New York, NY
Physical Therapy New York, NY
May 15, 2018
Recovery with Chiro and Physical Therapy
Whether it’s recreational or professional sports, the possibility of sustaining injuries while playing is always present. Though contact sports like football and basketball increase the chance of getting injured, swimmers, cyclists, and golfers also have their fair share of sports injuries.
First aid is very important to keeping the pain in check and preventing further damage to the affected area. Serious injuries may need
more than just an ice pack. Some may need regular rehab sessions to bring back peak performance while the worst injuries may call for surgery.
The most common sports injuries among professionals are pulled muscles, runner’s knee, shoulder impingement, shin splints, tennis elbow, ankle sprain, and Achilles tendonitis. Though these
rarely require evasive treatment, most may require physical therapy and chiropractic intervention for treatment and recovery.
Treatment will start with questions about your medical history, a physical exam, and other tests relevant to your injury. Thorough evaluation and a correct diagnosis of the injury will also result in providing the right treatment plan.
A chiropractor will check your posture, balance, and spine. A chiropractor will help you relieve tension in your body with manual adjustments to your spine and joints. Faster recovery, improved balance, and better performance can be achieved with regular visits.
Physical therapy will provide targeted exercises to relieve pain and reduce inflammation, after which a reconditioning treatment plan will help improve range of motion, flexibility, strength, and balance. Committing to the physical therapy and rehab can get you back to your game faster and safer.
Yes, enjoying your favorite sport is a great way to keep fit and healthy. However, there are a couple of tips that you should always remember: make sure that you warm up and cool down properly, and don’t overdo yourself and listen to your body.
November 17, 2017
Running Form Analysis Clinic in NYC
If you run regularly, I highly recommend having a professional running gait analysis performed. Having someone with expertise give you personalized tips can really help you to prevent injuries by improving the mechanics of your running form.
After running in a local 5K, I was entered in a drawing to win a few free sessions with a running coach. Against all odds and my previous experiences in such contests, I actually won.
Running gait analysis
When I had my running gait analyzed, I was told I took too few steps per minute. Runners should take 180 steps per minute. Elite runners have been shown to take 180 steps per minute or more naturally. This reduces the shock of the impact when the foot lands. If your foot hits the ground less frequently that means your body spends more time in the air. Your foot will then hit the ground with more force thus risking injury. Many injuries occur due to the impact of the runner’s foot with the ground. A great way to help you keep 180 steps per minute is to find some songs with 180 beats per minutes to listen to as you run.
I was also told that I needed to keep my wrists loose. There is a correlation between how relaxed your upper body is and your lower body. For example, if your shoulders are relaxed, your hips will be relaxed. If your elbows are relaxed, your knees will be relaxed. This also can help prevent injuries. Runners really need to consider the overall form of their entire body and not just the legs. Having this objectively measured by a pro really helps.
Foot strike needs to be carefully evaluated as well. Which part of your foot hits the ground first and how does it hit? This can vary depending on if you are training for a sprint or a long-distance race. Sprinters tend to hit the ground with balls of their feet while distance runners tend to strike heel first. When the middle or heel of the foot hits first, it can help to reduce calf pain and injuries. Wherever the foot falls first, an important thing to remember is to avoid having your toes pointed outward. How your toes are pointed can be difficult for you to determine yourself so having someone else analyze this is important.
Residents of NYC can visit the Manhattan running lab to get a much more in-depth running form analysis in NYC than I had with the local running coach just running around a track. State of the art technology used there can really drill down to all the nuances of your gait. If someone can help you with the form of your foot strike and your breathing rhythms as the professionals at CLINICUBE can, you’ll be on your way to your best, injury free performances.
September 28, 2017
The knee is one of the most vital tendon systems of our body. For athletes, especially those engaged in team sports, the health and well-being of their knee is so important. Their careers are dependent on how long their knees stay injury-free.
In sports, like volleyball and basketball which involve a lot of jumping, the knees are exposed to a myriad of injuries. One of them is patellar tendonitis, commonly known as jumper’s knee.
As its name suggests, jumper’s knee comes from “jumping”. Basketball and volleyball athletes are at risk of suffering from patellar tendonitis. When players dash and go for fast breaks, leap for rebounds and block spikes, dive for loose balls, the knee is always under duress and stress. As a result of all that activity, the patella tendon below the knee cap develops patella tendonitis.
