Nate – Uncommon Physical Therapy

When should my child begin to lift weights?

July 8, 2022July 8, 2022 Nate Injury Prevention

There are many health and fitness benefits to resistance training. Not only does it enhance muscular strength, it improves fundamental movement skills, increases bone mineral density, improves cardiorespiratory function, helps in weight management and body composition, and reduces injury risk in sport.

Despite the established benefits of resistance training, many health care professionals, teachers, coaches and parents have been led to believe that it is inappropriate to implement at the youth level. Probably the most common myth and unfound belief is that it is unsafe.

This is just not true.

In fact, research findings indicate a relatively low risk of injury in children and adolescents who follow age-appropriate resistance training guidelines with qualified supervision and instruction (see here).

Even the National Strength and Conditioning Association (NCSA) provides a position statement (see here) that encourages resistance training in youth populations given the myriad of health benefits.

Did you know that regular physical activity during childhood and adolescence not only promote growth and development, but has been shown to reduce the risk of developing chronic disease later in life? (see here)

At Uncommon Physical Therapy, not only do we help train your child how to properly move, we develop a comprehensive and individualized performance plan, and guide you along the way.

There is nothing wrong with getting strong.

Visit UncommonPT.com to schedule your visit today!

2022 Alabama Speed Golf Open Interview

June 23, 2022June 23, 2022 Nate General, Promotions

Check out our interview by sports anchor Jeh Jeh Pruitt with Fox 6 WBRC!

We are proud to sponsor this weekend’s Alabama Speedgolf Open benefitting the Ronald McDonald House! For more information, check out https://www.speedgolfusa.com.

Cash Pay Physical Therapy

June 22, 2022June 22, 2022 Nate General

Over the last several weeks I have received a number of inquiries pertaining to cash-based physical therapy, given that our clinic functions under this payment model. For those that have asked, and for others that may be curious, let me clarify what this payment system is and what it means for you.

In the most simplistic terms, a cash-based practice is one in which the clinicians do not accept insurance payments, accepting only direct payments from the patient, client or customer. This can occur through fees per visit, fees per package, or through monthly membership or subscription plans. Payment methods may include cash, checks, debit/credit cards, health savings accounts, or flexible spending accounts. Payment is due at the time of service, and is always at a stated price (at least it is here).

So you’re probably thinking, “but I have insurance, why wouldn’t I just go to a clinic that accepts my insurance?”

Let me further explain.

Most health insurance policies don’t cover the entire cost of physical therapy. Many patients are still responsible for copays and deductibles, so regardless, you will likely pay a fair amount out of pocket for physical therapy services. In fact, many in-network physical therapy clinics are charging $250/visit to your insurance company. If you haven’t met your deductible yet, not only are you responsible for your copay, but you would be responsible for the full cost of that visit.

Furthermore, at a traditional (insurance-based) physical therapy practice, in order to be in-network with insurance companies, clinicians agree to accept the insurance company’s rates, which are often low. As a result, providers will offset the reduced rates by increasing volume of patients they see. What this means is that patients might be booked alongside several others simultaneously, or, it will be recommended that you are seen 2-3x/week for 4-6 weeks.

In addition, most health insurance policies restrict the total number of visits you are allowed to seek physical therapy services. For those undergoing surgical intervention, this can be a major barrier to your full recovery.

Does this sound familiar?

At Uncommon Physical Therapy, we decided from the beginning to operate as a cash-based practice to eliminate these problems. Our emphasis is on quality over quantity to provide you with the most value.

Each visit with us is strictly 1:1, and can last anywhere from 30-60 minutes depending on your preference of services and specific needs. Our costs are publicly listed, as we believe in full transparency with our patients, clients and customers. And we will never limit your visits; if you need care, we are here for you. But remember, you still have options for seeking reimbursement for your physical therapy care. Speak with your health insurance company and see if your plan offers out-of-network benefits. If so, you may be able to submit the billing claim (what we call a superbill) to the insurance company for possible reimbursement.

As a final note, a recent study (see here) comparing cash pay to insurance-based physical therapy found that cash-based services…

1. Decreased the total number of visits

2. Reduced the cost per visit

3. Decreased the overall cost for the entire treatment plan

As an example:

Traditional (Insurance-Based) Physical Therapy

Cost Per Visit = $50 (co-pay)
Total Visits = 12
Total Cost = $600+ (does not include bills from services)
Time Spent 1:1 with PT = 15 minutes/visit
Total Time in Clinic = 180 minutes
Cost Per Minute = $3.33

Cash-Based Physical Therapy

Cost Per Visit = $125
Total Visits = 5
Total Cost = $625 (no additional bills)
Time Spent 1:1 with PT = 60 minutes/visit
Total Time in Clinic = 300 minutes
Cost Per Minute = $2.08

I hope this information has been helpful. At Uncommon Physical Therapy, our goal has always been to empower our patients to make the best healthcare decisions. That is what the uncommon healthcare experience is all about.

