help! Depending on the cause of symptoms, a general balance / strengthening program may be permitted for essential fall prevention. If symptoms are more vestibular / vertiginous in nature, vestibular rehabilitation may be warranted. Vestibular rehabilitation typically incorporates balance training and adaptation or habituation of activities that are symptom producing or magnifying. Balance and vestibular rehabilitation can be valuable and provide a substantial impact on one’s life with regard to fall prevention.

Lori Hooker, DPT

References: Jeff Walter, PT, DPT, NCS (Vestibular Rehabilitation Therapy: Practical Management of the Patient with Dizziness and Balance Dysfunction)

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Baked Parmesan Zucchini

Crisp, tender zucchini sticks oven-roasted to absolute perfection. It’s healthy, nutritious and completely addictive!

Ingredients

4 zucchini, quartered lengthwise

1/2 cup grated Parmesan

8 1/2 teaspoon dried thyme

1/2 teaspoon dried oregano

1/2 teaspoon dried basil

1/4 teaspoon garlic powder

Himalayan salt and freshly ground black pepper, to taste

2 tablespoons virgin olive oil

2 tablespoon chopped fresh parsley leaves

Instructions Preheat oven to 350 degrees F. Coat a cooling rack with nonstick spray and place on a baking sheet; set aside. In a small bowl, combine Parmesan, thyme, oregano, basil, garlic powder, salt and pepper, to taste. Place zucchini onto prepared baking sheet. Drizzle with olive oil and sprinkle with Parmesan mixture. Place into oven and bake until tender, about 15 minutes. Then broil for 2-3 minutes, or until crisp and golden brown. Serve immediately, garnished with parsley, if desired.

Total per serving: Calories 74, Carbs 4, Fat 5, Protein 3, Sodium 165, sugar 2

 

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Peroneal Tendonitis

Peroneal tendonitis is an inflammation of the tendons crossing the lateral side of the ankle. This can develop for several reasons including ankle sprains, fracture of the fibula, overuse from running, or from somebody with a high arch.

Symptoms include sharp pain along the lateral aspect of the ankle and foot with pushing off of the toes. Swelling and general soreness usually come along following activity.

Physical examination will show point tenderness along the peroneal tendons as the follow behind the ankle and insert into the foot. Resistance to turning your ankle outward (eversion) may also be weak and reproduce pain. A physician may order x-rays, an MRI, or ultrasound to find an underlying condition and to determine if there is a tear in the tendons or if it is simply inflammation.

Treatment for this condition includes rest for which a walking boot may be ordered. The physician may choose to prescribe an anti-inflammatory to reduce pain and swelling. Physical therapy is usually a necessity to restore normal range of motion and strength and to further determine the underlying imbalances associated with this condition.

Surgical treatment of peroneal tendonitis is a last resort and includes repairing the tear in the involved tendon or tendon sheath. Recovery is length at 3-4 months, but patients are often able to resume their normal activities.

Submitted by Brian Manning, MPT, CSCS

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HEALTHY RECIPE OF THE WEEK: BALSAMIC CHICKEN BREAST

Ingredients – original recipe makes 6 servings
6 skinless, boneless chicken breast halves 1 tsp. garlic salt
Ground black pepper to taste 2 T. olive oil
1 onion, thinly sliced 1 (4.5 oz) can diced tomatoes
½ c. balsamic vinegar 1 tsp. dried basil
1 tsp. dried oregano 1 tsp dried rosemary
½ tsp dried thyme

PREP, 10 min; COOK 25 mins; READY IN 35 mins

Directions
• Season both sides of chicken breasts with garlic salt and pepper.
• Heat olive oil in a skillet over medium heat; cook seasoned chicken breasts until chicken is browned, 3 to 4 minutes per side. Add onion; cook and stir until onion is browned, 3 to 4 minutes.
• Pour diced tomatoes and balsamic vinegar over chicken; season with basil, oregano, rosemary and thyme. Simmer until chicken is no longer pink and the juices run clear, about 15 minutes. An instant-read thermometer inserted into the center should read at least 165 degrees F (74 degrees C).

Nutrition
Calories, 196 kcal (10%); Carbohydrates, 7.6 g (2%); Cholesterol, 61 mg (20%); Fat, 7 g, (11%), Fiber, 1.2 g, (5%); Protein, 23.8 g (48%), Sodium, 511 mg, (20%), * Percent Daily Values are based on a 2,000 calorie diet.