The following are some of the symptoms that you are suffering from jumper’s knee or patellar tendonitis:
1. Gradual increase of pain in the knee with increase in level of activity
2. Patella Tendon feels tender
3. Stiffness in the tendon during morning
4. Pain gets worse whenever you jump, land, run
Jumper’s knee/patellar tendonitis can go beyond just knee pain. Additional stress on the tendon will do further damage and might lead to the whole knee being damaged for life. Athletes with severe jumper’s knee will not only be able to play at peak levels, and may have to refrain from playing again.
To treat jumper’s knee, we have the following advice:
1. Rest your injured knees and refrain from activities that would cause further stress to it.
2. Apply cold compress to the swelling and then warm compress after the swelling is reduced.
3. Always do warm-ups before any activity. Do these warm-up exercises to increase the strength of your knee.
4. Consult a professional therapist on stretching exercises, those which are specifically for the knees.
Do not let jumper’s knee end your athletic career end early, or make you stop playing the game you always loved. Visit Launchfit™ by Clinicube®and we will teach you how to overcome patellar tendonitis!
September 4, 2017
From the heart of the city arises a new healthcare facility that will restore, remediate, and improve your quality of life, with the help of our professionally dynamic team.
We are dedicated to rehabilitating, alleviating pain and healing impairments in a cost-efficient way. The Clinicube makes reinventing your body worry-free, pleasurable, and meaningful.
Chiropractic and Physical Therapy
Our chiropractic services will benefit people who have musculoskeletal issues and we specialize in helping with spinal problems. Effective manipulation of soft tissues and joints is key in providing maximum relief.
Physical therapy is a more diverse approach to body restoration. We are fully equipped – from manual therapy, various physical therapies to electrotherapy; making sure that you recover immediately without compromising the program’s quality.
Computerized Testing and Training
In physical therapy, motivation is crucial. And there’s no better way to motivate yourself than to see improvement in your condition. Our facility offers you a performance tracker so you can assess your weak points as well as your strengths.
This computer assisted functional evaluation and training program will give you real time accurate results and along with the supervision of your healthcare practitioner, you can adjust your program according to your needs.
Our Medical Massage makes the perfect pair to our innovative physical rehabilitation and wellness programs. Offering treatment to specific concern areas through a soothing massage is the ideal treat for you after a day of hard work.
Our healthcare providers are driven with the passion to rehabilitate physical impairments and disabilities in order to restore your body’s optimum capacity. Our main focus is full restoration or optimization of one’s quality of life with the help of our certified medical team.
Medically Supervised Fitness
Completed your rehabilitation program yet hesitant to work out on your own? This fitness program is best for you. Our trained medical staff will provide the guidance, techniques, and supervision that you need throughout your transitional period.
Acupuncture and Dry Needle
Acupuncture is a form of traditional Chinese medicine that relieves body pains through needle insertion in certain body points. It can help relieve pain and an important factor in physical rehabilitation.
Be more. Do more. Live more. Let our team stop whatever’s stopping you. Book an appointment now and reinvent yourself at the Clinicube.
August 11, 2017
Dr. Noam Sadovnik announces the opening of CLINICUBE, a new concept in health, wellness and peak performance services located in a newly constructed state of the art facility at 39 West 29th St., 11th Floor. Dr. Sadovnik, the founder and director of Chiropractic and Physical Therapy services at Launchfit™ by Clinicube®for Chiropractic & PT conceived of CLINICUBE to bring patient care and convenience to an even higher level. We are also adding several new practitioners to expand services in mind, body and fitness care.
A New Concept In Integrative Medicine
“The integrative and holistic care setting will increase patient convenience as Launchfit™ by Clinicube®adds more services. This will greatly reduce the time patients spend going from one provider to the next and will improve health care collaboration between providers,” says Dr. Sadovnik.
In addition to Dr. Sadovnik and associates Dr. Lauren Fries – lead chiropractor; Hector Zurita, DPT – physical therapist and Marilena Rizzo, M.S., L.AC – acupuncturist, two additional practitioners have joined Clinicube: Richard Mak, DPT – physical therapist and Nirmal Patel, MD – interventional pain management.
“Our list of services is growing as additional practitioners join Launchfit™ by Clinicube®to provide cutting edge health care to residents of the NOMAD district and all of NYC,” says Dr. Sadovnik. For more information or an appointment call 646.777.0916.
