Achilles Tendon Injury and Recovery for Eagles' Star Brandon Brooks

Achilles Tendon Injury and Recovery for Eagles' Star Brandon Brooks

The Eagles season did not end the way many had envisioned it and it does not look to be off to a good start next year either. Two- time pro-bowler, Brandon Brooks was carted off the field in the Eagles last playoff game against the New Orleans Saints and did not return. After the Eagles' unfortunate loss, news did not get any better, as it came out that Brandon Brooks had suffered a torn Achilles Tendon. The Eagles had an injury-riddled season which many fans believe had a lot to do with their up and down season. Now fans might be asking themselves, what exactly is a torn Achilles tendon? What is the recovery like? How long will the Eagles star player be out? And will this type of injury affect future performance?

An Achilles tendon tear is when the tendon at the back of your ankle breaks (complete tear) or rips (partial tear). This type of injury can occur in a few different ways; sudden bending up of the foot when the calf muscle is engaged, direct trauma, or chronic tendonitis. If you watch the video of the injury, you can see Brandon Brooks’ ankle is bent as he is attempting to push forward to drive his opponent backward, causing too much stress on his tendon and therefore rupturing.  A snapping sound, pain, lack of ability to push off with your foot, and bruising of your calf often accompany an injury like this. Now that we know what kind of injury we are dealing with we can look at the recovery process and when Brandon Brooks can get back on the field.

 

Protocols and timelines can vary from person to person and can depend on the exact type of surgery performed as well. The following is a general timeline for recovery. Initially after surgery the patient will be non-weight bearing for roughly 3 weeks and progress to full weight bearing in a boot around 6 weeks. Gentle active range of motion can start around 4 weeks and passive range of motion around 6 weeks. Strengthening of surrounding musculature can start around 6 weeks, but strengthening of involved musculature does not start until around 8 weeks. The reason for such a long, cautious recovery is to allow proper healing of the tendon to the bone since this is a powerful muscle that is used every time we stand, walk, run, and jump. Gradual progression of resistance/strengthening exercises occurs up to 6 months before starting more intensive sport specific strengthening. Most rehabilitation programs allow patients to return to physically demanding sports by 9 months.

Brandon Brooks experienced a very serious injury that will take a long time to recover, but a full recovery can be expected. After surgery, physical therapy will play a large role in monitoring and initiating appropriate stretching and strengthening exercises at the right time.  Progression will depend on the physiological healing of the tendon, and the amount of range of motion and strength that is gained each day of recovery. Once the tendon is deemed “well healed” by the surgeon, physical therapy will then be able to progress Brandon Brooks to sport specific strengthening exercises/activities that will allow him to get back on the field and help the Eagles back to the Super Bowl. If Brandon Brooks follows this general time line, Eagles fans can expect him to return to the field around October.

PTW’s AJ Moyer, PT, DPT is a staff physical therapist at our Souderton and Harleysville clinics. For an initial evaluation, call AJ at 267.382.0433 today! 

Beating the Winter Blues

BEAT THE BLUES

Winter can be a very frustrating time for many people.   Activity level goes down because the temperature drops, days get shorter, and the weather can make it hard to get around.   Winter is actually known for being the highest time for being diagnosed with depression, hence “The Winter Blues”.   However, what if I told you there are some things anybody can do to “Beat the Blues”?   And, what if I told you that it is as simple as taking 25-30 minutes a day to just exercise?    It’s that simple!   Here’s the catch though.   Most people don’t know or understand how to safely exercise in their own homes.   I will give you a quick idea of how simple exercise can be to give you the boost you need this winter.  

           

First, you have to forget the concept that exercise has to be done with equipment or in a gym, and it doesn’t need to make you tired.   Moderate exercise is also known as “walk and talk” exercise.  You should be able to hold a conversation even though you are exercising.  This ensures that you are not pushing too hard and causing unnecessary fatigue.    And remember exercise is simply “planned activity”.   Exercise can be anything!  It can be going up and down your stairs, sitting and standing in your chair repeatedly, or just walking laps around your house.   The beauty of exercising is you can find what you like, and make it fun.  

Second, get yourself moving for those 25-30 minutes!  Studies by the Center for Disease Control (CDC) show that daily moderate exercise of 25-30 minutes lowers anxiety and depression, reduces risk of heart and brain conditions, decreases falls risk, and improves overall well being.   All of this is what helps you “Beat the Blues”.   Some options I already mentioned are just doing simple stair climbing, repeated sit to stands, or just walking.  Some other options include, marching in place, leg kick outs while sitting, push-ups (if able), or sit-ups (if able).  Remember these should all feel like a moderate intensity, not too hard and not too easy.   And they should never cause pain.  (Consult a physician or medical provider if pain limits your activity).

 Lastly, get your friends involved!  Group exercise is shown to improve the psychological benefits of exercise.   If the weather permits, meet us with your friends and walk in the mall or at the gym.   Or, just give them a call and exercise while talking on the phone.   This also helps you stay more compliant with the program, and it gives you a buddy to hold you more accountable.    According to the CDC’s Physical Activity Guide for Americans, group exercise not only improves your compliance to a program but also your desire to be active.  If you want to exercise, it is much easier to stay active, healthy, and “Beat the Blues”. 

So remember, all you need to do to “Beat the Blues” is get moving 25-30 minutes of your day! And grab a buddy for a little extra push!  It’s that easy!  

           

Brandon Lewandowski  PT, DPT is Clinical Supervisor of PTW's newest location in Horsham, PA! To schedule a visit with Brandon call 215.394.5893

What Is Wrong with Markelle Fultz?