For more information, visit uncommonpt.com and schedule with us today!

Heat-Related Illnesses in Sport

June 14, 2022June 14, 2022 Nate Injury Prevention

Let me state the obvious: It is HOT outside! REALLY HOT!

This week I’ve been providing medical coverage for a local youth soccer camp. While I do not anticipate (and certainly do not wish to see) any significant injuries, my biggest concern has been the development of a heat-related illness in an athlete.

The prevention, recognition and treatment of exertional heat illnesses are major focuses of the on-field sports medicine team at all levels of sport. This week, and through the entirety of what always seems as the never-ending summer in Alabama, the risk of an exertional heat illness is ever present.

So how do you recognize a heat-related illness?

Common symptoms may include….

-Headache

-Dizziness

-Nausea

-Vomiting

-Diarrhea

-Muscle cramps

-Weakness

-Confusion

-Chills

-Cold, pale, clammy skin (heat exhaustion)

-Hot, red, dry skin (heat stroke)

-Quick pulse

What should be done if heat-related illness is suspected?

In most situations, removing the athlete from play, resting in a cool location, and slowly replenishing fluids is sufficient. However, if more severe symptoms are present, if symptoms worsen, or if symptoms last for longer than one hour, immediate medical attention is required.

For further clarification on recognizing signs/symptoms and the recommended response, see the CDC’s guidelines here.

In best minimizing heat-related illnesses, proper hydration is a key component.

A few easy ways to determine an athlete’s hydration status are to (1) check the color of urine, (2) pay attention to thirst sensation, and (3) measure body mass both pre- and post-exercise. Each of these items can help determine hydration needs both prior to and following activity or competition.

The National Athletic Trainers’ Association (NATA) has published several position statements related to both fluid replacement (see here) and exertional heat illnesses (see here) which I would encourage you to read for further information.

In the meantime, stay cool, and should you have any additional questions about how we can best help you, visit UncommonPT.com.

Blood Flow Restriction Training after ACL Reconstruction

June 8, 2022June 8, 2022 Nate ACL Rehab

One of the main priorities of rehabilitation after anterior cruciate ligament (ACL) reconstruction is the restoration of quadriceps strength. While there is certainly considerable pain, swelling, temporary loss of motion and reduced function associated with the surgical procedure, it has been estimated that approximately 30% of patients demonstrate quadriceps strength deficits up to 12 months after surgery, and those deficits can be as high as 30% years after the procedure. This is important, as these collective problems have been linked to reduced knee function, lower functional performance, faulty biomechanics, delayed return to sport, increased osteoarthritis risk, sub-satisfactory outcomes, and heightened risk of re-injury. (See here)

Current strength training guidelines recommend the use of higher loading mechanisms (i.e. 60-80% of 1-repetition maximum) to achieve adequate strength gains. However, training at this intensity following injury or surgery may not be feasible given symptoms of pain, swelling, loss of motion, or weight-bearing restrictions, not to mention the concern for adversely stressing healing tissues.

In recent years, the use of blood flow restriction (BFR) training has gained considerable interest. BFR training, by definition, is the combination of low-load exercises (20-40% of 1-repetition maximum) with the simultaneous application of a strap or pneumatic tourniquet/cuff to the limb(s) that occludes venous outflow while maintaining arterial inflow. This method is believed to induce muscle hypertrophy (mass and strength gains) through a series of physiologic events that leads to tissue hypoxia, cellular swelling, elevated systemic growth hormone production, among other metabolic processes.

In a recent systematic review (see here), the authors found that low-load blood flow restriction training (LL-BFR) after ACL reconstruction may be beneficial on both quadriceps strength and mass compared to non-BFR training. In addition, they found that LL-BFR may be an effective alternative to non-BFR as it relates to knee joint pain and ACL laxity.

For a more advanced explanation of BFR principles, safety, and recommendations refer to this article.

At Uncommon Physical Therapy, we offer BFR training as part of a comprehensive rehabilitation program following ACL reconstruction.

Schedule with us today to learn more.

UncommonPT.com

For Baseball Players, the Off-Season is Key for Success

May 26, 2022May 26, 2022 Nate Baseball, Injury Prevention

The off-season is a critical time for any athlete, particularly those participating in overhead or throwing sports. Given the progressive loads to both the neuromuscular and cognitive systems throughout the regular season, it is imperative that restoration takes place.

Specifically for baseball players, the cumulative stress on the dynamic (muscle) and static (ligament/tendon) stabilizers of both the upper and lower extremities leads to a variety of changes over the course of a competitive season. This includes a loss of shoulder and elbow range of motion, decreased strength, loss of velocity, and increased pain (see here). Therefore, an individualized off-season program should provide the athlete, and the body tissue, ample time for recovery followed by a preparatory/transitional period leading back into the competitive season. This is what we call the off-season.