Launchfit™ by Clinicube® provides:
• CHIROPRACTIC & PHYSICAL THERAPY
• PHYSICAL REHABILITATION
• INTERVENTIONAL PAIN MANAGEMENT
• FUNCTIONAL MEDICINE
• COMPUTERIZED TESTING & TRAINING
• MEDICALLY SUPERVISED FITNESS
• MIND BODY MEDICINE
• PREHAB SERVICES FOR PEAK PERFORMANCE, REDUCED INJURY RISK
Launchfit™ by Clinicube®occupies 5,000 square feet of newly constructed space located at 39 West 29th Street, 11th floor, NYC.
March 18, 2017
Physical therapy is as effective as surgery in treating carpal tunnel syndrome, according to a new study published in the Journal of Orthopaedic & Sports Physical Therapy® (JOSPT®).
Researchers in Spain and the United States report that one year following treatment, patients with carpal tunnel syndrome who received physical therapy achieved results comparable to outcomes for patients who had surgery for this condition. Further, physical therapy patients saw faster improvements at the one-month mark than did patients treated surgically.
Carpal tunnel syndrome causes pain, numbness, and weakness in the wrist and hand. Nearly half of all work-related injuries are linked to this syndrome, which can result from repetitive movements. Although surgery may be considered when the symptoms are severe, more than a third of patients do not return to work within eight weeks after an operation for carpal tunnel syndrome.
The study demonstrates that physical therapy – and particularly a combination of manual therapy of the neck and median nerve and stretching exercises – may be preferable to surgery, certainly as a starting point for treatment.
“Conservative treatment may be an intervention option for patients with carpal tunnel syndrome as a first line of management prior to or instead of surgery,” says lead author César Fernández de las Peñas, PT, PhD, DMSc, with the Department of Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine at Universidad Rey Juan Carlos, Alcorcón, Spain.
Dr. de las Peñas and his fellow researchers studied the cases of 100 women with carpal tunnel syndrome. By random allocation, 50 women were treated with physical therapy and 50 with surgery. Patients assigned to the physical therapy group were treated with manual therapy techniques that focused on the neck and median nerve for 30 minutes, once a week, with stretching exercises at home.
After one month, the patients in the physical therapy group had better hand function during daily activities and better grip strength (also known as pinch strength between the thumb and index finger) than the patients who had surgery. At three, six, and 12 months following treatment, patients in the surgery group were no better than those in the physical therapy group. Both groups showed similar improvements in function and grip strength. Pain also decreased similarly for patients in both groups. The researchers conclude that physical therapy and surgery for carpal tunnel syndrome yield similar benefits one year after treatment. No improvements in cervical range of motion were observed in either patient group.
The researchers caution that because the study only included women from a single hospital, additional research needs to be done to generalize their findings. Further, there are no available data on the most effective dosage for the manual therapy protocol applied.
The study was funded by a research project grant (FIS PI14/ 00364) from the Health Institute Carlos III (PN I+D+I 2014-2017; Spanish Government).
Article: The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial, César Fernández-de-las-Peñas, PT, PhD, DMSc, Joshua Cleland, PT, PhD, OCS, FAAOMPT, María Palacios-Ceña, PT, Stella Fuensalida-Novo, PT, Juan A. Pareja, MD, PhD, Cristina Alonso-Blanco, PT, PhD, Journal of Orthopaedic & Sports Physical Therapy, doi: 10.2519/jospt.2017.7090, published March 2017.
March 18, 2017
Multiple sclerosis is a disease that affects the central nervous system, which includes the brain, spinal cord, and optic nerves.
More than 2.3 million people have multiple sclerosis (MS) worldwide, according to the National Multiple Sclerosis Society.
Although researchers have made a great deal of progress on understanding and treating the disease, there are still many questions and misconceptions about MS. Here are five important facts that people should know about the disease.
1. Its cause is unknown
Although the exact cause of MS is unknown, it has been suggested that smoking may increase the risk of it developing.
MS is thought to be an autoimmune disease, a disease in which the body’s immune system attacks its own healthy tissues.
With MS, the body attacks myelin, the fatty substance that acts as a protective cover to nerve fibers. This causes communication issues between the brain and body.
Doctors don’t know why the body attacks the myelin, but they believe the following factors may increase the risk of MS developing:
- Having a family history of MS, other autoimmune diseases, or certain infections
- Being aged between 15 and 60
- Being Caucasian, particularly with Northern European descent
- Living in temperate climates
2. It can range in severity
With MS, the communication problems between brain and body can lead to major damage to the nerves. Symptoms of the disease can range from inconvenient and annoying to debilitating and even fatal.
