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Treating (& Preventing) Muscle & Ligament Strains and Sprains

On this recent podcast, Jared Johanns, DPT, Cornerstone Physical Therapy talks about why all types athletes (including weekend warriors) are more at risk for straining and spraining their muscles and ligaments — and how these injuries can be treated through physical therapy, and how to prevent them if possible.

Listen here:

Transcript

Carol Gifford: Welcome to Mason City Docs On Call, a podcast series with MercyOne North Iowa specialists who educate us about how to stay healthy. I’m your host, Carol Gifford. On today’s program we’re going to talk about sports injuries and physical therapy. So, people who are physically active, run, bike, play tennis or golf, play softball, volleyball, or ski oftentimes injure themselves. And these injuries can range from strains to sprains, tendonitis, dislocations, and back injuries. With us today is Jared Johanns, a doctor of physical therapy at Cornerstone Physical Therapy at the Mason city clinic, who will help us understand how physical therapy can help treat these injuries and will get you back into action. So, welcome to the program Jared.

Jared Johanns, DPT: Hi there.

Carol Gifford: So, tell us a little bit about yourself and your background and how long you’ve been at Cornerstone Physical Therapy.

Jared Johanns, DPT: I started my career with Mercy and I worked there for about three to four years. I’ve been with Cornerstone Physical Therapy here the last three years in Mason city. I’m originally from the area, I’m from a small town about 25 miles north of here, Grafton if anybody would know it. And like a lot of physical therapists, I actually got into the profession having my own injuries. So, I had three knee surgeries in the past, got to go through my own therapy, got to go through that whole process. Got really interested in it when I was younger and that’s kind of what got me into the profession.

Carol Gifford: So, Jared why are athletes so prone to injury?

Jared Johanns, DPT: Well I think with any particular activity comes its own inherent risks. Athletics in particular are going to have higher demands on both force and flexibility. Athletes are typically of your more your type A type of people who are going to tend to push themselves a little more to their limits, going to take it to that next level and that puts you a little more risk of injury.

Sometimes training for one particular sport or activity in general, leave some deficits in other areas as well as increasing that maybe injury risk from some muscle imbalances or things of that nature. A lot of times you’ll see your professional athletes who were multi-sport athletes when they were younger, as opposed to being a single sport athlete.

The other thing is that lack of cross training, getting those other muscles worked on, taking that time to rest your primary muscles. And again with that rest being another important factor tend to not to push it every day, giving your body time to recover can be a very important part of that. Iowa weather is also another big reason for that. So, going from indoor training here in the winter to outdoor training in the spring, so yeah the different surface, the different temperature, those can affect your performance as well as the stresses that are put on your body.

Carol Gifford: So, what are some of the injuries that you typically see in the practice? And then how are you helping them heal and get back to the sports they love?

Jared Johanns, DPT:
Some of our more common things that we’re going to run across are going to be like a muscle strain or sprain of a ligament, looking at maybe a back injury as well.

Regarding the muscle strains, one of the more common being a hamstring. You’re looking at there’s a graded on a scale of the severity and everybody’s going to be a little bit different. So, if you have a minor injury versus a major injury, the treatments and the appropriate action is going to be a little bit different there. But I would encourage everybody to see a PT, see a professional to help get you on the right path as far as moving forward with that injury. What we’re going to do right away is going to be trying to control the inflammation, get the pain down a little bit, and then it’s really all about appropriate loading of the tissue. So, getting some increased flexibility, getting some increased strength, and ultimately trying to get you back to the sport or the activity that you enjoy doing. And it can just sometimes take awhile but.

Carol Gifford: Yeah. So, typically what is the timeframe for if someone has and I know it’s different based on different people and age and injury, but it doesn’t seem like you can come in for a couple sessions. I mean physical therapy, you do the exercises and the therapy over a period of time isn’t that correct?

Jared Johanns, DPT: And that is correct. And yeah, and again that depends a little on the severity of the injury. So, your lower grade strains are going to take a lot less time than the major ones to recover. If I had to give an average, I’d say usually around four to eight weeks, probably more towards that eight weeks regarding those type of those types of injuries.

Carol Gifford: And then you have to do your home exercises, right?

Jared Johanns, DPT:  Yes, it’s very important to do your home exercises and I would like to tell people you get out of it a lot about what you put into it. So, if you’re not doing the homework, we can tell and it’s going to make it take longer, you’ll still get better but it is going to increase that time that you’re going through the process.

Carol Gifford: So, do you have any tips or recommendations to especially like weekend warrior, so people that aren’t athletes at school or college, but like to go out and run and like to go out on the weekend and play golf with their friends. Should we be stretching more or what are some of the preventative measures I would say that you could help us with, so that maybe we won’t be as prone to injure ourselves?

Jared Johanns, DPT: Probably one of the biggest things for that population is doing at least some sort of inappropriate warmup. Usually we look at stretching as a dynamic stretch prior to, that’s going to be your kind of quick, repetitive stretching. Your static stretching, where you’re going to hold it, that’s good afterwards to as far as preventing the injury as well. But dynamic stretching in the beginning is going to be a little more important, just getting your body warmed up, so you’re not putting all that stress on a cold muscle. You’re not putting all that stress on something that’s not been moving for a while. And those stresses are a lot different than what you’re doing at work.