In a recent study, it was found that an off-season of adequate length was beneficial in the prevention of throwing injuries due to overuse (see here), specifically at the elementary school-aged level.

In another study, it was found that nearly 25% of youth baseball players reported an overuse injury or fatigue during a given season (see here). In this same study, 30% reported that arm pain sometimes led to them having less fun participating in the sport. In addition, 46% reported being encouraged to keep playing despite pain or fatigue.

The baseball player’s offseason should consist of time dedicated to rest, active recovery, and rejuvenation both physically and mentally. The two goals of an offseason training program are simply this:

TO OPTIMIZE PERFORMANCE

TO REDUCE INJURY RISK

(FYI: Did you know the most common injuries in baseball include hamstring strains, throwing arm injuries, lumbar muscle strains, hip adductor strains, and oblique muscle strains?)

Principles of the Off-Season Training Program

1. Regular Functional Assessments

2. Optimize Mobility

3. Develop Strength

4. Maximize Speed & Power

5. Enhance Core Control

6. Frequent Arm Care

In addition to the above, appropriate workload progressions for baseball-specific activities such as sprinting, hitting and throwing need to be continually monitored.

As an example of what we offer, this is a basic outline to our offseason baseball program:

Phase 1: Recovery

-Restore range of motion

-Soft tissue mobilization

-Joint mobilization/manipulation

-Active and passive stretching

-Maintain muscle function

-Address pain and tenderness

Phase 2: Reconditioning

-Low-load resistance training

-Emphasis on form/technique

-Continued arm care

Phase 3: Strength & Speed

-Increase work capacity

-Progressive resistance training

-High intensity functional and multi-directional movements

-Velocity enhancement

Phase 4: Pre-competition

-Sport-specific movements

-Low training volume, but high intensity training

-Resume arm care program

The bottom line is this: A lack of adequate training in the offseason may be reflected by higher injury rates in the early months of the season as acute workload quickly increases. Proper off-season programming should be designed to progressively build the athlete’s workload to best prepare for in-season demands and minimize the risk for injury.

This is what we are here to help with. This is what makes us Uncommon.

Check out the clinic!

May 24, 2022May 24, 2022 Nate Uncategorized

Check out some photos of our clinic, taken by the amazingly talented Amy Dummier! Please feel free to stop in for a visit and/or to schedule an appointment for any of our services…

Attention Alabama Runners!

May 23, 2022May 23, 2022 Nate Injury Prevention, Recovery

Running is one of the most popular and accessible activities enjoyed by millions worldwide, and for good reason.

Numerous studies have shown that running regularly can do wonders for your overall health.

Running can:

-Reduce stress and anxiety

-Improve mood

-Enhance sleep

-Reduce the risk of cardiovascular disease

-Improve bone and joint health

-Help you look younger and live longer…and more…

Despite these health benefits, running-related injuries are common.

Did you know that nearly 50% of runners will sustain an injury over a 1 year period? (See here)

Did you know that 70% of running injuries are due to overuse? (See here)

Did you know that the number one barrier to implementing an injury prevention program, is simply that people “don’t know what to do?” (See here)

WE CAN HELP!!

We offer prevention, performance and recovery programs to keep you moving forward.

Visit Uncommonpt.com to schedule your Running Analysis, Program Development, Training or Recovery session with us today!

Can ACL injuries be prevented?

May 12, 2022May 12, 2022 Nate ACL, Injury Prevention

Did you know that ACL injuries account for nearly 20% of all knee injuries in youth and high school athletes? (See here)

Did you know that while the overall incidence of ACL injury is greater in males, the relative risk of an ACL injury in females its nearly 2-8x greater? (See here)

Did you know that by simply implementing an ACL injury prevention program, you can reduce the risk of an ACL injury by 50% in all athletes? And for female athletes, you can reduce the risk of a non-contact ACL injury by nearly 67%? (See here)

As you can imagine, there are significant financial costs associated with ACL surgery and rehabilitation. Perhaps more importantly, however, are the effects this injury has on long-term physical and mental health.

In a recent review (See here), the authors proposed the following recommendations:

“We recommend encouraging all female athletes who engage in high-risk sports involving jumping, landing and cutting to engage in an injury prevention program to decrease their risk of non-contact ACL injury. The intervention program should including plyometrics and strength components, as well as at least one other type (agility, balance, or stretching). Emphasis on technique or feedback should be provided throughout the program. Athletes should begin these programs in the pre-season and continue throughout the season.”

My advice, get started EARLY! That time is NOW! We offer comprehensive prevention programs that are individualized to your needs.

Schedule with us today at UncommonPT.com!