It is important to note that life expectancy with MS has increased over the years, according to the National Multiple Sclerosis Society. This is due to emerging therapies and a better understanding of the disease.
Some of the most common symptoms of MS include:
- Bladder problems
- Bowel problems
- Trouble with walking or balancing
- Sexual dysfunction
- Stiffness and numbness
- Muscle weakness
- Speech difficulties
- Swallowing problems
- Memory problems
- Problems with vision
Memory problems, depression, vision issues, and tiredness may indicate MS.
Some symptoms may not be noticeable in the early stages of MS. Others may cause a severe impact on a person’s quality of life. If untreated, MS symptoms can worsen over time.
Paralysis is one of the most severe symptoms but only affects about one-third of people with the condition. Most people with MS maintain mobility although some may need assistive devices, such as canes or walkers.
David Bexfield told Medical News Today that it is important for people diagnosed with MS to pay attention to their bodies, and do what helps them feel good. Bexfield started a group called ActiveMSers after his diagnosis in 2006.
“Thankfully, I don’t have many bad days,” he said. “Daily exercise has helped keep my fatigue in check, one of the most debilitating symptoms of this disease.”
“Few people understand how MS fatigue can be utterly pancaking. Imagine pulling an all-nighter, make that three of them in a row, and then running a marathon. Backwards. On stilts. While juggling chainsaws. Once you get that in your mind, realize that’s not even close to what it feels like. When MS fatigue hits, everything is exhausting: reading, thinking, even listening. And lying down to take a nap doesn’t help.”
Bexfield’s other piece of advice was to take help where people can get it:
“Check your ego at the door. Handicap parking placards, walking aids, protective undergarments – I’ve used them all. They’ve helped take me down the street, onto the hiking trail, and around the globe. Take advantage of the helpful tools available to you.”
3. It can be difficult to diagnose
MS can be difficult to diagnose because many symptoms overlap with those of other diseases and conditions. Unfortunately, this means it can take time for doctors to make a diagnosis. They may order multiple tests to rule out other conditions first.
A doctor will review a person’s medical history and do a physical examination. Then they may recommend the following tests:
- Blood tests
- Lumbar puncture
- Evoked potential tests
If a person displays more unusual symptoms or progressive disease, a doctor will order more exams. Relapsing-remitting MS is the most common form of the disease and although the diagnosis is easier in this particular type, MRI scans will usually confirm the diagnosis.
Experts say that with improving diagnostic methods, there is hope that better management will follow.
“Advances in MS management focus both on disease modification as well as symptomatic management,” said CEO of The Consortium of Multiple Sclerosis Centers and nurse practitioner June Halper. “While treatment regimens have become more complex and more challenging to the person with MS, there is now a clear message of hope for the future.”
4. It affects more women than men
Women aged between 20-40 may be the group most likely to develop MS.
For unknown reasons, MS is more common in women than in men. In fact, women are two to three times more likely to develop the disease than their male counterparts.
Additionally, people usually experience their first symptoms between the ages of 20 and 40, although older adults and children have been known to develop MS as well. For women in this age group, MS symptoms can cause complications to their reproductive health, especially during a pregnancy.
Medical student Jen Finelli described working with a female who had MS and her unique struggles while preparing to get pregnant:
“We had a sweet, sweet patient on one of my rotations who had MS attacks so severe
she went blind, and she was concerned when she became pregnant, because
she needed her medications to prevent these horrible attacks. She told us
that she’d quit her medications to protect her baby if she had to!”
“Thankfully, didn’t have to make that sacrifice,” she added, “but because of the autoimmune nature of the disease, patients must verify their medications
with their ob-gyn and their MS specialist before becoming pregnant.”
5. Vitamin D may help prevent and treat it
Although there are a number of FDA-approved pharmaceuticals available to treat some forms of MS, there is no cure for the disease. One main type of MS, which comprises periods of exacerbations and remissions and is known as a relapsing-remitting MS, does respond to drugs. Unfortunately, another main type of MS, known as primary-progressive MS, does not respond to medication.
Most of these drugs, called disease-modifying treatments (DMTs), have also been known to cause serious side effects.
“There are currently no highly effective and low risk DMTs available for people with MS,” Dr. Robert Glanzman told MNT.
