Cynergy Physical Therapy of New York

Alter G – Zero Gravity Rehab Treadmill

Cynthia Gormezano — Sun, 07 Oct 2012 19:14:23 +0000

Orthopedic Functional Rehabilitation

Enables pre-surgery conditioning with significantly reduced pain (prehab)
Expands the concept “Weight Bearing As Tolerated” from 20% of body weight to 100% in 1% increments, so patients can specify exactly where exercise becomes pain free and progress can be easily tracked and charted.
Provides precise early partial weight-bearing following injury or surgery to restore natural gait, range of motion and improved patient outcomes
Prosthetic training with improved balance and confidence
Neuromuscular and proprioceptive re-training

ACL Injury

Cynthia Gormezano — Wed, 23 May 2012 17:38:53 +0000

The Anterior Cruciate Ligament (or ACL) is a major ligament of the knee that connects the femur to the tibia. The ACL’s main function is to prevent an anterior translation of the tibia on the femur, providing stability to the front of the knee joint. ACL injuries are one of the most common sports injuries and an estimated 1 out of 3,000 people will suffer from one in any given year. They are most often seen in high impact sports such as football, basketball, soccer, gymnastics and skiing. Women are typically more prone to ACL injuries because of their increased Q angle (the angle between the anterior superior iliac spine of the pelvis and the midline of the patella). The actions that can provoke an injury are sudden changes in direction, jumping, and a direct blow to the knee joint. Injuries can range from an overstretching or a sprain of the ligament, to a complete tear of the ACL. Symptoms of an ACL injury are swelling around the joint, pain and tenderness towards the outside of the knee, and instability or a feeling of the knee “giving way” with standing and walking. They are best diagnosed with an MRI.

Physical therapy is needed for mild sprains of the ACL and complete tears to help restore the stability of the knee and return the patient to normal function. For a mild to moderate sprain, the course of physical therapy can last anywhere from 6-10 weeks and will initially include modalities such as ice and ultrasound to reduce pain and swelling, manual therapy techniques, range of motion exercises and stretching exercises. As the injury begins to heal, the therapist will incorporate progressive strengthening, balance and agility training. Physical therapists will also analyze a patient’s gait and body mechanics to ensure that the patient’s quality of movement is safe, and that they will be able to return to prior activities and sports without risk of re-injury to the knee.

In the event of a complete tear of the ACL, depending on a person’s level of activity, surgical reconstruction may be indicated. Post-surgically, the patient will then have to wear a knee brace when walking and undergo an extensive course of physical therapy to strengthen the knee and ensure that the reconstruction is a success.

Bursitis

Cynthia Gormezano — Wed, 23 May 2012 17:38:05 +0000

Bursae are small sacs of fluid which lubricate and cushion the areas where bone, muscle, and tendons meet. Healthy bursae allow for smooth movement of the joints. An inflamed bursa will cause a dull pain, with some tenderness and stiffness around the affected area; especially the morning after the physical activity which aggravates it. It may also swell, making the skin red and warm to the touch. Bursitis is most common in the elbows and knees, but is often found in the shoulders, hips, and feet as well.
The condition is usually instigated by overuse of a particular joint through repetitive actions such as swimming, running, repetitive jumping (as in plyometrics or basketball), gardening or cleaning. Additionally, any instance of direct trauma which causes the bone to impinge the bursa (leading to inflammation and a malalignment of the joint space) can result in a case of bursitis.
If not addressed, this condition will get progressively more serious so it is important to consult a doctor or your physical therapist as soon as possible. Typical treatment consists of a prescription for anti-inflammatory medication, along with rest and physical therapy. Physical therapy treatment will include activity modification, modalities to reduce inflammation, range of motion exercises to prevent stiffness, and exercises to strengthen the muscles around the joint for better support.