Markelle Fultz and Thoracic Outlet Syndrome

Some Philly sports fans out there may have heard about Markelle Fultz’s new diagnosis of Thoracic Outlet Syndrome (TOS), which may be what is causing his shot to look awkward and unnatural. TOS is an injury in the area of the neck and shoulder that is classified as compression of nerves, arteries, and veins that travel through a small space called the thoracic outlet. At times one or all of these structures are being compressed. If the arteries or veins are obstructed than you can experience symptoms such as pain in the arm, numbness/tingling, discoloration, temperature changes, and a weakened pulse. When the nerves are affected symptoms involve muscle weakness, muscle wasting, numbness/tingling, and pain down the arm.

In Fultz’s case his nerves are being compressed, which makes it difficult for him to control the muscles needed to shoot a basketball due to the weakness and inability to coordinate the appropriate motions. The compression on these structures is caused by either tight muscles of the neck (scalenes) and/or the first rib or clavicle or also called collar bone. In rare cases an extra rib is present at birth, but this is not present in most of the population.

Fultz’s specialist has recommended physical therapy to help resolve this problem, which can help in a few different ways. One way is stretching of those particular neck muscles combined with soft tissue massage to increase flexibility and reduce the overall tension on the nuerovascular structures. A second way physical therapy can resolve TOS is by performing mobilizations of the first rib and clavicle to increase mobility and facilitate proper movement of the bones/joints, thereby relieving compression on the nerves or vascular structures. A third way physical therapy can help is by correcting poor posture which can be a contributing factor to the underlying issue. We can do this by educating patients on proper posture and certain stretching/strengthening techniques for affected muscles. Often times a combination of all three of these treatments techniques are used to help resolve the TOS. The report is that Fultz is going to be out 3-6 weeks while receiving physical therapy so that he can have sufficient time to address his specific deficits to reduce the compression on his nerves.

Mark Romano PT, DPT is the newest PTW Clinical Supervisor in  our Glenside location. To schedule an appointment or evaluation call Mark at (215) 887-2001 today!

National Physical Therapy Month

National PT month is over.

We set out to spread the message to drop the pills, consider alternatives to pain management.

Over the 31 days in October, we had over 25 videos posted of our staff dropping the pills, we had over 3300 views of our customers watching us drop the pills, and we personally delivered about 350 medicine bottles filled with M&M candies (to simulate you can't have just one, much like an opioid) to our local communities and Doctors offices to help spread the word.

We spread a loud message about the opioid crisis in America, such as:

The Centers for Disease Control and Prevention (CDC), the American College of Physicians, and the National Academies of Sciences, Engineering, and Medicine have issued guidelines and reports urging health care providers to pursue safe nondrug alternatives, including physical therapy, for most non–cancer-related pain treatment.

Physical therapists (PTs) treat pain through movement, hands-on care, and patient education—and by increasing physical activity you can also reduce your risk of other chronic diseases.

A recent study published in Health Services Research found that patients who saw a PT before trying other treatments for low back pain were 89% less likely to need an opioid prescription.

Statistics from the CDC, the Agency for Healthcare Research and Quality, and the United States (US) Department of Health and Human Services reveal the gravity of the problem.

1. In 2016, health care providers across the US wrote more than 214 million prescriptions for opioid pain medication—a rate of 66.5 prescriptions per 100 people.

2. As many as 1 in 5 people receive prescription opioids long-term for noncancer pain in primary care settings.

3. More than 11 million people abused prescription opioids in 2016.

4. Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.

5. More than 40% of all US opioid overdose deaths in 2016 involved a prescription opioid.

6. Drug overdoses claimed the lives of nearly 64,000 Americans in 2016. Nearly two-thirds of these deaths (66%) involved a prescription or illicit opioid.

7. The CDC estimates the total economic burden of prescription opioid misuse in the US is $78.5 billion a year, including the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.

If you know someone in pain, encourage them to talk to their physician or PT about safe ways to manage pain.

The American Physical Therapy Association’s #ChoosePT campaign is raising awareness about the dangers of prescription opioids, and encourages consumers and prescribers to choose safer alternatives like physical therapy for most chronic pain management.


 If you have problems with pain, or know anyone in pain that could benefit from Physical Therapy to avoid use of medications and restore function, please give us a call! 




Bibliography
Centers for Disease Control and Prevention. US drug overdose deaths continue to rise; increase fueled by synthetic opioids. Updated March 29, 2018. Accessed July 26, 2018.
Centers for Disease Control and Prevention. Prescribing data. Updated August 30, 2017. Accessed July 26, 2018.
Centers for Disease Control and Prevention. Opioid basics. Updated August 27, 2017. Accessed July 26, 2018.
Centers for Disease Control and Prevention. Prescription opioid overdose data. Updated August 1, 2017. Accessed July 26, 2018.
Centers for Disease Control and Prevention. US prescribing rate maps.  Updated July 31, 2017. Accessed July 26, 2018.
U.S. Department of Health and Human Services, Office of the Surgeon General. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: US Department of Health and Human Services; 2016. Accessed July 26, 2018.
Florence CS, Zhou C, Luo F, Xu L. The economic burden of prescription opioid overdose, abuse, and dependence in the United States, 2013. Med Care. 2016;54(10):901–906. Free Article


Robert Babb, PT, MBA, is owner and practicing Physical Therapist at the Physical Therapy & Wellness Institute located in Lansdale, Montgomeryville, Quakertown, West Norriton, Glenside, Harleysville, and Souderton, Hatfield, and Horsham, Pennsylvania. Rated the Best Physical Therapy for over 15 years, the hands on, one on one care at The Physical Therapy & Wellness Institute has offered pain relief and improved function to our suburban Philadelphia communities since 2002. For back pain, knee pain, jaw pain, joint pain, shoulder pain, and now help with our advanced specialists in urinary and bowel incontinence, we are open from 7 am to 8 pm most nights, and Saturdays!