Dr. Glanzman, neurologist and Chief Medical Officer at GeNeuro, a clinical stage pharmaceutical company, explained that for more than a third of people with progressive MS, “none of the currently-available DMTs (with the exception of mitoxantrone, a chemotherapeutic agent) have been shown to be effective.”
Vitamin D may help to treat and prevent MS.
Additional DMTs are currently in development and “have positive studies in people with progressive MS,” he added. “However, in both of those studies, the therapeutic effect seems to have been largely limited to people with ongoing inflammation, as measured by brain MRI.”
Research shows that additional vitamin D treatment is safe for people with MS and may be effective in helping both prevent it and treat it. In fact, people who have low levels of vitamin D may have an increased risk of developing MS.
People with MS “should strive to lead a healthful lifestyle, which includes no smoking, vitamin D supplementation, reducing sodium intake, sleeping well, moderate exercise, and maintaining an ideal weight or body mass index,” said Dr. Ann Bass, clinical director at Neurology Center of San Antonio, TX.
” should form a strong and lasting support network, which includes healthcare professionals, families, friends, support groups that will assist them throughout their journey with this disease,” she added. “They should establish, continually assess and share their goals and expectations for their lives as well as for their MS treatments throughout the disease course.”
March 18, 2017
Scientists have developed sensor technology for a robotic prosthetic arm that detects signals from nerves in the spinal cord.
To control the prosthetic, the patient has to think like they are controlling a phantom arm and imagine some simple manoeuvres, such as pinching two fingers together. The sensor technology interprets the electrical signals sent from spinal motor neurons and uses them as commands.
A motor neuron is a nerve cell that is located in the spinal cord. Its fibres, called axons, project outside the spinal cord to directly control muscles in the body.
Robotic arm prosthetics currently on the market are controlled by the user twitching the remnant muscles in their shoulder or arm, which are often damaged. This technology is fairly basic in its functionality, only performing one or two grasping commands. This drawback means that globally around 40-50 per cent of users discard this type of robotic prosthetic.
The team in the study, published in the journal Nature Biomedical Engineering, say detecting signals from spinal motor neurons in parts of the body undamaged by amputation, instead of remnant muscle fibre, means that more signals can be detected by the sensors connected to the prosthetic. This means that ultimately more commands could be programmed into the robotic prosthetic, making it more functional.
Dr Dario Farina, who is now based at Imperial College London, carried out much of the research while at the University Medical Centre Gottingen. The research was conducted in conjunction with Dr Farina’s co-authors in Europe, Canada and the USA.
Dr Farina, from the Department of Bioengineering at Imperial, said: “When an arm is amputated the nerve fibres and muscles are also severed, which means that it is very difficult to get meaningful signals from them to operate a prosthetic. We’ve tried a new approach, moving the focus from muscles to the nervous system. This means that our technology can detect and decode signals more clearly, opening up the possibility of robotic prosthetics that could be far more intuitive and useful for patients. It is a very exciting time to be in this field of research.”
The researchers carried out lab-based experiments with six volunteers who were either amputees from the shoulder down or just above the elbow. After some physiotherapy training, the amputees were able to make a more extensive range of movements than would be possible using a classic muscle-controlled robotic prosthetic. They came to this conclusion by comparing their research to previous studies on muscle-controlled robotic prosthetics.
The volunteers were able to move the elbow joint and do radial movements – moving the wrist from side to side – as well as opening and closing the hand. This means that the user has all basic hand and arm functions of a real arm.
Further refinements are needed to make the technology more robust, but the researchers suggest the current model could be on the market in the next three years.
To take part in the study, volunteers underwent a surgical procedure at the Medical University of Vienna that involved re-routing parts of their Peripheral Nervous System (PNS), connected with hand and arm movements, to healthy muscles in their body. Depending on the type of amputation, this re-routing was either directed to the pectoral muscle in the chest or the bicep in the arm. This enabled the team to clearly detect the electrical signals sent from the spinal motor neurons – a process the team liken to amplification of the signals.
To create the technology, the researchers decoded and mapped some of the information in electrical signals sent from the re-routed nerve cells and then interpreted them in computer models. These models were then compared to models of healthy patients, which helped them to corroborate the results. Ultimately, the scientists want to decode the meaning behind all signals sent from these motor neurons, so that they can program a full range of arm and hand functions in the prosthetic. This would mean that the user could use the prosthetic almost as seamlessly as if it was their own arm.