Shoulder Labral Tear

Cynthia Gormezano — Wed, 23 May 2012 17:37:10 +0000

The labrum is a cartilaginous extension of the shoulder socket that gives the joint more stability and an incredibly wide range of motion. The labrum can be susceptible to tearing due to trauma or it can be prone to fraying as it becomes brittle with age. Common symptoms of a labral tear include an aching sensation in the joint, a catching or a clicking of the shoulder with movement, and a feeling of shoulder instability.
Symptoms of a labral tear can vary with the location and type of injury. A Bankart lesion occurs with an anterior dislocation of the shoulder. This increases the shoulder’s potential for future dislocations. Labral tears of the posterior shoulder can be found in athletes when their rotator cuff and labrum get pinched together in the back of the shoulder. This condition is called an internal impingement. SLAP tears are located at the superior portion of the joint, where the biceps tendon attaches to the shoulder. It is most commonly seen in athletes, such as baseball and tennis players, who frequently throw overhand.
Surgery may be required for extreme injuries but most labral tears can be treated through rest and physical therapy. Physical therapy will include modalities to promote healing and reduce pain, soft tissue work to address any inflammation and tightness and a strengthening program to return the muscles of the shoulder to normal function.

Rotator Cuff Tear

Cynthia Gormezano — Wed, 23 May 2012 17:35:27 +0000

The rotator cuff is comprised of the tendons of four muscles: the supraspinatus, infraspinatus, teres major and and subscapularis. These muscles all surround and attach to the shoulder, allowing for increased mobility and flexibility of the joint. At the same time, these muscles help to stabilize the shoulder by keeping the humeral head properly aligned inside the glenoid fossa of the scapula. The dual functions of the rotator cuff permit proper mechanics at the ball and socket joint, but can also make the cuff prone to muscle tears and tendonitis due to overuse and trauma.
A rotator cuff tear can occur if the tendons of the cuff are continuously inflamed and weakened through a repeated motion of the shoulder. Over time, an already compromised tendon can eventually sustain a partial or a full thickness tear. These injuries are common in athletes who perform overhead activities, such as swimmers, quarterbacks, and baseball players. In addition, women over 40 years old have an increased risk of developing a tear. A direct trauma to the shoulder may also lead to a tear, as in falling on an outstretched arm. Symptoms of a rotator cuff injury may include pain, swelling and restricted movement of the shoulder joint.
In most cases, conservative management of a rotator cuff tear, involving rest and physical therapy, will be sufficient for a return to normal function. However, in severe cases, surgical repair may be indicated. Physical therapy will include modalities, strengthening/stretching exercises, and postural assessment so that the patient will not compensate for their injury and risk straining other muscles.

Tendonitis

Cynthia Gormezano — Wed, 23 May 2012 17:30:17 +0000

Tendons are the thick, fibrous chords that attach our muscles to the bone. Tendonitis is the irritation and inflammation of these tendons, which can lead to increased pain and weakness with movement. The recovery process of tendonitis can often be slower than in other injuries because tendons, by comparison to muscles, do not receive a rich supply of blood. An untreated and inflamed tendon can be constantly exacerbated through daily activities, and will interfere with normal function.

Tendonitis is an overuse injury and is caused by repetitive motions. Symptoms include pain and stiffness around the joint, as well as heat and redness of the affected area. The pain tends to become worse during and after the activity that initially aggravated the tendon, followed by stiffness the next morning. Once a tendon is injured it can remain weak and at risk for a re-injury if untreated. Tendonitis is particularly common among athletes, although the area affected will often vary depending on the sport. Swimmers and baseball players may develop tendonitis of the biceps and supraspinatus tendons of the shoulder, while runners and basketball players often suffer from achilles and patellar tendonitis. Golfers, along with tennis and hockey players, are prone to tendonitis of the wrist extensors and flexors, due to the repetitive swinging motions that are required for their respective sports.

If a tendonitis injury is suspected, it is important to cease the activity that lead to injury (as well as any activities that cause increased pain) so that the inflammation can subside and the tendon can heal. Physical therapy, in combination with anti-inflammatory medications and proper rest, will help to manage this condition. A physical therapy protocol will initially include ice and ultrasound to reduce inflammation and stretching exercises to address the stiffness at the tendon. Therapists will then work with the patient to retrain the specific muscles surrounding the joint to ensure proper body mechanics, prevent re-injury of the tendon, and allow for a complete pain-free return to activities.