Carol Gifford: So, the other thing that you do at Cornerstone Physical Therapy is you see a lot of patients that have had knee surgery, hip surgeries, shoulder surgery. So, tell us a little bit about that kind of physical therapy and maybe how that differs a little bit from someone who maybe just sprains or strains a muscle or a ligament.

Jared Johanns, DPT: Yeah. Our post-surgical patients are going to be a little more along a kind of a guideline. So, we have a little better idea of the amount of time it’s going to take, what activities we’re going to go through, and what we’re going to do that way. One thing that gets overlooked as often with our knee patients in particular, whether you know you’re going to have a surgery, you can actually have therapy prior to that procedure. And getting that surgery prior to the outcomes afterwards are typically going to be quite a bit better and you’re going to have that pain for a lot shorter period of time and you’re going to go through that recovery period for a shorter period of time.

Jared Johanns, DPT:  Afterwards, we’re just working on again as with most of the injuries getting the inflammation down, getting the pain down, and then again starting to load that tissue as is appropriate. Our rotator cuff tears are pretty common thing right now, those are very long. So, understanding how long a process usually takes around six months, just understanding that again you got to put that work in, it is going to get better. There’s going to be days when it’s just not feeling like you’re making any gains and I like to tell people it’s more like going up a staircase then it’s like going up a hill. So, sometimes you’re going to have those plateaus but ultimately you’re going to end up going up.

Carol Gifford: So, it seems like a common injury across age groups and probably different levels of athletes or people that are interested in being active are back injuries. How do you help people heal from any sort of back injury? And typically why is back injury so prevalent?

Jared Johanns, DPT: So, yeah there’s been a lot of research out there and a lot of talk about this recently, in particularly with the opioid epidemic. A lot of new research suggesting best practice being getting you into a physical therapy and exercise versus going that pharmaceutical management. They estimate that at any given time 25% of the population has some sort of back pain. So, there’s a lot of it out there and a lot of it’s not getting managed properly. What we do with physical therapy again can be dependent on the injury. However, whether it be unstable, whether it be you’ve got muscle tightness, disc issues, all of those things are able to be managed with an appropriate physical therapy program.

Jared Johanns, DPT: That’s going to be kind of tailored to the particular patients and their needs. Some people are going to tolerate a little more than others, but the big thing is just don’t give into the fact that this is just going to be the way it is and getting moving does help. I like to use the old physics adage that a body in motion stays in motion, a body at rest stays at rest. And that’s kind of how our bodies operate throughout the day. So, if you’re sitting around all day, you’re going to adapt to sitting around all day. If you get up and get moving, you’re going to adapt to getting moving and we can help get that moving process started as physical therapists and kind of take care of some of those problems.

Carol Gifford: Yes. Well that’s very good to know. And just one follow up question. Why do people have so much back injury? Why is it so prevalent?

Jared Johanns, DPT: There’s a lot of different reasons, we can develop a back injury and a big one that we see here is more related to more your mechanics than it is actually to your strength or your function that way. I’ve seen really strong athletic people get back injuries, just because their technique wasn’t there with lifting. The most common reasons that people do suffer a back injury are lifting based. It’s lifting something too far away from your body, you’re lifting something that’s too heavy that you’re not prepared for. And a lot of times, along with know the core strengthening that’s just very important we do focus on muscle mechanics, activity mechanics, just trying to get you doing the exercises in the proper way, so you’re stressing your body appropriately.

Carol Gifford: So, tell us how people can get in touch with you if they’re interested in physical therapy either post-surgery or just some sort of sports or other injuries.

Jared Johanns, DPT: Yeah. So, we’re located again at the Cornerstone Physical Therapy, service and the Mason City clinic here at the VA building or the Westbrook building. With our post-surgical patients or the people that have scheduled surgeries, we do have a direct relationship with the orthopedic physicians, so they can refer directly to us. We can see their notes, we can see their referrals, those types of things, so that makes the communication a little bit easier. For our people that just maybe had an injury you’ve got several options. If you’ve got a private insurance, I was actually a direct access state. So, you can call directly and refer yourself without having to see a physician first. And then if there is a concern for a more severe injury, we can always get you referred out to the appropriate physician in that case as well.

Carol Gifford: So, how can people get in touch with you? What is the telephone number for scheduling an appointment with you? Or one of the physical therapists at Cornerstone?

Jared Johanns, DPT: We can be reached at 6-4-1-4-9-4-5-2-5-5. Or again you can contact through your physician directly and then they can get ahold of us as well.

Carol Gifford: Wonderful. Well thank you for all this information and we look forward to less injuries in the future.

Jared Johanns, DPT: You bet.

Carol Gifford: Thank you for listening to Mason City Docs on Call. For more episodes, go to mcclinic.com/radio-podcasts.

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