The team then encoded specific motor neuron signals as commands into the design of the prosthetic. They then connected a sensor patch on the muscle that had been operated on as part the re-routing procedure, which was connected to the prosthetic. The amputees worked with physiotherapists so they could learn how to control the device by thinking about specific phantom arm and hand commands.
This research has taken the team to the end of the proof of concept stage with laboratory tests. The next step will involve extensive clinical trials with a much wider cross section of volunteers so that the technology can be made more robust.
The work was supported by the European Research Council, the Christian Doppler Research Foundation of the Austrian Federal Ministry of Science, Research and Economy and the European Union’s Horizon 2020 research and innovation programme.
Article: Man/machine interface based on the discharge timings of spinal motor neurons after targeted muscle reinnervation, Dario Farina et al., Nature Biomedical Engineering, published 6 February 2017.
March 18, 2017
The fibula and tibia are the two long bones of the lower leg. The fibula, or calf bone, is a small bone located on the outside of the leg. The tibia, or shinbone, is the weight-bearing bone and is in the inside of the lower leg.
The fibula and the tibia join together at the knee and ankle joints. The two bones help to stabilize and support the ankle and lower leg muscles.
A fibula fracture is used to describe a break in the fibula bone. A forceful impact, such as landing after a high jump or any impact to the outer aspect of the leg, can cause a fracture. Even rolling or spraining an ankle puts stress on the fibula bone, which can lead to a fracture.
Types of fibula fracture
Fibula fractures can happen at any point on the bone and can vary in severity and type. Types of fibula fracture include the following:
The fibula bone is the smaller of the two leg bones and is sometimes called the calf bone.
- Lateral malleolus fractures occur when the fibula is fractured at the ankle
- Fibular head fractures occur at the upper end of the fibula at the knee
- Avulsion fractures happen when a small chunk of bone that is attached to a tendon or ligament is pulled away from the main part of the bone
- Stress fractures describe a situation where the fibula is injured as the result of repetitive stress, such as running or hiking
- Fibular shaft fractures occur in the mid-portion of the fibula after an injury such as a direct blow to the area
A fibula fracture can be due to many different injuries. It is commonly associated with a rolled ankle but can also be due to an awkward landing, a fall, or a direct blow to the outer lower leg or ankle.
Fibula fractures are common in sports, especially those that involve running, jumping, or quick changes of direction such as football, basketball, and soccer.
Pain, swelling, and tenderness are some of the most common signs and symptoms of a fractured fibula. Other signs and symptoms include:
- Inability to bear weight on the injured leg
- Bleeding and bruising in the leg
- Visible deformity
- Numbness and coldness in the foot
- Tender to the touch
People who have injured their leg and are experiencing any of the symptoms should consult a doctor for a diagnosis. The following steps occur during the diagnosis process:
- Physical examination: A thorough examination will be conducted and the doctor will look for any noticeable deformities
- X-ray: These are used to see the fracture and see if a bone has been displaced
- Magnetic resonance imaging (MRI): This type of test provides a more detailed scan and can generate detailed pictures of the interior bones and soft tissues
Bone scans, computerized tomography (CT), and other tests may be ordered to make a more precise diagnosis and judge the severity of the fibula fracture.
Simple and compound fibula fractures are classified depending on whether the skin has been broken or the bone is exposed.
Treatment for a fibula fracture can vary and depends greatly on how severe the break is. A fracture is classified as open or closed.
Open fracture (compound fracture)
In an open fracture, either the bone pokes through the skin and can be seen or a deep wound exposes the bone through the skin.
Open fractures are often the result of a high-energy trauma or direct blow, such as a fall or motor vehicle collision. This type of fracture can also occur indirectly such as with a high-energy twisting type of injury.
The force required to cause these types of fractures means that patients will often receive additional injuries. Some injuries could be potentially life-threatening.
According to the American Academy of Orthopedic Surgeons, there is a 40 to 70 percent rate of associated trauma elsewhere within the body.
Doctors will treat open fibula fractures immediately and look for any other injuries. Antibiotics will be administered to prevent infection. A tetanus shot will also be given if necessary.
The wound will be cleaned thoroughly, examined, stabilized, and then covered so that it can heal. An open reduction and internal fixation with plate and screws may be necessary to stabilize the fracture. If the bones are not uniting, a bone graft may be necessary to promote healing.
Closed fracture (simple fracture)
In a closed fracture, the bone is broken, but the skin remains intact
The goal of treating closed fractures is to put the bone back in place, control the pain, give the fracture time to heal, prevent complications, and restore normal function. Treatment begins with the elevation of the leg. Ice is used to relieve the pain and reduce swelling.