Hint: For lower sodium, use sea salt and fresh garlic instead of garlic salt. There are recipes on the web to make your own low sodium vinaigrette dressing. Check out this article on low sodium in vinegar: http://healthyeating.sfgate.com/much-sodium-vinegar-8276.html.

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EMPLOYMENT OPPORTUNITY

Excel Sports and Physical Therapy is looking for a certified and licensed athletic trainer to cover 5-6 days per week at a high school for the 2015-16 academic year.

Responsibilities include every day practice and game coverage, first aid and emergency care,  running and managing an athletic training facility, budgeting, injury tracking and record keeping. The athletic trainer will report to the Activities Director and the Outreach Program Director. The high school uses Sportsware  for injury tracking and ImPACT testing for concussion testing. New graduates are welcome to apply. Benefits package offered.

Applicants should e-mail a cover letter, resume and five references to Nathan Wilmes at nwilmes@excelsportspt.com.

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Employment Opportunity

Excel Sports and Physical Therapy is looking for a PRN Athletic Trainer to assist in the afternoons/evenings on a daily basis. Interested applicants should contact Nate Wilmes to apply.

Nathan J. Wilmes, MEd, ATC, LAT, EMT-B, CSCS
Director of Outreach Athletic Training Services
Excel Sports & Physical Therapy
Cell: 314.805.4627
NWilmes@excelsportspt.com

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OCTOBER IS NATIONAL PHYSICAL THERAPY MONTH!

“National Physical Therapy Month (NPTM) is hosted by APTA each October to recognize how physical therapists and physical therapist assistants help transform society by restoring and improving motion in people’s lives.” – APTA

Visit the APTA website for more information about Physical Therapists and Physical Therapist Assistants!

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The Athletic Trainer’s Dish of the Week: Chocolate Pumpkin Cupcakes

These cupcakes are great for any athlete looking for a low fat and low calorie option. They are easy to make and they’re portable. Instead of icing, you can use Cool Whip or add peanut butter for more protein.

INGREDIENTS:
1 package Devil’s Food cake mix
1 can of 100% pumpkin (15oz)
1 can water

DIRECTIONS:
Preheat oven to 325 degress for dark nonstick pan. Stir together all ingredients and pour into foil-lined muffin cups about 2/3 full. Bake 30-35 minutes. *Tip: To see if the cupcakes are done, stick a toothpick in the middle of one; if the toothpick comes out clean, then they’re done; if not, cook them for a few more minutes.

NUTRITIONAL VALUES:
Servings: 24
Calories: 90.8 Fat: 1.8g Carbohydrates: 17.8g Protein: 1.3g

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The Athletic Trainer’s Dish of the Week: Black Bean Chicken Chili

This recipe is great for any athlete because it’s packed with carbohydrates and protein. This meal is low in fat and heart healthy.

INGREDIENTS:
1 Tbsp. vegetable oil
1 large onion, chopped
1 medium green bell pepper, chopped
3 cloves garlic, minced
1 fresh jalapeno, seeded, minced
2 Tbsp. chili powder
1 tsp. cumin
1/2 tsp. oregano
1/2 tsp. cayenne pepper
3 cups chopped cooked chicken
2 cups low-sodium canned crushed tomatoes
1 1/2 cups no-salt added chicken broth
1 cup chili sauce
2 tsp. Worcestershire sauce
1/2 tsp. black pepper
1 cup black beans, rinsed, drained
3/4 cup plain nonfat yogurt
1/2 cup chopped red onion

DIRECTIONS:
Heat the oil in a stockpot over medium heat until hot. Add onion, green pepper, garlic and jalapeno. Cook for 5 to 7 minutes or until tender, stirring frequently. Stir in chili powder, cumin, oregano, and cayenne pepper. Cook for 1 minute, stirring constantly. Add the chicken, tomatoes, broth, chili sauce, Worcestershire sauce and black pepper. Bring to a boil; reduce heat. Simmer covered for 15 minutes, stirring occasionally. Stir in the black beans. Cook covered for 5 minutes longer, stirring occasionally. Serve topped with a dollop of plain yogurt and chopped red onions.

NUTRITIONAL VALUES:
Servings: 8
Calories: 187 Fat: 3.8g Carbohydrates: 25g Protein: 17g

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