Hip Pain

Cynthia Gormezano — Mon, 27 Feb 2012 15:52:43 +0000

The Hip consists of the pelvis, which connects the two femurs, as well as numerous muscles and ligaments that surround the joint and provide it with support. Our hip joints afford us the stability we need when performing all of our activities of mobility, including walking, running, standing up, and climbing stairs. That is why, when experiencing hip pain, it important to specifically locate where the pain is coming from in order to identify and treat its cause.

Hip Pain that is localized in the front of the hip or the groin can involve strains or tendonitis of the hip flexors or adductor muscles, arthritic changes of the head of the femur or acetabulum (hip socket), a stress fracture of the femur, or a possible labral tear. Pain coming from the outside of the hip can indicate bursitis – inflammation of a fluid-filled sac at the hip joint, or a tendonitis of the illio-tibial band that attaches from the hip to the knee. In many cases, dysfunction of the lumbar spine can manifest as posterior hip and buttocks pain that can radiate down the leg when aggravated. Pain in the lower back or buttocks can also be indicative of sacro-illiac joint dysfunction. A hip labral tear can cause the patient to present with pain in different areas surrounding the hip, depending on the portion of the labrum that is torn. The labrum is a cartilaginous ring lining the acetabulum that deepens the socket and allows for a better alignment of the joint.

Hip physical therapy, in many cases will be indicated to treat a hip injury. Both the therapist and patient will work together to develop a plan that can include modalities, stretching exercises, and a personalized home exercise program that will strengthen the muscles of the hip while allowing the injured structures time to heal.

Achilles Tendonitis

Cynthia Gormezano — Thu, 17 Nov 2011 19:01:54 +0000

Recently, we have seen an increased prevalence in patients presenting with Achilles tendonitis. There are several factors that contribute to pain in one’s heel or achilles tendon.

Overuse is one common cause. You should never ignore pain if it is consistent and persistent. It is easier to treat an acute injury completely than it is to treat a condition once it becomes chronic.

Foot mechanics play a heavy role in why some people develop Achilles tendonitis. When the sub talar joint in the ankle is functioning in neutral you are less likely to develop an Achilles tendon injury when running or cycling. If you pronate and your sub talar joint turns medial with heel strike to toe off, it creates friction of the tendon. Overuse of that improper mechanics leads to inflammation, micro-tears and continuous thickening of the sheath.

To treat Achilles tendonitis, you have to have your foot mechanics evaluated by a health care professional. Ice, rest and the use of modalities i.e. cold laser and or ultrasound, can significantly reduce your pain. To prevent Achilles tendonitis, ensure you have proper sneaker wear when running and proper running mechanics. Additionally, if you are found to pronate, you may benefit from a custom made orthotics to be worn in your sneakers or shoes.

Core Strengthening

Cynthia Gormezano — Wed, 19 Oct 2011 15:57:41 +0000

Core Gym Ball

Clam Shells

Bridge

Core Strengthening: Have you been strengthening your pelvis and core? If you are running for the first time or for the tenth time, you should not neglect the pelvis and core as it provides stabilization to the extremities.

A few good quick tips: Bridging with both knees bent or single leg at a time and clam shells to keep the gluteus medius muscle (which helps stabilize the pelvis) strong.

Behind the scenes of my Fitness Magazine photo shoot

Cynthia Gormezano — Wed, 12 Oct 2011 20:11:13 +0000

I was interviewed for Fitness magazine because of the work I have done with Team in Training. Who knew having cancer a few times and completing a bunch of endurance of events was so interesting?

My family and I went to the FDR with bikes on a bright sunny day. We met photographers and a hair and makeup stylist and hung out taking pictures in the park.

As a physical therapist, endurance events were always intriguing, but after having Hodgkin’s the first time, I joined TNT and did my first century ride. It was so exhilirating I got hooked. I found that overcoming Hodgkin’s lymphoma and also completing these events gave me a confidence and sense of accomplishment that no other expereince had given me.

- Cynthia