If no surgery is needed, crutches are used for mobility and a brace, cast, or walking boot is recommended while healing takes place. Once the area has healed, individuals can stretch and strengthen weakened joints with the help of a physical therapist.
There are two main types of surgery if a patient requires them:
- Closed reduction involves realigning the bone back to its original position without the need to make an incision at the fracture site
- Open reduction and internal fixation realigns the fractured bone to its original position using hardware such as plates, screws, and rods
The ankle will be placed into a cast or fracture boot until the healing process is complete.
Rehab and physical therapy
After being in a cast or splint for several weeks, most people find that their leg is weak and their joints stiff. Most patients will require some physical rehabilitation to make sure their leg regains full strength and flexibility.
Some physical therapy may be required to regain full strength in a person’s leg.
A physical therapist will evaluate each person individually to determine the best treatment plan. The therapist may take several measurements to judge the individual’s condition. Measurements include:
- Range of motion
- Surgical scar tissue assessment
- How the patient walks and bears weight
Physical therapy usually begins with ankle strengthening and mobility exercises. Once the patient is strong enough to put weight on the injured area, walking and stepping exercises are common. Balance is a vital part of regaining the ability to walk unassisted. Wobble board exercises are a great way to work on balance.
Many people are given exercises that they can do at home to further help with the healing process.
Proper treatment and rehabilitation supervised by a doctor increases the chance the person will regain full strength and motion. To prevent fibula fractures in the future, individuals who participate in high-risk sports should wear the appropriate safety equipment.
People can reduce their fracture risk by:
- Wearing appropriate footwear
- Following a diet full of calcium-rich foods such as milk, yogurt, and cheese to help build bone strength
- Doing weight-bearing exercises to help strengthen bones
Fractured fibulas typically heal with no further problems, but the following complications are possible:
- Degenerative or traumatic arthritis
- Abnormal deformity or permanent disability of the ankle
- Long-term pain
- Permanent damage to the nerve and blood vessels around the ankle joint
- Abnormal pressure buildup within the muscles around the ankle
- Chronic swelling of the extremity
Most fractures of the fibula do not have any serious complications. Within a few weeks to several months, most patients make a full recovery and can continue their normal activities.
March 18, 2017
Researchers at Southern Methodist University in Dallas have developed a concise new explanation for the basic mechanics involved in human running.
The approach offers direct insight into the determinants of running performance and injuries, and could enable the use of individualized gait patterns to optimize the design of shoes, orthoses and prostheses according to biomechanics experts Kenneth Clark, Laurence Ryan and Peter Weyand, who authored the new study.
The ground force-time patterns determine the body’s motion coming out of each step and therefore directly determine running performance. The impact portion of the pattern is also believed to be a critical factor for running injuries.
“The human body is mechanically complex, but our new study indicates that the pattern of force on the ground can be accurately understood from the motion of just two body parts,” said Clark, first author on the study and currently an assistant professor in the Department of Kinesiology at West Chester University in West Chester, Pennsylvania.
“The foot and the lower leg stop abruptly upon impact, and the rest of the body above the knee moves in a characteristic way,” Clark said. “This new simplified approach makes it possible to predict the entire pattern of force on the ground – from impact to toe-off – with very basic motion data.”
This new “two-mass model” from the SMU investigators substantially reduces the complexity of existing scientific explanations of the physics of running.
Existing explanations have generally relied upon relatively elaborate “multi-mass spring models” to explain the physics of running, but this approach is known to have significant limitations. These complex models were developed to evaluate rear-foot impacts at jogging speeds and only predict the early portion of the force pattern. In addition, they are less clearly linked to the human body itself. They typically divide the body into four or more masses and include numerous other variables that are hard to link to the actual parts of a human body.
The SMU model offers new insight by providing concise, accurate predictions of the ground force vs. time patterns throughout each instant of the contact period. It does so regardless of limb mechanics, foot-strike type and running speed.
“Our model inputs are limited to contact time on the ground, time in the air, and the motion of the ankle or lower limb. From three basic stride variables we are able to predict the full pattern of ground-force application,” said Ryan, who is a physicist and research engineer at SMU’s Locomotor Performance Laboratory.
“The approach opens up inexpensive ways to predict the ground reaction forces and tissue loading rates. Runners and other athletes can know the answer to the critical functional question of how they are contacting and applying force to the ground.” added Ryan.
Current methods for assessing patterns of ground force application require expensive in-ground force platforms or force treadmills. Additionally, the links between the motions of an athlete’s body parts and ground forces have previously been difficult to reduce to basic and accurate explanations.
The researchers describe their new two-mass model of the physics of running in the article, “A general relationship links gait mechanics and running ground reaction forces,” published in the Journal of Experimental Biology.
“From both a running performance and injury risk standpoint, many investigations over the last 15 years have focused on the link between limb motion and force application,” said Weyand, who is the director of SMU’s Locomotor Performance Laboratory. “We’re excited that this research can shed light on this basic relationship.”
Overall force-time pattern is the sum of two parts
Traditional scientific explanations of foot-ground forces have utilized different types of spring and mass models ranging from complex to very simple. However, the existing models have not been able to fully account for all of the variation present in the force-time patterns of different runners – particularly at speeds faster than jogging. Consequently, a comprehensive basis for assessing performance differences, injury risks and general running mechanics has not been previously available.
The SMU researchers explain that the basic concept of the new approach is relatively simple – a runner’s pattern of force application on the ground is due to the motion of two parts of the body: the lower portion of the leg that is contacting the ground, and the sum total of the rest of the body.
The force contributions of the two body parts are each predicted from their largely independent, respective motions during the foot-ground contact period. The two force contributions are then combined to predict the overall pattern. The final prediction relies only upon classical physics and a characteristic link between the force and motion for the two body parts.
New approach can be applied accurately and inexpensively
The application of the two-mass approach is direct and immediate.
“Scientists, clinicians and performance specialists can directly apply the new information using the predictive approach provided in the manuscript,” Clark said. “The new science is well-suited to assessing patterns of ground-force application by athletes on running tracks and in performance training centers.”
These capabilities have not been possible previously, much less in the inexpensive and accurate manner that the new approach allows for with existing technology.
“The only requirement is a quality high-speed camera or decent motion sensor and our force-motion algorithms,” Clark said. “It’s conceivable that even shoe stores would benefit by implementing basic treadmill assessments to guide footwear selection from customer’s gait mechanics using the approach.”
A critical breakthrough for the SMU researchers was recognition that the mass contribution of the lower leg did not vary for heel vs. forefoot strikes and was directly quantifiable. Their efforts lead them to recognize the initial force contribution results from the quick stopping of the lower part of the leg — the shin, ankle and foot — which all come down and stop together when the foot hits the ground.
Olympic sprinters were a clue to discovery
The SMU team discovered a general way to quantify the impact forces from the large impacts observed from Olympic-caliber sprinters. Like heel strikers, the patterns of Olympic sprinters exhibit a sharp rising edge peak that results from an abrupt deceleration of the foot and lower leg. However, sprinters accomplish this with forefoot impacts rather than the heel-first landing that most joggers use.
“The world-class sprinters gave us a big signal to figure out the critical determinants of the shape of the waveform,” said Weyand. “Without their big impact forces, we would probably have not been able to recognize that the ground-force patterns of all runners, regardless of their foot-strike mechanics and running speed, have two basic parts.”
When the researchers first began to analyze the seemingly complicated force waveform signals, they found that they were actually composed of two very simple overlapping waveforms, Ryan said.
“Our computer generated the best pattern predictions when the timing of the first waveform coincided with the high-speed video of the ankle stopping on impact. This was true to within a millisecond, every single time. And we did it hundreds of times,” he said. “So we knew we had a direct physical relationship between force and motion that provided a critical insight.”
New approach has potential to diagnose injury, rehab
The SMU team’s new concise waveforms potentially have diagnostic possibilities, Weyand said.
For example, a runner’s pre-injury waveforms could be compared to their post-injury and post-rehab waveforms.
“You could potentially identify the asymmetries of runners with tibial stress fractures, Achilles tendonitis or other injuries by comparing the force patterns of their injured and healthy legs,” he said.
And while medical images could suggest the injury has healed, their waveforms might tell a different story.
“The waveform patterns might show the athlete continues to run with less force on the injured limb. So it may offer an inexpensive diagnostic tool that was not previously available,” Weyand said.
Article: A general relationship links gait mechanics and running ground reaction forces, Kenneth P. Clark, Laurence J. Ryan, Peter G. Weyand, Journal of Experimental Biology, doi: 10.1242/jeb.138057, published online 18 January 2017.